male circumcision

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male circumcision

Surgical removal of the end of the foreskin of the penis. Circumcision usually is performed at the request of the parents, in some cases for religious reasons. Considerable controversy exists whether the procedure has medical benefits: some authorities suggest that circumcision is associated with a reduced risk of HIV infection, urinary tract infections, sexually transmitted diseases, and penile carcinoma. Other authorities dispute these findings, suggesting that the procedure may have adverse effects on sexual, emotional, or psychological health. If the procedure is performed, anesthesia should always be used.

Patient care

Preoperative: The procedure and expected sensations are explained to the patient or his parents. Adult patients should be reassured that the procedure will not interfere with urinary, sexual, or reproductive function. Necessary equipment, including a restraining board for the newborn, and appropriate anesthetics are assembled. The newborn should not receive food within 1 hr before the procedure.

Postoperative: Vital signs are monitored, and the incision is inspected for bleeding every 15 min for the first hour, then hourly for 12 to 24 hr, as protocol directs. Bleeding is controlled by applying gentle pressure with sterile gauze sponges; any heavy or persistent bleeding should be reported, and preparations made for blood vessel ligation. A sterile petroleum gauze dressing is applied after circumcision, remains in place for 24 hr, and is replaced if it becomes dislodged during that time. The penis is gently washed at diaper change, and fresh sterile petroleum gauze is reapplied. The dressing, glans penis, and sutures, if present, are periodically examined for swelling, redness, or purulent exudate; any signs of infection are reported, and a specimen of the exudate is obtained. A plastic bell instead of petroleum gauze may be used to cover the glans and to prevent hemorrhage and contamination. The newborn is diapered loosely to avoid irritation and should not be positioned on the abdomen for the first few hours after the procedure.

For the adult patient, analgesics are provided, and a topical anesthetic ointment or spray is applied as needed. If prescribed, a sedative is given to help prevent nocturnal penile tumescence and resulting pressure on the suture line. The patient is encouraged to void within 6 hr after the procedure. Either the patient or his family is instructed how to keep the area clean and how to change and apply dressings. They are also instructed to watch for and report renewed bleeding or signs of infection. Adult patients can resume normal sexual activity as soon as healing is complete, usually within a week or so. Use of prescribed analgesics is recommended to relieve discomfort during intercourse.

See also: circumcision
References in periodicals archive ?
Attitudes towards male circumcision among attendees at a sexually transmitted infection clinic in Kingston, Jamaica.
Advising patients that male circumcision has not been proven to reduce HIV /STI acquisition through oral or anal sex.
Young men to be encouraged to get circumcised by raising awareness of the benefits of male circumcision through media campaigns and outreach activities (including in all schools); Behavioural change
Within three years, the adult male circumcision rate jumped from 17 percent to 54 percent, said Bertran Auvert, a physician at the University of Versailles in France who works on the project.
The skeptic asks: how then can we distinguish between religious practices that we should allow, like male circumcision, and others--like female genital multination or the denial of necessary medical treatment--that we want to ban?
Guidelines for male circumcision in the Victorian Public Health System.
Or to take another example, I might be very much for praising male circumcision, not because I have a high degree of certitude that male circumcision is right, but because an evil demon has threatened to torture my family unless I am for praising male circumcision.
Sponsors of the ballot measure likened male circumcision to female circumcision practices already banned by federal law.
As of October 16, 2011, two new states joined in eliminating Medicaid insurance for male circumcision.
male circumcision is widely considered a critical new HIV prevention tool.
Our findings indicate that male circumcision should now be accepted as an efficacious intervention for reducing the prevalence and incidence of HPV infections in female partners.
Synopsis: Belief that all men should be circumcised and that male circumcision reduces the risk of being infected with HIV/AIDS is relatively high in several sub-Saharan African countries with low reported circumcision rates.