LYCOS RETRIEVER 
Circumcision: Infants
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Circumcision substantially reduces an infant´s chances of getting a urinary tract infection (UTI) during the first year of his life. Although the rate of urinary tract infections for infants is not very high (around xxx %), UTI´s are becoming increasingly difficult to treat (see here for a discussion).
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Significantly, virtually all that has been written about circumcision over the centuries ignores the infant's experience. An infant being circumcised is restrained while having part of his body cut off. Imagine yourself in the same situation. From the infant's perspective, this is a physical attack. His physical struggle to escape and his piercing screams are evidence of an appropriate response to attack. It is a violation of Torah law to physically assault or harm another person (Exodus 21:18-27).
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Despite a long-standing belief that infants do not experience serious pain from circumcision, physicians now believe that some form of local anesthesia is necessary. Over 80% of pediatric residents, 80% of family practice residents, and 60% of obstetric/gynecological residents are routinely given instruction on pain control for circumcisions. Local anesthesia is often injected at the base of the penis (dorsal penile nerve block) or under the skin around the penis (subcutaneous ring block). Both anesthetics block key nerves and provide significantly lowered perceived pain. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) can ... be used.
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Newborns experience pain during circumcision. (1) When anesthesia is used, methods include the topical eutectic mixture of local anesthetics (EMLA), the dorsal penile nerve block (DPB), and the ring block. A randomized controlled trial investigating these methods in 52 infants found that all provided more analgesia than placebo based on heart rate, cry, and methemoglobin levels, and that the ring block was the most effective. (25) Complications from local anesthesia are uncommon and consist mainly of hematomas and local skin necrosis. The most common complication is bruising; one study on complications found bruising in 11% of neonates who had a DPB, (26) and another found a minor complication rate of 1.2%, of which bruising was the most frequent. (27) There have not been any studies to evaluate the long-term complications of the various analgesics.
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INTRODUCTION — Circumcision in the male is the removal of the foreskin of the penis. The practice of circumcision dates to ancient times. In ancient Egypt, prior to biblical times, circumcision was performed to improve male hygiene. Later, routine circumcision of male infants was part of the Abrahamic covenants with Jehovah, giving rise to religious circumcisions that continue to this day in the Jewish and Muslim faiths.
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When done without pain medicine, circumcision is painful. There are pain medicines available that are safe and effective. It is recommended that they be used to reduce pain from circumcision. Local anaesthetics can be injected into the penis to lower pain and stress in infants. There are ... topical creams that can help. Problems with using pain medicine are rare and usually not serious.
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