One of the best articles that I have read on circumcision appeared in JAMA in or around 1973, and was entitled 'Whither the foreskin?'. I believe that a good many physicians, including myself, re-evalauted their attitude to, and practice of, circumcision following that publication. It was such an easy operation to perform compared to, say tonsillectomy or vagotomy, and the parents -- but not the patient -- were so grateful. Sure, one read of occasional disasters,including death, following neonatal circumcision, but they all happened to other doctors.

Parents, but not the patients, still ask me to perform neonatal circumcision, to which I reply with a firm and absolute "No".

"Well how do I clean under Billy's foreskin?" they ask.

"You don't.", I say. "Leave it alone! Do nothing. Do unto a son's foreskin as you would to a daughter's vagina. Don't touch it."

The occasional case of balanitis that I have seen seems to follow a mother's attempts to retract the foreskin, often on the advice of a friend or another physician or as a result of the prolonged wearing of wet diapers.

Bob Holmes, MB, BS, LMSSA, FRCSC

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