Penile phimosis: treating it the French way!

[Wounded Ronin]

In medical articles from the US, things are always very logical, very evidence-based, and, dare I say it, somewhat dry. However, look at this medical article from France for comparision. Although the author makes a pretty compelling case, look at all the philosophical and historical overtones. Here, clearly, is quite a cultural difference:

(And yes, it's translated)

http://www.cirp.org/library/treatment/phimosis/beauge/

(Citation: Beaugé M. Conservative Treatment of Primary Phimosis in Adolescents [Traitement Médical du Phimosis Congénital de L'Adolescent]. Saint-Antoine University, Paris VI, 1990-1991. )

Here are some exerpts:

The conventional treatment of phimosis is surgical:

Circumcision which removes the foreskin, or simple plastic surgery which preserves the fold of skin but opens the ring.

For a number of reasons I have come to reject this therapeutic procedure:

* Surgical intervention:
- is traumatic, brutal, and irreversible
- necessitates anaesthesia
- is bloody.
These two latter features give rise to the possible complications of any other form of surgery.
- in the case of circumcision reduces the mobility of the penile skin; this factor is important and we shall return to it at length on page 12.
- is psychologically stressful by cutting an organ which is highly symbolic for a male at the dawn of his sexual life.
- creates a mutilation: the amputation causes the penis to differ from that of his friends at an age where he has scarcely acquired knowledge of normality.
- causes brutal exposure of the mucous membrane by the excision of the protection of the glans.
- interferes with the pattern of masturbation which may be seriously traumatic.
- in the case of plastic surgery may fail due to scar formation.
- is expensive and requires hospitalisation.

And

Faced with a man suffering from phimosis, I propose:

After analysis of the patient's method of masturbation, it is necessary to explain to him the roles of masturbation during adolescence, such as are described in the five preceding points. The discussion has the advantage of removing feelings of guilt, if necessary.

Next it is advisable to instruct him on the technique that seems to be most useful, attempting thus to pull back the foreskin by exposing the tip of the glans. In fact it is only rarely possible for a boy who has developed for himself a method that leads to orgasm to replace it initially by another. Generally the new method fails to give pleasure and may even tend to impair the quality of the erection. This could explain why boys fail in their first attempts at sexual intercourse; a man who has become accustomed to rotational movements on his penis for several years will be quite unable to use this technique in the vagina. Therefore I advise "prescribe" alternating a few pleasurable manipulations known to be stimulative with the remodelling manipulations. It is of course essential that the preputial opening be stretched round the circumference of the fully erect glans. This technique meets the requirements of the kinesitherapy of soft tissues, gradual stretching. In some cases I have recommended instrumental dilatation with the use of a dilator in patients who agree to this procedure, or I have advised the introduction of two fingers into the opening of the foreskin to stretch it. Figure 18.

Perhaps it is logical to draw a parallel between the preputial ring of the boy and the hymen of the girl. In both cases there is a mucocutaneous stricture obstructing intercourse, but allowing the passage of urine and in the case of the hymen the flow of menses. The opening of the hymen may occur through traumatic rupture during brutal penetration, or by gradual and gentle dilatation when the lover is careful or shy.

Prepuce or hymen, it is the erect glans acting as a mould (or mandrel) which dilates (and models) the orifice.

Thus the boy can progressively expand his foreskin until the diameter is equal to that of the erect glans, allowing him subsequently to proceed to sexual intercourse without risk of paraphimosis.

The thing is, in spite of all these kinds of philosophical, "soft" discussions, I still think that the author makes a compelling medical case. What can I say? Vive la difference?

[Judah Maccabee]

If parents are truly concerned about their children getting circumcised appropriately, they can get a trained Rabbi (a mohel) to do it. Many of the arguments against circumcision go down the tubes when it's done in the context of a Jewish brit millah.

http://aish.com/literacy/lifecycle/bris_milah_beautiful_or_barbaric$.asp

As for complications:

As an operation, circumcision has an extremely small complication rate. A study in the New England Journal of Medicine (1990) reported a complication rate of 0.19 percent when circumcision is performed by a physician. When performed by a trained mohel, the rate falls to 0.13 percent or about 1 in 1000. When a complication occurs, it is usually excessive bleeding, which is easily correctable. No other surgical procedure can boast such figures for complication-free operations.

As for the issues of "psychological stress" and masturbation interference, I call bullshit until proof is presented.

For the issue of "being different from others", all kids have something different from others. And if circumcision is widespread, then he's different from others for NOT being circumcised, and at least in America, it's been my perspective that women prefer a "cut" man.

[Tarendol]

I've always been against circumcision. The only real health benefit it provides that can't also be provided by proper hygiene is a reduction in the incidence of penile cancer (which would really, really, really suck.) However, penile cancer is so rare anyway the benefit is minimal. Anyway, I think that the medical arguments from both sides basically cancel each other out.

The reason I am against circumcision is that I don't think parents have the right to do something like that to a child without a valid medical reason. If for some reason penile cancer ran in the family and the child had a good chance of getting it later, of course the parents should consider circumcision. But otherwise... it is like if some tradition required that the little toes be amputated at birth, would that be legal or ethical? I don't think there would be any disadvantage to having your little toes amputated at birth, but shouldn't that be something for the child to decide when he gets old enough? How about if the tradition insisted that the child be tattooed at birth? Or have an earlobe cut off? I just think these should all be something people are allowed to decide for themselves.

It would be cool to have a discussion about this, but only if we can all control ourselves and not just insult each other (this goes for me too.) I feel rather strongly about this, but even when I am polite people tend to get really upset about this subject which is something I would like to avoid!ethign I would like to avoid!

[SFGOON]

The French Don't brush thier teeth, bathe, shave their bodyhair or speak proper english - and now they don't cut thier dongs either?! It's no wonder the bubonic plauge started there and persists to this day!

[BackFistMonkey]

The French Don't brush thier teeth, bathe, shave their bodyhair or speak proper english - and now they don't cut thier dongs either?! It's no wonder the bubonic plauge started there and persists to this day!

that wasnt funny .., and full of bullshit ... thank you for shitting up the thread and continuing conservitive christian right wing propaganda .

you fail

[MEGALEF]

Whoa, I'm really glad I never needed specialist help to get my technique right.

[SFGOON]

You misread me. I'm not a christian (read the "I was mugged by a christian" post for evidence.) I just hate french people. And Christians. And probably you too.

[BackFistMonkey]

You misread me. I'm not a christian (read the "I was mugged by a christian" post for evidence.) I just hate french people. And Christians. And probably you too.

I never said you were .. just saying you were shitting up a decent thread with their lies , mistruths , and propoganda .

[SFGOON]

Yes but you completely ignore the fact that the French **** up the medical literature with phrases like "interferes with the pattern of masturbation which may be seriously traumatic." I've lived in Kentucky and can DEFINEITELY see why you hate christians so much - but you should meet French people, they're just as bad in the opposite way.

[Nid]

SFgoon seems to consistently boff, screw, and pork teh cor3kt.