In response to a previous post, “Circumcision–A New Perspective | Long Lasting Implications ” a reader named Elizabeth wrote:
“Glad you gave your patient tender care. But I do think that this case points more what is lacking in the system (time, skilled attendants, knowledge) rather than that this gentleman escaped RIC. I can imagine infections/conditions of all kinds might thrive in a struggling system. For men and women. If these stresses on “the system” look unsolvable, maybe it would be more fair to offer adult circumcision upon being eligible for medicare. (If our leaders allow it to still exist) That way, men don’t miss out on a whole lifetime of benefits of having a foreskin. Was wondering if you are in communication with any nurses in Europe anywhere. Do they feel the same way? Most men in Europe are not circumcised, so I wonder how common problems are for them, as they age.”
Elizabeth, thank you for reading and commenting. Many of my blog entries focus on “what is lacking in the system,” and my post is just as much about the state of U.S. health care as it is about circumcision.
To your point regarding elective adult circumcision, I just finished a contract at an ambulatory surgical center and I recovered many men in their 30s who underwent the procedure. All of the patients that I cared for were circumcised in an attempt to resolve chronic infections in which all other treatment options had been exhausted. Through conversation, each of them stated, in one way or another, that they would not have undergone circumcision if it had not been a last resort.
Medicare does not cover an adult circumcision to prevent future infections unless there is a documented history of infection. A costly, out-of-pocket adult circumcision to prevent an uncertain outcome secondary to aging is not recommended by doctors nor is it appealing to men. Fear associated with manipulating a man’s healthy penis far outweighs anything he can imagine happening in his twilight years.
You bring up a good point about infection rates in nursing homes in Europe. However, care for the elderly and the culture of aging is different, so much that a comparison is difficult. Families assume care of their elderly in the home and socialized medicine has altogether different priorities than American healthcare facilities. Owning a nursing home in America is a profitable business as long as staffing is poor, the pay is low, and education is minimal.
Also, there are no billable tracking codes to follow foreskin related infection rates in U.S. nursing homes and the only evidence is anecdotal; empirical data is needed. Therefore I offer my perspective on circumcision not as a directive, but as a discussion point.
Elizabeth, I’m glad you are continuing the conversation in a thoughtful way. I hope that others continue to do the same.
[For anyone considering the procedure, this is a link to the personal blog of a 22 year old Canadian man who elected to have the procedure because of visual and functional issues rather than infection.]