Letter: Circumcision

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Sir: Raymond Buick, the paediatric surgeon at Birmingham Children's Hospital quoted in your article on the General Medical Council's latest guidelines on the circumcision of baby boys (22 September, Health News), is absolutely right to complain that the guidelines do nothing to tell parents about the full medical implications of circumcision. How are parents to be informed if doctors themselves are in ignorance? Many doctors, particularly if they are circumcised themselves, still imagine that the foreskin is simply ordinary skin. At worst one still sees it described as redundant, unnecessary tissue, as if nature had somehow blundered in designing this area. We now know that the foreskin is tissue men can little do without.

None of the following complications figure in doctors' lists of the more serious complications of circumcision: removal of most of the shaft skin; excessive bleeding; severe scarring; misaligned suturing; narrowing of the urinary opening occasioned by ulceration of the unprotected glans in baby's nappies; partial or total amputation of the glans; trauma; death.

The structure of a baby's penis is not a suitable subject for unnecessary surgery and the GMC should gather its forces to say so.The more so, since the baby cannot give consent and since parental consent, in the absence of full medical guidance regarding the damage circumcision does, even when "correctly" performed, is very unlikely to be informed.

Dr G R Edwards