From: fo6a001 my first email address@rrz.uni-hamburg.de (Robin Stuart)
Newsgroups: sci.med
Subject: Re: Male Circ. - The Third Perspective
Date: Mon, 30 Sep 1996 13:41:41 +0200

A RE-INTERPRETATION of OSTER

Statistics and the self resolving possibilities of phimosis

Dr. Med. Werner Schoeberlein says that "in medical examinations of 3,000 young men, mostly of an age between 18 and 22 years. . . . A phimosis was found in 8.8%." (1)

Beauge M.D. reports "nearly 10%" of young men between the ages of "18 to 22" had phimosis. He was "in charge for over ten years of the routine examination of college freshmen" he recommended "treatment for 30 to 40 boys annually". He says he had "observed several hundred cases", l feel we may conservatively calculate that his study involved at least 4,000 men.(2)

If phimosis (according to Oster) is self resolving, why do Beauge and Schoeberlein report such high figures?

Either, 1) Coupled with Oster's yearly careful attempts at retraction, he says "the boys received regular instruction about preputial hygiene". This instruction started previous to puberty, and it may have helped to relieve phimosis to some extent, Or, 2) boys with sexual inhibitions stay away from school when they know their penis will be examined, . . . . . or 3) he was wrong.

I feel we can discount the idea that the relationship foreskin to glans develops eratically around the age of 16-18, and the proximity in Europe suggests there is no important dietary difference or any basic anatomical difference (as there is between say the Chinese, and Europeans).

Have you any other suggestions? what other possibilities are there?

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Beauge reports that instruction over normal methods of masturbation cured many of his patients. This would correlate with Oster's regular instruction, with attention to the retraction of the foreskin. Surely if Beauge was correct, the sooner such a process could begin with a young boy, the more possibility it would have of working.

I suspect that a phimose or frenulum breve which had been stretched in youth would need a more permanent cure in later years, particularly in old age as the preputial skin tightens again. This would at least give an individual time to think.

Anyone want to comment? - or shall we presume this re - interpretation is correct?

1) Dr. Med. Werner SCHOEBERLEIN "Bedeutung und Haufigkeit von Phimose und Smegma" Muenchener Medizinische Wochenschrift 7, pages 373 - 377 (1966)
https://www.rrz.uni-hamburg.de/fo-p1/schoeberlein.html

2) Michel BEAUGE M.D. "Traitment Medical du Phimosis Congenital de L'adolescent" Thesis for the University Diploma of Andrology. Faculty of Medicine, Saint-Antoine University. Paris V1. University Year 1990-1991
http://www.cirp.org/CIRP/library/treatment/phimosis/beauge/

3) Jacob OSTER:"Further Fate of the Foreskin" Archives of Disease in Childhood (published by the British Medical Association), April 1968. 43:p.200-203.
http://www.cirp.org/CIRP/library/general/oster

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Saitmacher studied only 229 boys (ages 14-19) and found 8.7% where "the foreskin could be retracted only with difficulty or with pain"

4) Dr. med. F. SAITMACHER : "Sozialhygienische Betrachtung zu einer routinemaessigen Zirkumzision maennlicher Saeuglinge" Das Deutsche Gesundheitswesen Jahrgang 15 Heft 23 Pages 1217-1220 (1960) p.1218.

Apart from the above four studies, are there any others which review the statistics??

Robin Stuart
https://www.rrz.uni-hamburg.de/fo-p1/welcome.html

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EXTRA CONFUSION from OSTER

Oster never adds his figures for phimosis and tight prepuce together, this would make 2.4% and not 1% in the 16-17 yr.old age group. Mathematics can't have been Oster's strong point.

His closing words are "1086 boys observed in 1964-65" led to "1052 observations"

Apart from French and German studies), every medical study which mentions statistics, quote Oster's figures, . . . or other sources which in turn quote Oster. (e.g. see the anti-circ. library :"CIRP"),

(The only exception is a reference to Dr. Spock. While confirming Oster's ideas - Spock gives no references, need we ask where his ideas comes from?) - (This is all no reflection on CIRP, it is a reflection on medical information).

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Iatrogenic cases?

Oster suggests that some cases of phimosis may be caused by the doctor's interferance in the normal and natural growth process, he says "raising the possibility that the phimosis in these cases may have been iatrogenic."

In reports from parents about operations before and at puberty, they always say no-one checked, and no-one told them how to check, just all at once their child had either paraphimose or, an infection and a phimose.

One medical report EX-CIRP/library, from Kikiros CS, Beasley SW, Woodward AA disagrees with Oster's "possibility" that early attempts at retraction may cause phimosis.

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EXTRA rather boring POINTS

The frequency of phimosis can not be established by adding up the medical diagnose on the circumcision operation's list. (Or from any individual doctor's opinion or guess).
1) Most men do not openly complain about sexual problems, and in order to avoid embarrassment,would be happy with a diagnosis of "free choice".
2) A congenital primary phimosis can often lead to infections, and be cured for reasons of this secondary symptom. The reason such cases go to the doctor is because of the infection. At this stage there appears to be no way of establishing if the phimose is cause or effect of the infection. The infection is the most serious problem and the obvious diagnosis.
3) In addition paraphimose is not diagnosed as a phimosis.

Around a third of the cases I have spoken with, had problems with the frenulum breve, (for which there are no statistics.),and some of the others still had adhesions at puberty, these cases could not have been caused by doctors tampering. If the reports I heard were in actual fact, reports of secondary phimoses which had developed previous to puberty, then this indicates that children must be checked at the age of 8 or 9 years old, instead of 3 or 4yrs. old.

I believe the total figure is at least 10% simply because of the men I talked with. If there were only 1% then surely I wouldn't have heard of so many cases among the hundred or so people I asked.

As I say in the essay "If the statistics were only 1%, this would be too many". I believe, if parents were aware of a 1% chance, they would want to check their children.I have never seen any source references for this 1% figure, (or to which country such statistics refer) apart from Oster.

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Please continue with Prevention : new answers, new questions

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