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Circumcision: Men
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If circumcision reduces ulcerative genital diseases in men and ulcerative diseases such as HCV infections are a co-factor for HIV infection, then the effect should be lower HIV infection rates over all. That's one of the theories anyway behind prophylactic circumcision. Yet a large study presented at the 15th Conference on Retroviruses and Opportunistic Infections using Aciclovir to suppress HCV in infected individuals should in theory ... have reduced HIV infection in the HCV infected group and their partners. That didn't happen.
The effect of circumcision on penile sensation or sexual satisfaction is unknown. Because the epithelium of a circumcised glans becomes cornified, and because some feel nerve over-stimulation leads to desensitization, many believe that the glans of a circumcised penis is less sensitive. Opinions differ about how this decreased sensitivity, which may result in prolonged time to orgasm, affects sexual satisfaction. An investigation of the exteroceptive and light tactile discrimination of the glans of circumcised and uncircumcised men found no difference on comparison. (24) No valid evidence to date... supports the notion that being circumcised affects sexual sensation or satisfaction.
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The oldest documentary evidence for circumcision comes from ancient Egypt. Tomb artwork from the Sixth Dynasty (2345-2181 BCE) shows men with circumcised penises, and one relief from this period shows the rite being performed on a standing adult male. The Egyptian hieroglyph for "penis" depicts either a circumcised or an erect organ. The examination of Egyptian mummies has found some with foreskins and others who were circumcised.
Complications as a result of circumcision are usually minor if the physician is experienced and makes sure the Mogen or Gomco clamps that are used are in good working order. Severe penile injuries are rare, but they are serious, and include penile amputation (partial or total), laceration, hemorrhage, and damage to the urinary tract. Other serious complications such as meningitis, penile necrosis, necrotizing faciitis, and sepsis can occur. Some of these, like meningitis and sepsis, can even cause death.
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The authors concluded that public sector capacity in Soweto to perform circumcision would have to be substantially improved to deal with the caseload required for sufficient numbers to have a public health impact. Circumcision of 60% of the male birth cohort (estimated at 15,000/year) would require at least 8,000 procedures per year, not including expansion to other uncircumcised men. The reason for variation in adult procedures by season is not clear, but ... poses a challenge for planning services.
In August, the actual ceremony of initiation was preceded by a "week of seclusion," which emulated the traditional healing period after circumcision. The young women were accompanied by female mentors during this week, who taught them skills they will need for their own families. Other community trainers instructed the young women on issues such as sexually transmitted diseases, relationships, and reproductive anatomy.
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