By James Ketter © 2014
"I made an educated decision to circumcise my son."
Did you? Really? That can be easily verified.
POP QUIZ:
1-a) In what style did you choose to circumcise your son:
a) Low and Loose.
b) Low and Tight.
c) High and Loose.
d) High and Tight.
e) Radically High.
f) Radically Tight.
g) Dorsal Slit.
h) Button Hole.
1-b) What are the benefits and negatives of each style?
2-a) What method of circumcision did you request for your child?
a) Plastibell.
b) Mogen Clamp.
c) Gomco Clamp.
d) Freehand.
e) Traditional Mohel.
f) Traditional Tribal.
g) Electro-cauterization.
2-b) What are the risks and possible complications associated with each method?
3) What are the most common possible immediate complications of the circumcision surgery?
4) What is the most common possible LATE term complication of circumcision? (from circumcision to 12 years.)
5) What is the greatest risk factor for ADULT men circumcised in infancy?
6) What is the most common cause of foreskin infection in boys that have NOT been circumcised?
7) How do you clean and care for a circumcised boy's penis immediately after circumcision (from circumcision to healing)? List all necessary steps.
8) How do you clean and care for a circumcised boy's penis after healing? List all necessary steps.
9) How do you clean and care for a boy's penis who is intact (has not been circumcised)? List all necessary steps.
10) How does an adult care for his own penis that has:
a) been circumcised?
b) never been circumcised?
*Bonus Question*
What are the 16 functions of the foreskin lost to circumcision?
If you cannot answer the above questions, you did NOT research, or make an educated decision to circumcise your son.
Answer Key:
1-a) Pick one. (5 points.) If you are unable to recognize which style of circumcision was inflicted upon your son, no marks are awarded.
1-b) (5 points each.)
a) Most inner foreskin removed, minimal outer foreskin removed. A fold of outer foreskin remains. Without inner foreskin, penile sensitivity is reduced. With a fold of skin remaining, penile skin must be forcibly retracted at each cleaning. Frenulum (male G-spot) commonly destroyed.
b) Most inner and outer foreskin removed, no folds remain. Without inner foreskin, penile sensitivity is reduced. Causes tight, possibly painful erections. Frenulum (male G-spot) commonly destroyed. Rolling, gliding action not possible.
c) Most outer foreskin removed, minimal inner foreskin removed. A fold of inner foreskin remains. With a fold of skin remaining, penile skin must be forcibly retracted at each cleaning. High risk of possible skin adhesions, skin bridges, and highest risk for subjecting your child to corrective surgery (second circumcision) when inner foreskin attempts to heal back onto the glans.
d) Maximum outer penile skin and outer foreskin removed, minimal inner foreskin removal. Loss of the protective layers of outer penile skin leaves penis more prone to injury from abrasion and tension. Increased chances of keritinization, leading to adult loss of sensitivity. Rolling, gliding action not possible.
e) All of the outer penile skin is removed, leaving only inner foreskin. Painfully tight erections are assured. Most of the penis is trapped withing the pubis. Penetrative sex may not be possible.
f) All of the inner foreskin, and most of the outer penile skin, is removed. Painfully tight erections are assured. Most of the penis is trapped withing the pubis. Penetrative sex may not be possible.
g) All the foreskin remains, though split at the dorsal line. Foreskin must be forcibly retracted at each cleaning. Maximum possibility of skin bridges, adhesions, and secondary surgeries. Greatest possibility of foreskin healing incorrectly. Least appealing cosmetic result.
h) All of the foreskin remains, though the glans is exposed through an incomplete slit in the top of the foreskin, like a button through a button hole, where it heals in place. Cleaning is virtually impossible. Most sensitive regions of the penis is trapped and inaccessible. Penetrative sex may be impossible.
2-a) Pick one. (5 points.) If you are unable to recognize which method of circumcision was inflicted upon your son, no marks are awarded.
2-b) (5 points each.)
a) Frenulum commonly destroyed. Possible slippage of ring causing excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
b) Possible amputation of some or all of the glans. The company that manufactured this clamp went out of business settling lawsuits because of injuries of this type. Complete loss of the penis, complete degloving of the penis (loss of all outer skin,), wound dishiscence (skin coming apart), necrosis, infection, complete loss of penis, poor cosmetic result, and many others, up to and including death.
c) Frenulum commonly destroyed. Possible crushing of and loss of the penis if correct bell sizes are not used, excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
d) Riskiest method. The slightest slip of the doctor's scalpel and damage can occur anywhere on the infant penis. Excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
e) As risky as any of the above, with a far greater chance of infection and transference of diseases such as herpes to your infant.
f) Extraordinarily dangerous and unsanitary. By far the riskiest and most damaging circumcision method of them all.
g) Electro cauterization burns and seals shut the vascular system around the cut reducing bleeding, but excessive heat travels through the skin destroying nerve tissue far removed from the circumcision site. Heat can destroy much more of the penis, and is famously known for causing necrosis of the penis. All other above complications remain possible.
3) (5 points for each of the following. 25 points max): Pain, bleeding, infection, inability to bond with mother, lack of interest or ability to breastfeed, and infant post-traumatic stress disorder (PTSD).
4) (10 points) Meatal Stenosis. Studies differ, and place this late term complication at 5 to 30% of all circumcised children who will experience this painful and dangerous complication of missing their foreskin. Surgical correction may be the only remedy. Even at only 5%, this remains the greatest risk to all circumcised boys.
5) (10 points) Erectile Dysfunction. Adult circumcised men suffer from ED 4.5 times more frequently than their intact counterparts.
6) (10 Points) Premature Forcible Foreskin Retraction. PFFR occurs when an adult, caregiver, or doctor forcibly retracts (even “gently”) the foreskin of a child prematurely. The average age of retraction is 10.4 years. Prior to that the foreskin is fused to the glans to prevent infection from foreign materials and pathogens. Some males may not have a retractable foreskin until late puberty. (17 years old or later.) NEVER retract the foreskin of an intact child. It is self cleaning until post-puberty, at which time only clean water is required to rinse off the glans and inner foreskin.
7) (5 points) Care must be taken with the circumcised child's wound. It will be raw and sensitive. Vaseline or petroleum jelly is used to keep the raw wound from sticking to his diaper. If the foreskin appears to be healing to glans, gently pull the penile skin down, breaking the adhesions. This will be both painful and traumatic for your baby. Excessive touching or cleaning of the circumcision wound may disrupt the infant/parent bond and disrupt breastfeeding. Watch for excessive bleeding. If more than a few drops of blood are visible in the diaper, your child may be at risk of hemorrhage. It only takes 2.3 oz. of blood loss for your baby to go into shock and possibly die.
8) (5 points) Clean the outside like a finger... unless a fold of skin remains at the edge of the glans. If a fold remains, gently pull it down and clean around the edge of the corona, this is a fold where dirt and foreign pathogens can collect. As the natural cleaning mechanism of the penis has been destroyed, be careful that the entire penis, including any folds of skin are carefully inspected and cleaned. If you notice skin bridges or adhesions, a second surgery and breaking of the adhesions may be necessary.
9) (10 points) Clean only what is seen. Wipe the outside like you would a finger. NEVER retract the foreskin or you will disrupt the natural cleaning function of the penis.
10) a) (5 points) Clean the outside like a finger... unless a fold of skin remains at the edge of the glans. If a fold remains, gently pull it down and clean around the edge of the corona, this is a fold where dirt and foreign pathogens can collect. As the natural cleaning mechanism of the penis has been destroyed, be careful that the entire penis, including any folds of skin, are carefully inspected and cleaned. If you notice skin bridges or adhesions at any point, a second surgery and breaking of the adhesions may be required.
b) (5 points) Clean the outside like a finger. Retract the foreskin briefly and rinse the glans and inner foreskin with warm water. Avoid soap inside the penis. Soaps can disrupt the natural cleaning mechanism of the penis.
BONUS QUESTION (30 points)
1. Erotic pleasure via the ridged band.
2. Rolling, gliding action during sex or intercourse. Acts as the male contribution to lubrication.
3) Prevents dyspareunia (painful intercourse).
4) Stimulates partner's genitalia, giving erotic pleasure.
5) Supplies skin to cover the shaft in erection and prevent tightness.
6) Stores pheromones and releases them on arousal.
7) Stores, releases and helps distribute natural lubricants ("smegma" and pre-ejaculatory fluid).
8) Makes the glans a visual signal of sexual arousal.
9) Provides a seal against the vaginal wall to contain semen.
10) Prevents the glans becoming keritinised, and keeps it soft and moist.
11) Protects the thin-skinned glans against injury.
12) Protects the nerves of the glans, retaining their erotic function.
13) In infancy, protects the urethra against contamination, meatal stenosis, and UTIs.
14) Provides lysosomes for bacteriostatic action around the glans.
15) Pigmented, it protects the unpigmented glans against sunburn.
16) Vascular (rich in blood vessels that bring heat to the tissues), it protects the less vascular glans against frostbite, as Sir Ranulph Fiennes found on his epic transpolar walk.
Total possible points including the Bonus Question = 200
145 or higher – Congratulations, you are likely an advocate for genital autonomy and chose to keep your child intact.
100 to 144 – You are very educated on this subject.
75 to 99 – You have a lot more to learn.
Less than 75 – You did NOT make an informed decision.
"I made an educated decision to circumcise my son."
Did you? Really? That can be easily verified.
POP QUIZ:
1-a) In what style did you choose to circumcise your son:
a) Low and Loose.
b) Low and Tight.
c) High and Loose.
d) High and Tight.
e) Radically High.
f) Radically Tight.
g) Dorsal Slit.
h) Button Hole.
1-b) What are the benefits and negatives of each style?
2-a) What method of circumcision did you request for your child?
a) Plastibell.
b) Mogen Clamp.
c) Gomco Clamp.
d) Freehand.
e) Traditional Mohel.
f) Traditional Tribal.
g) Electro-cauterization.
2-b) What are the risks and possible complications associated with each method?
3) What are the most common possible immediate complications of the circumcision surgery?
4) What is the most common possible LATE term complication of circumcision? (from circumcision to 12 years.)
5) What is the greatest risk factor for ADULT men circumcised in infancy?
6) What is the most common cause of foreskin infection in boys that have NOT been circumcised?
7) How do you clean and care for a circumcised boy's penis immediately after circumcision (from circumcision to healing)? List all necessary steps.
8) How do you clean and care for a circumcised boy's penis after healing? List all necessary steps.
9) How do you clean and care for a boy's penis who is intact (has not been circumcised)? List all necessary steps.
10) How does an adult care for his own penis that has:
a) been circumcised?
b) never been circumcised?
*Bonus Question*
What are the 16 functions of the foreskin lost to circumcision?
If you cannot answer the above questions, you did NOT research, or make an educated decision to circumcise your son.
Answer Key:
1-a) Pick one. (5 points.) If you are unable to recognize which style of circumcision was inflicted upon your son, no marks are awarded.
1-b) (5 points each.)
a) Most inner foreskin removed, minimal outer foreskin removed. A fold of outer foreskin remains. Without inner foreskin, penile sensitivity is reduced. With a fold of skin remaining, penile skin must be forcibly retracted at each cleaning. Frenulum (male G-spot) commonly destroyed.
b) Most inner and outer foreskin removed, no folds remain. Without inner foreskin, penile sensitivity is reduced. Causes tight, possibly painful erections. Frenulum (male G-spot) commonly destroyed. Rolling, gliding action not possible.
c) Most outer foreskin removed, minimal inner foreskin removed. A fold of inner foreskin remains. With a fold of skin remaining, penile skin must be forcibly retracted at each cleaning. High risk of possible skin adhesions, skin bridges, and highest risk for subjecting your child to corrective surgery (second circumcision) when inner foreskin attempts to heal back onto the glans.
d) Maximum outer penile skin and outer foreskin removed, minimal inner foreskin removal. Loss of the protective layers of outer penile skin leaves penis more prone to injury from abrasion and tension. Increased chances of keritinization, leading to adult loss of sensitivity. Rolling, gliding action not possible.
e) All of the outer penile skin is removed, leaving only inner foreskin. Painfully tight erections are assured. Most of the penis is trapped withing the pubis. Penetrative sex may not be possible.
f) All of the inner foreskin, and most of the outer penile skin, is removed. Painfully tight erections are assured. Most of the penis is trapped withing the pubis. Penetrative sex may not be possible.
g) All the foreskin remains, though split at the dorsal line. Foreskin must be forcibly retracted at each cleaning. Maximum possibility of skin bridges, adhesions, and secondary surgeries. Greatest possibility of foreskin healing incorrectly. Least appealing cosmetic result.
h) All of the foreskin remains, though the glans is exposed through an incomplete slit in the top of the foreskin, like a button through a button hole, where it heals in place. Cleaning is virtually impossible. Most sensitive regions of the penis is trapped and inaccessible. Penetrative sex may be impossible.
2-a) Pick one. (5 points.) If you are unable to recognize which method of circumcision was inflicted upon your son, no marks are awarded.
2-b) (5 points each.)
a) Frenulum commonly destroyed. Possible slippage of ring causing excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
b) Possible amputation of some or all of the glans. The company that manufactured this clamp went out of business settling lawsuits because of injuries of this type. Complete loss of the penis, complete degloving of the penis (loss of all outer skin,), wound dishiscence (skin coming apart), necrosis, infection, complete loss of penis, poor cosmetic result, and many others, up to and including death.
c) Frenulum commonly destroyed. Possible crushing of and loss of the penis if correct bell sizes are not used, excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
d) Riskiest method. The slightest slip of the doctor's scalpel and damage can occur anywhere on the infant penis. Excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
e) As risky as any of the above, with a far greater chance of infection and transference of diseases such as herpes to your infant.
f) Extraordinarily dangerous and unsanitary. By far the riskiest and most damaging circumcision method of them all.
g) Electro cauterization burns and seals shut the vascular system around the cut reducing bleeding, but excessive heat travels through the skin destroying nerve tissue far removed from the circumcision site. Heat can destroy much more of the penis, and is famously known for causing necrosis of the penis. All other above complications remain possible.
3) (5 points for each of the following. 25 points max): Pain, bleeding, infection, inability to bond with mother, lack of interest or ability to breastfeed, and infant post-traumatic stress disorder (PTSD).
4) (10 points) Meatal Stenosis. Studies differ, and place this late term complication at 5 to 30% of all circumcised children who will experience this painful and dangerous complication of missing their foreskin. Surgical correction may be the only remedy. Even at only 5%, this remains the greatest risk to all circumcised boys.
5) (10 points) Erectile Dysfunction. Adult circumcised men suffer from ED 4.5 times more frequently than their intact counterparts.
6) (10 Points) Premature Forcible Foreskin Retraction. PFFR occurs when an adult, caregiver, or doctor forcibly retracts (even “gently”) the foreskin of a child prematurely. The average age of retraction is 10.4 years. Prior to that the foreskin is fused to the glans to prevent infection from foreign materials and pathogens. Some males may not have a retractable foreskin until late puberty. (17 years old or later.) NEVER retract the foreskin of an intact child. It is self cleaning until post-puberty, at which time only clean water is required to rinse off the glans and inner foreskin.
7) (5 points) Care must be taken with the circumcised child's wound. It will be raw and sensitive. Vaseline or petroleum jelly is used to keep the raw wound from sticking to his diaper. If the foreskin appears to be healing to glans, gently pull the penile skin down, breaking the adhesions. This will be both painful and traumatic for your baby. Excessive touching or cleaning of the circumcision wound may disrupt the infant/parent bond and disrupt breastfeeding. Watch for excessive bleeding. If more than a few drops of blood are visible in the diaper, your child may be at risk of hemorrhage. It only takes 2.3 oz. of blood loss for your baby to go into shock and possibly die.
8) (5 points) Clean the outside like a finger... unless a fold of skin remains at the edge of the glans. If a fold remains, gently pull it down and clean around the edge of the corona, this is a fold where dirt and foreign pathogens can collect. As the natural cleaning mechanism of the penis has been destroyed, be careful that the entire penis, including any folds of skin are carefully inspected and cleaned. If you notice skin bridges or adhesions, a second surgery and breaking of the adhesions may be necessary.
9) (10 points) Clean only what is seen. Wipe the outside like you would a finger. NEVER retract the foreskin or you will disrupt the natural cleaning function of the penis.
10) a) (5 points) Clean the outside like a finger... unless a fold of skin remains at the edge of the glans. If a fold remains, gently pull it down and clean around the edge of the corona, this is a fold where dirt and foreign pathogens can collect. As the natural cleaning mechanism of the penis has been destroyed, be careful that the entire penis, including any folds of skin, are carefully inspected and cleaned. If you notice skin bridges or adhesions at any point, a second surgery and breaking of the adhesions may be required.
b) (5 points) Clean the outside like a finger. Retract the foreskin briefly and rinse the glans and inner foreskin with warm water. Avoid soap inside the penis. Soaps can disrupt the natural cleaning mechanism of the penis.
BONUS QUESTION (30 points)
1. Erotic pleasure via the ridged band.
2. Rolling, gliding action during sex or intercourse. Acts as the male contribution to lubrication.
3) Prevents dyspareunia (painful intercourse).
4) Stimulates partner's genitalia, giving erotic pleasure.
5) Supplies skin to cover the shaft in erection and prevent tightness.
6) Stores pheromones and releases them on arousal.
7) Stores, releases and helps distribute natural lubricants ("smegma" and pre-ejaculatory fluid).
8) Makes the glans a visual signal of sexual arousal.
9) Provides a seal against the vaginal wall to contain semen.
10) Prevents the glans becoming keritinised, and keeps it soft and moist.
11) Protects the thin-skinned glans against injury.
12) Protects the nerves of the glans, retaining their erotic function.
13) In infancy, protects the urethra against contamination, meatal stenosis, and UTIs.
14) Provides lysosomes for bacteriostatic action around the glans.
15) Pigmented, it protects the unpigmented glans against sunburn.
16) Vascular (rich in blood vessels that bring heat to the tissues), it protects the less vascular glans against frostbite, as Sir Ranulph Fiennes found on his epic transpolar walk.
Total possible points including the Bonus Question = 200
145 or higher – Congratulations, you are likely an advocate for genital autonomy and chose to keep your child intact.
100 to 144 – You are very educated on this subject.
75 to 99 – You have a lot more to learn.
Less than 75 – You did NOT make an informed decision.
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