What is Circumcision?

Excerpt from:
Cutting Kids
Why the pain of circumcision lasts far longer than the procedure
By Karen Burka
Issue 132, September/October 2005 Mothering Magazine

Circumcision is the cutting off of the fold of skin that normally covers the glans, or head, of the penis. This double layer of skin, the prepuce, is commonly known as the foreskin. In a circumcision, a baby boy is spread-eagled on his back on a board or table; his arms and legs are strapped down so that he can't move. The baby's genitals are scrubbed and covered with antiseptic. The foreskin is torn from the glans and slit lengthwise so that the circumcision instrument can be inserted. The foreskin is then cut off.⁴ Years ago, doctors believed—and told new parents—that babies didn't feel pain, and that therefore circumcision didn't hurt and would be forgotten as the child matured. Today, experts both within and outside the medical community agree that babies do feel pain, and that circumcision is extremely painful for them. Many circumcisions are performed without anesthesia. Most doctors and childbirth educators agree that the administering of the available painkillers—including the most effective, the ring block, which requires four injections—can itself be extremely painful for an infant. And even when anesthesia is administered, it does not completely eliminate the pain.

Increasingly, the trauma experienced by the infant during circumcision is being linked to later childhood intolerance of pain. According to an article by British researchers Dr. Maria Fitzgerald and Dr. Suellen Walker, "One important study shows that boys who have been circumcised at birth show increased pain responses to vaccinations at four to six months compared to those who have not. . . . In a follow-up, prospective study of 87 infant boys, uncircumcised infants were found to have the lowest pain scores at vaccination four to six months later, followed by those circumcised after treatment with lidocaine-prilocaine cream (EMLA), while those circumcised after placebo cream showed the greatest responses."⁵

What Is the Foreskin?

Excerpt from:

The Case Against Circumcision
By Paul M. Fleiss
Issue 85, Winter 1997 Mothering Magazine

The foreskin is a uniquely specialized, sensitive, functional organ of touch. No other part of the body serves the same purpose. As a modified extension of the penile shaft skin, the foreskin covers and usually extends beyond the glans before folding under itself and finding its circumferential point of attachment just behind the corona (the rim of the glans). The foreskin is, therefore, a double-layered organ. Its true length is twice the length of its external fold, comprising 80 percent or more of the penile skin covering,6 or at least 25 percent of the flaccid penis's length.7

The foreskin contains a rich concentration of blood vessels and nerve endings. It is lined with the peripenic muscle sheet, a smooth muscle layer with longitudinal fibers. These muscle fibers are whirled, forming a kind of sphincter that ensures optimum protection of the urinary tract from contaminants of all kinds.

Like the undersurface of the eyelids or the inside of the cheek, the undersurface of the foreskin consists of mucous membrane. It is divided into two distinct zones: the soft mucosa and the ridged mucosa. The soft mucosa lies against the glans penis and contains ectopic sebaceous glands that secrete emollients, lubricants, and protective antibodies. Similar glands are found in the eyelids and mouth.

Adjacent to the soft mucosa and just behind the lips of the foreskin is the ridged mucosa. This exquisitely sensitive structure consists of tightly pleated concentric bands, like the elastic bands at the top of a sock. These expandable pleats allow the foreskin lips to open and roll back, exposing the glans. The ridged mucosa gives the foreskin its characteristic taper.

On the underside of the glans, the foreskin's point of attachment is advanced toward the meatus (urethral opening) and forms a bandlike ligament called the frenulum. It is identical to the frenulum that secures the tongue to the floor of the mouth. The foreskin's frenulum holds it in place over the glans, and, in con junction with the smooth muscle fibers, helps return the retracted foreskin to its usual forward position over the glans.