By Mariam Msangi – Art in Tanzania internship
Circumcision is defined as the surgical removal of the foreskin. The foreskin retractable fold of skin that covers the end of the penis. It is the continuation of the skin that covers the whole penis. Male circumcision has been shown to considerably reduce the risk of sexually acquired HIV infection. Male circumcision is defined as the complete removal of the entire foreskin (the skin that can be rolled forward or back over the head of the penis) and it may be carried out for a number of reasons. Medical reasons: in men, circumcision is most commonly carried out when the foreskin is tight and won’t pull back (retract). Non-medical reasons: circumcision is a common practice in the Jewish and Islamic communities, and it’s also practiced by many African communities. Most non-medical circumcisions are carried out on children.
Medical reasons for men to have a circumcision
In men, circumcision is sometimes considered a possible treatment option for the following conditions.
Tight foreskin (phimosis): phimosis is where the foreskin is too tight to be pulled back over the head of the penis (glans). This can sometimes cause pain when the penis is erect and, in rare cases, passing urine may be difficult;
Recurrent balanitis: balanitis is where the foreskin and head of the penis become inflamed and infected;
Paraphimosis: paraphimosis is where the foreskin can’t be returned to its original position after being pulled back, causing the head of the penis to become swollen and painful. Immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis;
Balanitis xerotica obliterans: this condition causes phimosis and, in some cases, also affects the head of the penis, which can become scarred and inflamed;
Cancer of the penis: is a very rare type of cancer, where a red patch, wart-like growth or ulcer appears on the end of the penis or under the fore.
Male Circumcision Acceptability
In Tanzania Several observational studies have shown that the traditional patterns of circumcision in Tanzania are changing a substantial number of men belonging to traditionally noncircumcising tribes have been circumcised. For instance, the prevalence of male circumcision increased from 19% to 30% in 2004 in the traditionally non-circumcising populations in Mwanza Region. The prevalence of male circumcision was 21% in selected communities of Mwanza Region in 1994 and 54% in the 2003/04. The changes in the pattern of circumcision may be due to health reasons, social mixing between circumcising and non-circumcising cultures, desire for sexual pleasure. With regard to health reasons, circumcised men are believed to be less susceptible to STDs because the foreskin secretes dirty fluid which is a favourable medium for the growth of disease-causing agents and may be a source of bad smell and also circumcised men heal genital ulcers much faster compared to uncircumcised men. The urbanisation in Tanzania and the establishment of district capitals with government officials from all over the country has led to increased mixing of circumcising and noncircumcising ethnic groups. The mix of ethnic groups is most obvious in secondary schools, and has led to increased acceptance of male circumcision.
Rate of circumcised men in Tanzania
An estimated 70 percent of Tanzanian men are circumcised, according to government surveys, but prevalence varies from region to region. In some districts up to 80 percent of men especially in the western parts of the country are not circumcised. For this case there has to be more effort in providing more education to people so as to increase the rate of circumcised men and reduce the rate of transmission disease such as HIV, STD’S and other infections.
There is some evidence that circumcision has health benefits, including:
- Less risk of urinary tract infections;
- A reduced risk of some sexually transmitted diseases in men;
- Protection against penile cancer and a lower risk of cervical cancer in female sex partners;
- Prevention of balanitis (inflammation of the glans) and balanoposthitis (inflammation of the glans and foreskin);
- Prevention of phimosis (the inability to retract the foreskin) and paraphimosis (the inability to return the foreskin to its original location;
- Circumcision also makes it easier to keep the end of the penis clean.
Like any other surgical procedure, there are risks in getting circumcision. But this risk is low. Problems linked to circumcision include:
- Risk of bleeding and infection at the site of the circumcision;
- Irritation of the glans;
- Higher chance of meatitis (inflammation of the opening of the penis);
- Risk of injury to the penis.