Argument: Circumcision always risks permanent injury and disfigurement
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Paul M. Fleiss, MD. "The Case Against Circumcision". Mothering. Winter 1997 - Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500.48 These complications include uncontrollable bleeding and fatal infections.49 There are many published case reports of gangrene following circumcision.50 Pathogenic bacteria such as staphylococcus, Proteus, Pseudomonas, other coliforms, and even tuberculosis can cause infections leading to death.51, 52 These organisms enter the wound because it provides easy entry, not because the child is predisposed to infection.
Medical journals have published numerous accounts of babies who have had part or all of their glans cut off while they were being circumcised.53, 54, 55 Other fully conscious, unanesthetized babies have had their entire penis burned off with an electrocautery gun.56, 57, 58 The September 1989 Journal of Urology published an account of four such cases.59 The article described the sex-change operation as "feminizing genitoplasty," performed on these babies in an attempt to change them into girls. The March 1997 Archives of Pediatrics and Adolescent Medicine described one young person's horror on learning that "she" had been born a normal male, but that a circumciser had burned his penis off when he was a baby.60 Many other similar cases have been documented.61, 62 Infant circumcision has a reported death rate of one in 500,000.63, 64
Mothers Against Circumcision - Some people complain that not enough skin was removed during their son’s circumcision. They fear he looks uncircumcised. Children are often subjected to circumcisions being ‘redone.’ Sometimes, a circumcision may only appear to be incomplete when actually it is not. There may be fat pads in the pubic area. “When the child grows and the fat pad disappears,” it will likely have the look of an ordinary circumcised penis. [Semel] Often too much tissue is removed, although this is not become obvious until later. This can cause painful erections and curvature of the penis. And finally, the circumcised penis is not immune to infections, sexually transmitted diseases or penile cancer.
Necrosis refers to the death of body tissue. This has happened to the glans following circumcision due to an overly tight bandage or a Plasti-bell ring that is too small.
Kaplan describes this occurrence:
On occasion, in an attempt at hemostasis, the circulation to the glans penis may be compromised, resulting in either cyanosis or necrosis of the glans penis. I was asked to see a child with cyanosis of the glans penis one day following circumcision. Many sutures were present. Additionally, an anaerobic streptococcus was cultured from the wound so that it was not clear whether the cyanosis was secondary to the sutures used or to an underlying infection. With removal of the sutures and use of antibiotics, this problem resolved without tissue loss. 43.
Injury and Loss of Glans
Occasionally the glans can be injured or entirely cut off during circumcision. Usually a permanent deformity results. Both the Plasti-bell and the Gomco clamp employ the protective "bell" which covers the glans before the clamp or string is applied, thus precluding injury to the glans. Other methods not employing a "bell" pose greater risk of injuring the glans. The glans can also be injured before the bell is in place, during the dorsal slit procedure, or as the operator frees the foreskin from the glans.
Rosemary Romberg. "Circumcision - The Painful Dilemma. Chapter Eleven: Complications of Circumcision (Condensed)". Bergin & Garvey Publishers, Massachusetts. 1985 - Laceration of Penile or Scrotal Skin
Circumcision jokes often center around, "What if the knife slips?" This feared event has happened. Shulman etal report:
Accidental laceration of the penile skin and scrotum following circumcision has been seen in 2 cases.... [In one case] the Mohel slipped during the performance of the operation, and the knife opened the ventral surface of the penis and scrotum and exposed both testes. The skin was sutured under general anesthesia six hours after the accident and healing was uneventful. 52.
A keloid is an abnormal development consisting of a raised, firm, thickened, red piece of scar tissue. Such a formation at the site of circumcision creates a grotesque deformation of the organ, with obstruction of its function.
Ecstein describes an extensive keloid scar which developed on a small boy 6 months after he was circumcised "without any good clinical indication." 58
Lymphedema or Elephantiasis of Skin
These terms refer to the swelling or obstruction of the lymph vessels. This can result from circumcision. According to Shulman, et al.:
A baby with lymphedema of the penis had been circumcised at 8 days. He was referred at age 10 months. Several days after circumcision the penis and scrotum had become swollen. On examination at 25 days it was found that a large portion of the prepuce remained and covered the glans. The penis and scrotum were edematous. Several weeks later the scrotal edema regressed but the penile skin of the ventral surface remained edematous. On admission, marked edema of the lower part of the penile skin was found.... At operation, the lymphedematous tissue was excised down to the penile fascia. The defect on the ventral surface was easily closed by the remaining dorsal flaps. 30.
Paul M. Fleiss, MD. "The Case Against Circumcision". Mothering. Winter 1997 - "Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft. Because circumcision usually necessitates tearing the foreskin from the glans, pieces of the glans may be torn off, too, leaving it pitted and scarred. Shreds of foreskin may adhere to the raw glans, forming tags and bridges of dangling, displaced skin[...]Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection. The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely."
The Gomco clamp and Plasti-bell devices produce an even circular cut … Older methods such as smashing the skin with a hemostat and slicing it off present greater risk that an uneven cut will result. Browne uses the quaintly British expression: "Untidy tags of skin." 37
Removal of only a tiny bit of foreskin can cause dissatisfaction on the part of parents who are conditioned to believe that the denuded state is preferable. Sometimes such parents will take their babies back to the doctor to have more foreskin cut off because they believe that his penis does not look circumcised enough.