Circumcision is the most frequently performed operation in childhood in our country, as it is in all Muslim countries, due to religious beliefs and traditions. In fact, although it is basically a surgical intervention, since it is not an operation performed for therapeutic purposes, it can be widely applied by non-physicians and often far from the rigor and principles required by surgical procedures.
In our country, circumcision is mostly performed by circumcisers. Some survey studies have revealed that even parents with higher education in the society do not mind having their children circumcised by circumcisers. The social dimensions of the circumcision process, which is generally considered as “stepping into manhood”, far exceeds the health dimension. Circumcision halls, weddings, clothes and accessories, and some traditional habits have caused circumcision to become a sector. In fact, this process, which is so worrying for the child, has a ceremonial meaning by the family members, and the social aspect of circumcision is emphasized rather than the health aspect.
Circumcision is the surgical removal of the skin part called “preputium” in the penis. However, the importance of this process is unfortunately either ignored or interestingly underestimated even by families. In our country, who can carry out this operation is determined by the provisions of the “Law No. 1219 on the Execution of the Medicine and Medicine Arts” prepared in 1928, and it is not allowed to carry out this operation by unlicensed and unlicensed persons. However, a license may be granted to a person who does this work for a period of 10 years. The limitations brought by this law are extremely inadequate in today’s conditions, in the age of modern medicine, and it is necessary to introduce a new set of regulations.
Since circumcision is an operation performed in our country, mostly at home, in the health cabin or in a corner of the wedding halls, far from all kinds of medical conditions, often by incompetent people, the complication rate (1-38%) is not at all. not to an insignificant level. In our country, there are many articles published in both domestic and international journals on these complications. Many circumcision complications applied to our clinic by non-specialists every year. These complications include infection at the wound site, bleeding, incomplete or excessive cutting of the foreskin, injury of the urinary tract (urethra), and partial or complete incision (amputation) in the penis. Some of these complications can be partially or completely corrected by surgical interventions. However, sometimes it requires much more severe corrective surgical operations, and sometimes it may result in permanent disabilities despite all kinds of surgical interventions. As a result, mental and sexual problems that can affect the child’s life for life arise and may cause unhealthy individuals to join the society.
One of the most important problems experienced in circumcision in our country is “collective circumcisions”. Although such initiatives seem to be made for a “charity” purpose, unfortunately they serve the advertisement of individuals, institutions or organizations. It is inevitable that complication rates will be high after these “so-called services”, which take place in a limited time, in extremely inappropriate and unhealthy environments, often in chaos.
Circumcision is one of the most frequently performed operations in childhood in Western countries, Christian and Jewish societies. However, differently, in these societies, circumcision is carried out by experts in extremely healthy operating room conditions, by fulfilling all the requirements of modern medicine and surgery. Naturally, the complication rate is also extremely low.
Circumcision is a surgical procedure. Therefore, it should ideally be performed in accordance with the requirements of the surgical intervention. It should be performed in the operating room and under general anesthesia, without time constraints, in a safe and healthy way. Sometimes families have concerns about general anesthesia. Unfortunately, the fact that very few unfortunate practices have been exaggerated and brought up repeatedly in the media causes families to have great concerns about this issue and to move away from the idea of general anesthesia. Today, however, anesthesia is administered by specialists in an extremely safe way. Advances in medicine have also reached a high level in the science of anaesthesiology. Today, anesthesia can be applied safely without any problems, even for much heavier and larger operations. In addition, it should be kept in mind that the rate of complication development in circumcisions performed under unsanitary conditions by non-specialists is statistically much higher than in general anesthesia. Therefore, superficial general anesthesia to be applied for circumcision is extremely comfortable for both the child and the surgeon, rather than being a problem.
Children are afraid of circumcision whether they show it or not. In our country, circumcision is mostly performed between the ages of 6-8. No matter how effectively local anesthesia is applied in a child who has not yet completed the psychological developmental stages, circumcision is a source of great concern for the child. In addition, as the experiences of those who have been circumcised before are shared among friends, this anxiety may settle in children early and the fears experienced may grow exponentially. Because, from a child’s point of view, a piece of his limb will be “cut off”. Although it is more weighty in the psychological developmental stage called the “Phallic Period”, a surgical intervention for the genital area, which is performed in a hurry and where he will experience every stage under local anesthesia in inappropriate environments, may cause a psychological trauma in the child. General anesthesia provides an advantage in this respect as it allows the most traumatic part of the circumcision to be performed without being felt by the child.
Improving circumcision practices in our country and society is an inevitable necessity. It should not be forgotten that circumcision is a surgical procedure. For this reason, it should ideally be performed in a hospital setting, with the severity of an operation, by specialist and experienced physicians. The probability of developing both medical and psychological complications in circumcisions performed under appropriate conditions is extremely low.
