WARNING TO PARENTS:
PREMATURE, FORCIBLE, FORESKIN RETRACTION OF INTACT BOYS — AN EPIDEMIC
by John V. Geisheker, J.D., LL.M.
Executive Director, General Counsel
In my capacity as the Executive Director of Doctors Opposing Circumcision, an international physicians’ non-profit, I field around three anguished complaints each week from parents of intact (not circumcised) boys whose foreskins were forcibly retracted by ignorant medical practitioners. Premature, forcible, foreskin retraction (PFFR) is a much more painful, serious, and potentially permanent injury than most parents imagine. It is also epidemic in English-language medicine (though apparently not elsewhere). I speculate that only one in 1,000 cases in N. America comes to our attention. Indeed many parents have no idea their child was injured or why. That might mean as many as 150,000 cases in the USA each year, but no one knows for sure.
Here is a typical incoming email. (For reasons of HIPAA protection of our parents, this complaint is a composite, details changed, but it is very typical).
“Dear Mr. Geisheker,
I have read on a mothering website that you handle complaints about retracting the foreskin of little boys. We kept our boy, Ethan, now six months old, intact because we know circumcision is unnecessary, painful and risky. Last week during a routine doctor visit, and before I could stop him, our pediatrician, Dr. ‘Paul,’ peeled my son Ethan’s foreskin back all the way. It happened so fast there was nothing I could do.
“Ethan screamed instantly, cried for hours, and has been restless and fussy ever since. There are now small circles, like cracks, around his foreskin, which ooze blood. His whole penis is red and swollen. Ethan is now unusually fussy as soon as his diaper is wet, and we think it must sting when he urinates. He screams when we change him or the diaper touches his penis. It just breaks my heart to hear him. He had no problems at all before this doctor visit.”
“Dr. Paul told us that we must pull Ethan’s foreskin back this way every day or at least at every bath, to prevent what he called ‘adhesions’ and to clean out the smegma that builds up there. He said that if we don’t, our boy will need to be circumcised for sure.”
“Is all this necessary? I can’t believe you need to hurt a boy to keep him clean. It makes no sense to me and I am very angry at what happened to Ethan. He was a very happy baby before this.”
“Please help us.”
Sad Mom of Beautiful Ethan
What happened to ‘Ethan’ in this composite anecdote (my three cases each week all have similar heart-breaking details) is an unmitigated, inexcusable disgrace, indefensible medical malpractice, and a clinically unnecessary (and illegal) injury to the child. ‘Mom of Ethan’ has exactly the right instincts, and with good reason.
Forced retraction is only rarely defensible. Inguinal hernia, undescended testicle, hydrocele, and varicocele can all be addressed without forcible retraction. The penis should be repositioned for any necessary intervention with sterile tape, not by inserted hemostat. Catheterization can be done by ‘feel,’ without retraction. Only in the instance of significant hypospadias or epispadias (congenital malposition of the urethral opening) might retraction be necessary and, even then, only if it is unavoidable collateral damage for which there should be specific follow-up care.
[D.O.C. follows up all such complaints with a footnoted 10-page letter to the physician or nurse, detailing the correct medical protocol, and if the parents agree, a formal complaint to their state licensing authority we are only too happy to file.]
This post is the beginning of a much longer, more detailed article on the D. O. C. website by John Geisheker.