Circumcision & Vasectomy

Circumcision&Vasectomy Jelena Marinković Mentor: A. Žmegač Horvat

Definition • removal of some or all of the foreskin (prepuce) from themale reproductive organ

History Ancient Egyptian carved scene of circumcision • religious sacrifice • riteof passage marking a boy's entrance into adulthood • form of magic to ensure virility • means of suppressing sexual pleasure • increasing a man's attractiveness to women • aid to hygiene Family circumcision set and trunk, eighteenth century Circumcision being performed in central Asia, (most likely Turkestan) c. 1865-1872

Cultures and religions • commonly practised in the Jewish and Islamic faiths • the Catholic Church condemned circumcision as a mortal sin and ordered against its practice Jewish ritual circumcision Illustrated account of the circumcision ceremony of Sultan Ahmed III's three sons Circumcision of Jesus. Illumination from a missal, ca 1460

Prevalence • the proportion of males that are circumcised worldwide vary from one-sixthto a third • 70% Muslim • most prevalent in the Muslim world, parts of South East Asia, Africa, United States, Philippines, Israel, South Korea Grey = No data; Yellow = <20% prevalence; Orange = 20-80% prevalence; Red = >80% prevalence

Circumcision procedures • in some African countries, male circumcision often performed by non-medical personnel under unsterile conditions • in parts of Africa, the foreskin may be dipped in brandy and eaten by the patient, eaten by the circumciser, or fed to animals • according to Jewish law the foreskin should be buried • after hospital circumcision, the foreskin may be used in biomedical research, consumer skin-care products, skin grafts, or β-interferon-based drugs

Controversy • ethical issues • psychological and emotional consequences • legal issues Protest against routine infant circumcision Group advocating stopping infant circumcision demonstrates on the U.S. Capitol lawn in Washington, D.C., in March 2008

Medical aspects • medical cost-benefit analyses of circumcision vary • pain and pain relief • sexual effects • complications (0.06% to 55%) • sexually transmitted diseases • hygiene, infectious and chronic conditions • penile cancer

Vasectomy • minor surgical procedure wherein the vasa deferentia of a man are severed, and then tied or sealed in a manner such to prevent sperm from entering the seminal stream • first use in 1899 (experiments from 1785)

Types • typically done in outpatient setting • no-scalpel method • "open-ended" • "Vas-Clip" method

Risks Benefits • prevention of pregnancy • no need for general anesthesia • lower cost compared to other surgical sterilization procedures • bleeding with formation of hematoma • chronic testicular pain • infection • failure of the vasectomy to prevent pregnancy (1 in 2000) • regret and a desire to reverse the vasectomy • formation of a sperm granuloma

Tubal ligations vs. vasectomy

Reversal - vasovasostomy • effective at achieving pregnancy in only 50%-70% of cases • $7,000 • frequently impermanent • higher rates of aneuploidy and diploidy in the sperm cells

in 1976, a huge government campaign for sterilization was launched - responsible for the sterilization of millions of Indian couples

THE END “Vasectomy means not ever having to say you are sorry” Larry Adler , an American musician

Circumcision & Vasectomy