Frequently Asked Questions
What to Do When Your Son’s Circumcision Goes Wrong:
1. What is a Botched Circumcision?
Circumcisions can be botched in many ways. The most common error is to remove too much penile shaft skin. This can result in excessive bleeding and an attempt to cover the wound with skin from the base of the penis. When the wound heals the effective length of the penis is reduced, the junction of the scrotum and the penis is pulled onto the shaft, and at puberty pubic hair will appear on the shaft of the penis. Surgery can only partially correct these conditions. Another result can be the “burying” of the penis in the pubic fat pad, which requires surgical correction and often results in an unsightly bulge of skin in the mid-shaft area. Upon occasion the round end of the penis, called the glans, can be cut or cut off in whole or in part. If the severed part is not immediately re-attached the boy will have a permanent and serious disfigurement. Not all re-attachment attempts are successful. These are just a few of the preventable errors that occur with circumcisions.
2. How Common are Botched Circumcision?
No one knows how often circumcisions are botched. But surgical errors, all of which are preventable by careful attention to detail, are quite common. Taking off too much shaft skin seems to be the most common error, as many men complain that they have hair on the shaft of their penis, that their scrotum is pulled up on the shaft when they are erect, and/or that the skin of the shaft is too taut when the penis is erect. Many men with penises that appear to be “buried” when they are not erect are victims of botched circumcisions but do not realize it. Some circumcisions result in damage to the glans – either through cutting of the glans or strangulation of it by a retained plastic ring or otherwise. Some babies bleed to death either immediately or later when a scab is disturbed. Some infants die of anesthetic errors if circumcision is done under general anesthesia.
3. Are There Contraindications for Circumcision?
Yes. Any anomaly of the penis is a contraindication. One out of at least every 150 boys is born with hypospadias, a condition where the urinary opening is not at the tip of the penis, but is on the underside. Such boys should not be circumcised except upon the advice of a pediatric urologist. Other congenital anomalies include webbed penis, buried penis, congenital chordee or bending of the penis, penile torsion, abnormalities of the foreskin including a very short foreskin, and ambiguous genitalia. In all of these cases it is malpractice for a circumcision to be performed without the advice and perhaps participation of a specialist.
4. What Should I Do if I Think My Son’s Circumcision is Botched?
Find out the names of the doctor who did the circumcision and of all of the hospital staff involved in assisting. Take in focus, digital photos of your son’s damaged penis as soon as possible and every day as the penis heals. Upon discharge from the hospital order a “certified” copy of his medical records and of his mother’s records. Keep a daily diary noting any discomfort your son feels, any fussiness he exhibits, and any other difficulties he encounters such as difficulty in breastfeeding, sleeping,or urinating. See a pediatric urologist right away. Follow all medical advice. Immediately contact a lawyer who is knowledgeable about botched circumcisions and who concentrates on medical malpractice cases in general and circumcision cases in particular. DO NOT agree to any settlement with the doctor or the hospital until you have met with a lawyer. Many times one or both will try to get you to “settle cheap and fast” before you have legal representation. This is always a bad idea.
5. Can Adult Circumcisions be Botched?
Absolutely. Most adult circumcisions are done by the “sleeve resection” method. If the surgeon does not estimate correctly how much skin to leave he will take off too much shaft skin, will cover the shaft with pubic hair bearing skin from the base of the penis, will advance the junction of the penile shaft and the scrotum from the base of the shaft to mid-shaft or beyond. This results in a penis whose functional length, both flaccid and erect, has been significantly reduced. Erections can be impossible or painful. Other errors include re-circumcision of a circumcised man, which is almost always malpractice, cutting into the neurovascular bundle on the shaft resulting in numbness of the glans, and causing other damage to the glans. Anyone who thinks he has suffered circumcision damage should seek advice from a lawyer experienced in circumcision cases.
6. Why Was I Not Warned About the Risks?
It is an unfortunate fact that doctors often do not fully discuss the risks and disadvantages of circumcision with parents or their patients before obtaining consent for the operation. Too often circumcision is viewed as a minor surgery. [Of course, the definition of minor surgery is that which is done on another, while major surgery is that which is done on oneself!] The fact is that in most states the parents of a baby boy or the man about to undergo a circumcision are entitled to be fully informed about the risks and disadvantages. If such is not done, circumcision is performed, and a reasonable person would not have consented if told about the risks and disadvantages, then a suit may be brought for “lack of informed consent.”
Additional Resources:
Stanford Medical School has excellent information with photographs of contraindications and complications of newborn circumcisions at http://newborns.stanford.edu/Circumcision.html. Other excellent sources on circumcision in general include www.cirp.org, www.circumstitions.com, www.nocirc.org, www.intactamerica.org, www.circumcision.org, www.doctorsopposingcircumcision.org, www.foreskin.org, www.mothersagainstcirc.org, www.intact.ca (video of a circumcision), www.drmomma.org, and www.circumcisionandhiv.org. Most of these latter sites oppose neonatal circumcision, but all provide what I believe to be accurate information.
What to Do When Your Baby Boy Has Been Circumcised Without Your Consent:
1. What is Wrongful Circumcision?
Circumcision is the surgical removal of the foreskin of the penis, that structure that covers the round end of the penis known as the glans. Circumcision is not medically necessary or even desirable as it removes a structure that is now known to protect the glans penis and to provide sexual pleasure to both the owner and his sexual partner. (See www.cirp.org). More and more parents are deciding against circumcision. They refuse to consent to it for their son. Unfortunately, on occasion either the hospital staff or the doctor or both make a mistake that results in the circumcision of a boy whose parents have decided he should not be circumcised. When this occurs it is both a legal “battery” (a harmful or offensive touching of the body without consent) and medical malpractice (failure to follow the standard of care applicable to the medical professional in the circumstances). Wrongful circumcision results in pain, suffering, and damage for which your son should be compensated.
2. What Should I Do if My Son is Circumcised Against My Wishes?
You should immediately find out the names of the doctor who did the circumcision and of all of the hospital staff involved in assisting. Take good, in focus, digital photos of your son’s damaged penis as soon as possible and every day as the circumcision heals. Upon discharge from the hospital order a “certified” copy of his medical records and of his mother’s records. Keep a daily diary noting any discomfort your son feels,any fussiness he exhibits, and any other difficulties he encounters such as difficulty in breastfeeding or sleeping. Immediately contact a lawyer who is knowledgeable about circumcision and its bad effects and who concentrates on medical malpractice cases in general and circumcision cases in particular. DO NOT agree to any settlement with the doctor or the hospital until you have met with a lawyer. Many times one or both will try to get you to “settle cheap and fast” by offering a settlement before you have legal representation. This is always a bad idea.
3. Why Do I Need a Lawyer Who is Familiar with Circumcision Issues?
Because circumcision has been so common until recently in the United States many lawyers do not realize the value of the foreskin or the harm, including the pain, suffering, and disfigurement, caused by circumcision. This lack of knowledge causes them to undervalue the case and to settle for far less than the case is worth. It is important to have a lawyer who is familiar with normal penile anatomy and with the function of the foreskin, as well as the extensive medical literature on all sides of the circumcision issue, since such a lawyer can best represent your son and get him the compensation he deserves.
Additional Resources:
The best general resource is www.cirp.org. Other excellent sources include www.nocirc.org, www.intactamerica.org, www.circumcision.org, www.doctorsopposingcircumcision.org, www.foreskin.org, www.mothersagainstcirc.org, www.intact.ca (video of a circumcision), www.drmomma.org, www.circumcisionandhiv.org, and www.circumstitions.com.