By Dr. Gifford Jones
There is one fundamental rule in surgery, ‘If it ain’t broke, don’t fix it.’ Why? Because as one of Harvard’s great neurosurgeon once remarked, “There is no such thing as minor surgery, but there are a lot of minor surgeons.” He could have added that minor surgery can also result in needless tragic deaths. And that one major operation can be avoided.
The best adult example is Joan Rivers, the comedian, who allegedly had undergone several cosmetic face lifts and joked about it. But she had one too many and died of cardiac arrest during the operation.
The youngest tragedy is the newborn baby who recently suffered a circumcision, apparently unwanted by his parents. He died from hemorrhage. For some families the decision for circumcision is important. They believe it should be performed for religious or for medical reasons. But if that’s not the case remember, “If it ain’t broke don’t fix it.”
One lame argument for circumcision is that it prevents cancer of the penis, an extremely rare problem. Another reason is that this procedure decreases the number of urinary infections during the first year of life. But it also decreases the pleasure of sex for the next 75 or more years as the foreskin is loaded with blood vessels and nerves! There’s also a general belief that foreskin covers only a small surface of the penis, but once removed the skin measures three to five inches in length. That’s about half of the total skin of the penis.
What about complications? Compared to brain surgery circumcision is a minor procedure normally without bad results. But no surgical procedure, to my knowledge, has been devised, regardless of how minor, that is without some untoward results.
The world’s medical journals are full of reports of a variety of surgical mishaps. The vast majority of severe complications are not acts of God, but due to technical errors made during the procedure. A primary problem is the incorrect use of the circumcision clamp. In some cases an excessive amount of skin is pulled into the clamp resulting in injury, not only to the shaft of the penis, but also to the urinary tube (urethra) that runs through it. In one case, the traumatic complication resulted in amputation of part of the penis. Traumatic injuries to the penis and urethra often result in urinary stricture and difficulty passing urine. Or, the injury may result in a urinary fistula in which urine is discharged through an abnormal opening. These complications are not easy to repair so what starts as a ‘minor’ procedure becomes a major one. There have been bizarre problems that one would think could never happen.
For instance, one newborn screamed with such intensity that his stomach ruptured requiring emergency surgery. Another died from a bleeding disorder. It’s easy to see how this could occur since blood coagulation studies are not routinely done prior to circumcision.
My reaction to circumcision is that unless it’s needed for religious or other reasons, it’s a barbaric and somewhat sadistic procedure. Yet doctors continue to do circumcisions without giving much thought to unintended consequences. Some argue that circumcision violates the United Nations Declaration of Human Rights. I concur as these helpless newborns have absolutely no say in this matter. It’s also little wonder they scream in pain. I question how many males would agree to circumcision later in life if informed of the consequences and performed without anesthesia!
What major surgery can often be avoided? Today, gallbladder stones are often accidentally discovered during ultrasound tests done for other conditions. Small stones often cause trouble by entering the cystic duct that carries bile to the small intestine. This can result in severe pain and require emergency surgery. However, large stones cannot escape from the gallbladder and can remain quiescent for a lifetime. The best treatment for these stones is the crematorium.
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