|
Circumcision is a universal
practice which is greatly influenced by cultural and religious
traditions, especially of the
Moslems
and Jews.
It is the most frequent operation on males not only in
Islamic
countries, but also other parts of the world. For example, in
the United States of America more than one million male infants
are circumcised each year. The performance of circumcision is
one of the rules of cleanliness in
Islam. It
is reported by Abu Hurairah that the
Prophet
Muhammed (Peace Be Upon Him) mentioned:
Five are the acts quite akin to fitra: circumcision, shaving the
pubes, cutting the nails, plucking the hair under the armpits
and clipping (or shaving) the moustache (Recorded in "Sahih
Muslim", "Sahih Bukhari", "Musnad Ahmed" and "Sunnah At-Tirmidhi").
The word fitra in relation to cleanliness can refer to the
Sunnah of the
Prophet
(pbuh) with regard to this matter, and fitra also "implies an
inner sense of cleanliness in man which is proof of his moral
convictions and mental health".
Circumcision means removal of the foreskin of the penis.
The Islamic
scholar Al-Mawardi said, "The ideal method is to remove the skin
completely from the beginning of the glens, and the minimum
condition is that nothing is left to cover the end of the glens".
The Prophet
Muhammed (pbuh) recommended performing circumcision at an
early age. Al-Mawardi stated that the chosen time is the 7th day
after birth, but it can be carried out up to 40 days after birth
or thereafter until the age of 7 years, depending upon the
health of the infant or child at the time.
There is an ongoing debate on the value of neonatal circumcision.
Indeed, the position of the American Academy of Pediatrics since
1975 has been that there are no valid or absolute medical
indications for routine circumcision of newborn male infants. On
the other hand, the results of recent clinical and
epidemiological studies are supportive of the practice of
circumcision in newborn and infant males.
From a two-part study involving cohorts of 3,924 and 422,328
infants respectively Wiswell and Roscelli found a higher rate of
urinary tract infection in uncircumcised compared with male
circumcised infants. These investigators observed that as the
circumcision frequency rate decreases, the incidence of urinary
tract infections increases. Infection usually begins in the
foreskin which becomes swollen and difficult to retract. A
medium for bacterial growth and further spread of infection is
provided by the fecal material trapped between the foreskin and
glens of the penis. Such a condition probably leads to other
more serious complications.
The cause for cancer of the penis is not known, but it is
associated with related infections. According to current belief,
cancer of the penis occurs less frequently among
Muslims
and Jews.
Whether this is so and is a benefit of circumcision should be
investigated in carefully controlled clinical studies. Foreskin
complications are more common in uncircumcised children.
According to the report of Herzog and Alvarez early circumcision
of male infants protects them from these conditions. Proper
hygienic care of the penis, which includes regular washing, will
prevent some infections, but among children this is difficult to
maintain and is probably not as effective as circumcision. Some
conditions, such as phimosis, often lead to circumcision at a
later age that could have been prevented if it had been
performed earlier. The possible risk for long term urological
complications in the infected, uncircumcised male infant has not
been properly studied. It is known, however, that as many as 50%
of male infants with urinary tract infections will subsequently
reveal demonstrable radiological abnormalities. Thus, the
performance of circumcision and the practice of Sunan Al-Fitra
as recommended in
Islam is
medically beneficial and reflects the wisdom of the
Islamic
statements.
Today the doctors say that lack of circumcision:
- Is the biggest risk factor for heterosexually-acquired
AIDS virus infection in men (8-times higher risk by itself, and even higher
when lesions from STDs are added in).
- Is responsible for a 12-fold higher risk of
urinary tract infections. Carries a higher risk of death in the first year of
life (from complications of urinary tract infections: kidney failure,
meningitis and infection of bone marrow).
- One in 900 uncircumcised men will die from
cancer of the penis or require at least partial penile amputation as a result.
(In contrast, penile cancer never occurs in men circumcised at birth).
- Often leads to balanitis (inflammation of the
glens), phimosis (inability to retract the foreskin) and paraphimosis (constriction
of the penis by a tight foreskin). Up to 18% of uncircumcised boys will
develop one of these by 8 years of age, whereas all are unknown in the
circumcised.
- Means problems that may result in a need for
circumcision late in life: complication risk = 1 in 100 (compared with 1 in
1000 in the newborn).
- Is associated with higher incidence of
cervical cancer in the female partners of uncircumcised men.
There is no evidence of any long-term
psychological harm arising from circumcision. The risk of damage to the penis is
extremely rare and avoidable by using a competent, experienced doctor. Surgical
methods use a procedure that protects the penis during excision of the foreskin.
As an alternative, for those who might prefer it, a device (PlastiBell) is in
use that clamps the foreskin, which then falls off after a few days, and so
eliminates the need to actually cut the foreskin off. For some, cultural or
religious beliefs dictate the method.
|