Circumcision and Urology Review Questions with Complete Solutions Graded A+

Circumcision and Urology Review Questions with Complete Solutions Graded A+ what is circumcision? - Answers -surgical removal of the foreskin of the penis to expose all or part of the glans for therapeutic, prophylactic, ritual or religious reasons history of circumcision - Answers -practiced in Egypt at least 6000 years ago *reason not known. some mummies circumcised, some not -spread from Egyptians to other Semetic people (Jews, Arabs, East Africans) -Romans and Greeks did not circumcise but promoted circumcision in Jews in order to identify them -europeans have traditionally not practiced circumcision -England: in 1800's became popular -in 1950, was deemed "elective" rather than "routine" so no longer covered by national health insurance modern religion stances on circumcision - Answers -Jewish: circumcise on the 8th day -Muslims: circumcise prepubertal boys -Christian: no stance one way or the other Ethnicities and circumcision - Answers -do circumcise *Muslims *50% Americans *50% Canadians -do not circumcise *Europeans *Asians (except Phillipino) *Latin Americans advantages to circumcision - Answers -decreased incidence of UTI in first year of life *1/1000 in circumcised males *1/100 in uncircumcised males -decreased rate of squamous cell cancer of the penis but actual rate is only 1:100,000 Balanitis - Answers -infection of the foreskin -generally caused by staph and strep organisms -can cause inflammation leading to phimosis -recurrent balanitis is an indication for therapeutic circumcision Phimosis - Answers -inability to retract foreskin -normal in neonate -foreskin should be fully retractable by age 4 -can be a problem if obstructive (if it blocks urine flow) Paraphimosis - Answers -when a "tight" foreskin is retracted and forms a tourniquet around the glans -surgical emergency STI's and circumcision - Answers -decreased incidence of ulcerative lesions caused by sexually transmitted infections -HIV in high risk populations *new evidence from Africa indicates that circumcision in prepubertal boys can decrease likelihood of developing AIDS (mucosa surface of foreskin contains T4 cells and Langerhans cells-HIV targets) Objections to circumcision - Answers -invasive procedure without clear advantage to patient -unnatural -decreased sexual sensation and pleasure circumcision techniques - Answers -Plastibel method -Gomco -Mogen clamp Plastibel circumcision advantages and disadvantages - Answers -very safe, good for students -disadvantage: leaves an unsightly and in rare cases, dangerous, foreign body in place Gomco circumcision advantages and disadvantages - Answers -very good technique in