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Types of Circumcision Methods (and The Risks Each Cut Carries)

Types of Circumcision Methods (and The Risks Each Cut Carries)

Most parents do not even realize that circumcision, often referred to and minimized as a procedure, is traditionally a surgery involving a scalpel or surgical scissors that alters a fundamental aspect of an individual’s genitalia. It is an act that has both long- and short-term implications for both health and the ethics of personal autonomy.

“Even my friends were looking away nervously when I described the mechanics of a circumcision—how the doctor swabs the immobilized baby, pries his foreskin from the head of the penis with a metal probe, clamps the foreskin for several minutes to keep it from bleeding, and then cuts away between half and two-thirds of the penile skin. And during the whole thing, the baby is shrieking until he passes out in shock.”

– Georganne Chapin, author of “This Penis Business” (Lucid House Publishing, 2024)

Any circumcision carries risks of infection, hemorrhage, urinary retention, inflammation, glans amputation, glans necrosis, hematoma, excessive removal of the foreskin, adverse reaction to and the potential for meatal stenosis, chordee, skin adhesion to glans, fistula, inclusion cyst, penile rotation, trapped penis, penis amputation or disfigurement, sexual, psychological, and emotional repercussions, and death.

In this article, we will look at the types of circumcision that are done to infants, along with the consequences of this medically unnecessary surgery. Through this exploration, we hope to shed light on a practice that Intact America staunchly opposes, empowering individuals to make informed decisions about their bodies and raising essential questions about cultural norms, medical justifications, and the fundamental right to bodily autonomy.

Types of Circumcision

1) The Gomco Clamp

The Gomco Clamp method, one of the more traditional approaches to circumcision, has been continuously employed for over 70 years in various healthcare settings. Recognized for its standardized procedure, the Gomco Clamp is characterized by its distinctive clamping device, which is central to its technique.

How Gomco Clamp Works: This device consists of a bell-shaped instrument (cap), platform, hooking arm, and screw device. First, the foreskin is clamped by two hemostats, creating an opening down which an instrument is inserted to separate the skin from the glans. Then the skin is cut lengthwise to expose the glans (dorsal slit). It may require probing to break up skin adhesions. Then the bell or cap is placed over the glans, and the penis, foreskin, and covered glans are drawn through the hole in the platform. Turning the screw device forces the cap against the hole and squeezes the foreskin. A scalpel is then used to cut the foreskin around the base of the Gomco Clamp.

Consequences and Dangers: Watching the surgery on an infant is not for the squeamish. The Gomco Clamp has faced scrutiny regarding potential complications, such as issues related to the placement and removal of the clamp, causing too much skin to be removed from the shaft of the penis. As with all circumcisions, there is the danger of excessive bleeding and infection, and there is no question that it results in discomfort and potential trauma for an infant.

2) The Mogen Clamp

Designed by Rabbi Harry Bronstein in 1954, the Mogen clamp is the most commonly used by mohels for ceremonial circumcision.

How the Mogen Clamp Works: The Mogen Clamp is a surgical instrument with a flat, shield-like base and a hinged, circular blade. To perform a circumcision using this method, the operator first separates the foreskin from the penis glans in the same way that preceded the Gomco Clamp method. The Mogen Clamp is then placed over the glans, with the foreskin securely held between the blade and the base. Once in position, the clamp is closed, severing the foreskin that extends beyond its edge.

Consequences and Dangers: This technique and device are considerably quicker than the Gomco Clamp procedure, although still traumatic and painful for the baby, even with an anesthetic. Many medical professionals and advocacy groups have voiced concerns about the potential for uneven cuts and inadequate removal of the foreskin, which may result in complications such as skin bridges and the need for corrective surgery.

3) The Plastibell Method

Introduced in the 1950s, the Plastibell Method is recognized by its distinctive plastic ring device that adheres to the penis until falling off in 10 to 14 days.

How the Plastibell Method Works: The Plastibell Method involves using a specially designed plastic ring with a groove running around its circumference. As with the Gomco and Mogen Clamp techniques, the foreskin is first clamped and cut. The Plastibell ring is then inserted over the glans and foreskin, with the foreskin protruding through the ring’s groove. A ligature or string is tied around the groove, compressing the foreskin and causing it to lose blood circulation, with the tissue withering away, exposing the glans.

Consequences and Dangers: Although this technique does not require the removal of the foreskin by surgery, there are still complications, and it is visibly uncomfortable. The most common complication is delayed separation of the ring, followed by bleeding, excess mucosa, infection, disposition, and hematoma.

One baby after another was circumcised, and parents didn’t have a clue about what their babies were experiencing during the procedure. I began providing accurate information so that when parents signed a consent form, they were truly informed. Due to my sharing what I was learning, other nurses were doing this, each in their way.

First, I would ask what the mother knew: for example, I would say, “I have a consent form here for your baby’s circumcision, which you will need to sign. May I ask why you have decided to have your baby circumcised?”

The answers varied somewhat, but often it was, “Because it’s cleaner and healthier.”

If that were a mother’s response, I would ask, “Did you know that the American Academy of Pediatrics says that soap and water offer all the advantages of circumcision without the risks of surgery?”

“Circumcision is surgery?” the mother would invariably ask.

When I said it was, a mother often asked about anesthesia. I would tell the truth—babies were not anesthetized for circumcision. Even today, after the harmful effects of pain and trauma to the baby’s developing brain and body are well documented, about half of the babies in the United States still are circumcised without anesthesia.

Marilyn Milos, Please Don’t Cut the Baby!, 2023, Lucid House Publishing

Circumcision Scars, Bumps, and Lumps (Another Truth They Won’t Tell You)

Circumcision Scars, Bumps, and Lumps (Another Truth They Won’t Tell You)

Significant scars, bumps, and lumps as a result of circumcision are often not even mentioned as potential side effects. However, these deformities can cause both physical and psychological distress.

By providing a comprehensive understanding of this overlooked aspect of circumcision, we aim to help readers make more informed decisions about the procedure. These choices have lasting effects and should be made with a complete awareness of the immediate procedure aftermath and the possibility of long-term complications, such as scars, bumps, and lumps.

Circumcision Scars: A Permanent Reminder

After a circumcision, a scar usually forms where the foreskin is removed, resulting in a noticeable line or change in color on the penis shaft. The look of the circumcision scar can differ from person to person, ranging from a faint line to a more prominent, thicker scar. Hypertrophic or keloid scarring may arise, which can cause unsightly raised or irregular scarring. Skin bridges may also emerge in more severe instances.

Circumcision scars can have multiple physical effects. They can decrease sensitivity or cause uncomfortable sensations like itching and pain, which may interfere with sexual activities and cause distress. Additionally, pronounced or irregular scars could lead to difficulties during erections or sexual intercourse.

Circumcision scars can also have psychological effects in addition to physical ones. They can serve as a constant reminder of the procedure and result in feelings of loss, anger, or dissatisfaction with the penis’s appearance. These feelings can lead to problems with self-esteem, body image, and intimate relationships. It’s crucial to acknowledge and address these possible effects to provide complete care and support for people affected by circumcision scars.

Remaining Intact is the Best Way to Avoid Scars

An article on circumcision scarring on healthline.com lists the various devices used for circumcision on an infant, ranging from the gomco clamp, over which the foreskin is pulled and clamped to cut off blood flow to the skin. In contrast, a doctor uses a scalpel to remove the foreskin from a mogen clamp into which the foreskin is inserted and then removes it with a scalpel from a plastibell device inserted between the foreskin and over the glans for removal by the scalpel of the foreskin (the plastic ring remains to help the skin reattach to the shaft). Stitching may be required if excess bleeding occurs.

If reading this makes you squirm and feel uncomfortable, why would you subject an infant to it?

Scarring is an inevitable and “normal” result of infant circumcision. Recommendations are made for minimizing scarring, like applying petroleum jelly to prevent friction between the penis and diaper and washing the penis wound with soap and water. Adults are warned not to scratch as their circumcision heals and feels itchy. Infants will feel the discomfort of itching, but no attention will be paid since they can’t yet communicate other than crying.

There is no medical benefit or reason for causing this discomfort to an infant or creating a lifelong scar carried into adulthood.

Bumps and Lumps: Unexpected After-effects of Circumcision

The formation of bumps and lumps after circumcision is another after-effect of circumcision not commonly mentioned that can have a significant impact. These formations are a result of the body’s healing process, in which abnormal skin or tissue growth might occur due to the trauma caused by circumcision.

A skin bridge can occur when a wound sticks to the glans, resulting in a bridge of skin between two typically separate areas. Pain can be a long-term effect of skin bridges, especially during sexual activity or erections. Granuloma is a type of formation that occurs when the body produces excess tissue during healing. It can show up as small, firm bumps on the site of the circumcision. Although they are generally not painful, they can cause cosmetic concerns due to their visible appearance. Another type of lump that may develop is an inclusion cyst, which happens when skin cells are trapped under the skin during the healing process. They are typically small and painless. Bumps and lumps may require surgical correction, medical treatments, or psychological support.

Real-Life Experiences: Men Living with Circumcision Scars, Bumps, and Lumps

The personal stories of men who have lived with the physical after-effects of circumcision provide a moving and human outlook compared to the clinical facts and figures. These stories highlight not only the physical challenges of having scars, bumps, and lumps but also the profound impact on self-confidence, how one views one’s body, and sexual encounters.

Consider this story relayed by Intact America Board Member Marilyn Milos, “A Coming Out Story.”

Bathhouses in San Francisco were in full swing, and gay men had an opportunity to see lots of penises and the scars of circumcision on most penises. The men were shocked by the damage they saw. They told me about the extensive scarring, skin bridges, curvatures, and missing hunks and slices. Many recognized their scars and shared their reactions to the realization of what a doctor or mohel had done to them. This openness is something most straight men have never experienced; instead of witnessing the harm, they often tout the benefits of circumcision and choose to pass the scars on to their sons. As gay men began to educate themselves and others, that began to change. I asked Paul Tardiff, a gay man who had been circumcised as an adult if he’d be willing to talk about the differences he felt for a mini-documentary we were making to air during Dr. Dean Edell’s medical segment on the televised evening news. Paul agreed, and on the show, he said the difference between being intact and then circumcised is like first seeing in color and then only seeing in black and white.

Surgical Revision of Circumcision Scars, Bumps, and Lumps

Corrective surgery for scars may involve separating the dartos fascia around the penis from the underlying skin, releasing tension in the affected area, and allowing for more movement to reduce inflammation and flatten out raised tissue. Excess skin or fat tissues may be removed and stitched onto other irregularities to smoothen the skin contour. Of course, there is always the possibility of infection. The best thing is not to circumcise baby boys, which would completely prevent the need for surgical revision to begin with.