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Tuesday, March 20, 2012

In Talking to a Urologist

At today's bris, the mohel was actually the baby's grandfather, a Urologist by profession. I served as the facilitator and the bandager, setting things up and taking care of the baby afterwards [see here, where I describe what is done when I play this role, in the context of a father who "blanked" in the heat of the moment].

Just a few observations from a Urologist who has been around the block a few times, with whom I chatted for a few minutes afterwards.

1. When I opened the diaper at the bris, he spontaneously said, "Wow. You already marked it!" He told me afterwards that he always marks the foreskin when he does a surgery (which I would have assumed anyway), and he's never seen any other mohel who did this. I personally know of a couple of mohels who do mark the baby - but I still can't figure out what it isn't a more common practice. For the sake of the baby!

2. Personal observation is that mohels generally do a better job than physicians who do circumcisions. This may be because we are not averse to taking off a little more skin than a little less skin. [I'll add from my own experience watching doctors circumcise that some doctors are of the opinion that any minimal amount of skin removed from the tip constitutes a circumcision. We are looking for the glans to be completely cleared - which is why we estimate a little more skin to be removed.]

3. At the same time, if a repair will be in order, it is always better to have removed less skin than more. [which is really why you want it done right the first time.

4. It is better to take off more skin at the top (the dorsal side) than on the ventral side.

5. At the same time, the "penis is a very forgiving organ. It has a way of working things out as it heals and grows."

When I asked him what are the kinds of cases he generally sees, when "touch-up is required," he mentioned that some people leave over too much membrane and it either becomes a little unsightly or develops skin tags. [I take care of these at the bris, when necessary, in order to avoid these problems down the road.] These are not a big deal to repair, but - [again, I ask] wouldn't it be better to get it right the first time.

He told me of the worst case he ever dealt with (over 20 years ago), which was when a mohel amputated the glans [which should never happen - it's a very simple precaution (see approach #2) with the use of a shield]

And he even told me of a certain mohel (did not mention name) who should not be in the business. Too many "not good" stories. Not that the man is not a nice person. On the contrary - but he's like the caterer who can't cook a proper dish. He should not be in this business.

Very enlightening.

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