Circumcision Vasectomy Jelena Marinkovi Mentor A mega Horvat

Circumcision & Vasectomy Jelena Marinković Mentor: A. Žmegač Horvat 1

Definition • removal of some or all of the foreskin (prepuce) from the male reproductive organ 2

History • religious sacrifice • rite of passage marking a boy's entrance into adulthood • form of magic to ensure virility • means of suppressing sexual pleasure • increasing a man's attractiveness to women • aid to hygiene Ancient Egyptian carved scene of circumcision Family circumcision set and trunk, eighteenth century Circumcision being performed in central Asia, (most likely Turkestan) c. 1865 -1872 3

Cultures and religions • commonly practised in the Jewish and Islamic faiths • the Catholic Church condemned circumcision as a mortal sin and ordered against its practice Jewish ritual circumcision Illustrated account of the circumcision ceremony of Sultan Ahmed III's three sons Circumcision of Jesus. Illumination from a missal, ca 1460 4

Prevalence • the proportion of males that are circumcised worldwide vary from one-sixth to a third • 70% Muslim • most prevalent in the Muslim world, parts of South East Asia, Africa, United States, Philippines, Israel, South Korea Grey = No data; Yellow = <20% prevalence; Orange = 20 -80% prevalence; Red = >80% prevalence 5

Circumcision procedures • in some African countries, male circumcision often performed by non-medical personnel under unsterile conditions • in parts of Africa, the foreskin may be dipped in brandy and eaten by the patient, eaten by the circumciser, or fed to animals • according to Jewish law the foreskin should be buried • after hospital circumcision, the foreskin may be used in biomedical research, consumer skin-care products, skin grafts, or β-interferon-based drugs 6

Controversy • ethical issues • psychological and emotional consequences • legal issues Protest against routine infant circumcision Group advocating stopping infant circumcision demonstrates on the U. S. Capitol lawn in Washington, D. C. , in March 2008 7

Medical aspects • medical cost-benefit analyses of circumcision vary • pain and pain relief • sexual effects • complications (0. 06% to 55%) • sexually transmitted diseases • hygiene, infectious and chronic conditions • penile cancer 8

Vasectomy • minor surgical procedure wherein the vasa deferentia of a man are severed, and then tied or sealed in a manner such to prevent sperm from entering the seminal stream • first use in 1899 (experiments from 1785) 9

Types • • typically done in outpatient setting no-scalpel method "open-ended" "Vas-Clip" method 10

Benefits • prevention of pregnancy • no need for general anesthesia • lower cost compared to other surgical sterilization procedures Risks • bleeding with formation of hematoma • chronic testicular pain • infection • failure of the vasectomy to prevent pregnancy (1 in 2000) • regret and a desire to reverse the vasectomy • formation of a sperm granuloma 11

Tubal ligations vs. vasectomy 12

Reversal - vasostomy • effective at achieving pregnancy in only 50%70% of cases • $7, 000 • frequently impermanent • higher rates of aneuploidy and diploidy in the sperm cells 13

• in 1976, a huge government campaign for sterilization was launched - responsible for the sterilization of millions of Indian couples 14

THE END “Vasectomy means not ever having to say you are sorry” Larry Adler , an American musician 15