[blparent] [Bulk] bathing an infant

[Amber Boggs]

Alizabith, Not to be rude, but do you have an intact boy? Were you around 
the mother every second of the day to no what and how she was doing  with 
her kid? Have you red books articles etc from well known and respected PEDS 
and doctors on Circomsition? Have you visited nocirc.org and red the 
articles on The care of an intact boy? If no to any of these questions, then 
I would be happy to pass on some information t oyou. I have no problems 
debaiting to circ or not to, and feel very strongly about keeping a boy 
intact, but to sit and see someone giving advice and telling people what 
will and can happen when they do not have one all the facts, and two have a 
circed boy and are only going on second hand experience, it makes me crazy. 
Here is just one of many many articles and well resurched advice about an 
intact baby and man.
Note this Part. "Thanks to the foreskin, the intact penis is protected from 
dirt
and contamination.
While this important protective function is extremely useful while the baby 
is in
diapers, the foreskin provides protection to the glans and urinary opening 
for a
lifetime. At all ages, the foreskin keeps the glans safe, soft, and clean.
Throughout childhood, there is no need to wash underneath the foreskin. 
Mothers used
to be advised to retract the foreskin and wash beneath it every day. This 
was very
bad advice indeed. When the foreskin becomes fully retractable, usually by 
the end
of puberty, your son can retract it and rinse his glans with warm water 
while he
is in the shower."
Protect Your Uncircumcised Son: Expert Medical Advice for Parents
By Paul M. Fleiss
Mothering Magazine, Issue 103, November/December 103
Increasing numbers of American parents today are protecting their sons from 
routine
circumcision at birth, but as their boys grow up, they often find themselves 
at odds
with doctors who cling to old-fashioned opinions and hospital routines.
I often receive calls from distraught parents who say that a doctor insists 
that
their little boy needs to be circumcised because there is something wrong. 
When they
bring their son into my office, I almost always find that there's nothing 
wrong with
the child's penis. Occasionally there's a slight infection, but that can be 
quickly
cleared up with an antibiotic cream. In all my years of practice, I've never 
had
a patient who had to be circumcised for medical reasons.
When a doctor advises that your son be circumcised, it's usually because he 
or she
is unfamiliar with the intact penis, misinformed about the true indications 
for surgical
amputation of the foreskin, unaware of the functions of the foreskin, and 
uncomfortable
with the movement away from routine circumcision.
Doctors can be psychologically challenged by the sight of an intact boy. 
They may
see problems with the penis that do not really exist. They may try to 
convince you
that the natural penis is somehow difficult to care for. They may cite 
"studies"
and "statistics" that appear to support circumcision.
Probably, the only problem you will encounter with the foreskin of your 
intact boy
is that someone will think that he has a problem. The foreskin is a 
perfectly normal
part of the human body, and it has very definite purposes, as do all body 
parts,
even if we do not readily recognize them. There's no need to worry about 
your son's
intact penis.
What to Say When the Doctor Says to Cut
Below is a list of some of the things that doctors have said to parents in 
an attempt
to convince them to agree to circumcision. After each incorrect statement, 
I've given
the medical facts to help you understand what your doctor may not know about 
the
intact penis and its care, and what you need to know to protect your child 
from unnecessary
penile surgery. If you ever find yourself in a situation where a doctor 
suggests
that your child should be circumcised, the best thing that you can say is 
simply:
"Leave it alone."
-Your son's foreskin should be cut off in order to facilitate hygiene.
My experience as a pediatrician has convinced me that circumcision makes the 
penis
dirtier, a fact that was confirmed by a study recently published in the 
British Journal
of Urology.1 For at least a week after circumcision, the baby is left with a 
large
open wound that is in almost constant contact with urine and feces--hardly a 
hygienic
advantage. Additionally, throughout life the circumcised penis is open and 
exposed
to dirt and contaminants of all kinds. The wrinkles and folds that often 
form around
the circumcision scar frequently harbor dirt and germs.
Thanks to the foreskin, the intact penis is protected from dirt and 
contamination.
While this important protective function is extremely useful while the baby 
is in
diapers, the foreskin provides protection to the glans and urinary opening 
for a
lifetime. At all ages, the foreskin keeps the glans safe, soft, and clean.
Throughout childhood, there is no need to wash underneath the foreskin. 
Mothers used
to be advised to retract the foreskin and wash beneath it every day. This 
was very
bad advice indeed. When the foreskin becomes fully retractable, usually by 
the end
of puberty, your son can retract it and rinse his glans with warm water 
while he
is in the shower.
-Your son's foreskin is too tight. It doesn't retract. He needs to be 
circumcised.
The tightness of the foreskin is a safety mechanism that protects the glans 
and urethra
from direct exposure to contaminants and germs. The tight foreskin also 
keeps the
boy's glans warm, clean, and moist, and when he is an adult, it will give 
him pleasure.
As long as your son can urinate, he is perfectly normal. There is no age by 
which
a child's foreskin must be retractable. Do not let your doctor or anyone try 
to retract
your child's foreskin. Optimal hygiene of the penis demands that the 
foreskin of
infants and children be left alone. Premature retraction rips the skin of 
the penis
open and causes your child extreme pain. There is no legitimate medical 
justification
for retraction. The child's discomfort is proof of that.
-Your son's foreskin is "adhered" to the glans. It must be amputated.
The attachment of the foreskin and glans is nature's way of protecting the 
undeveloped
glans from premature exposure. Detachment is a normal physiological process 
that
can take up to two decades to complete. By the end of puberty, the foreskin 
will
have detached from the glans because hormones that are produced in great 
quantities
at puberty help with the process. There is no age by which a child's 
foreskin must
be fully separated from the glans.
Some misguided doctors might suggest that the "adhesions" between the 
foreskin and
glans should be broken so that your son can retract his foreskin. This 
procedure
is called synechotomy. To perform it, the doctor pushes a blunt metal probe 
under
the foreskin and forcibly rips it from the glans. It's as painful and 
traumatic as
having a metal probe stuck under your fingernail to pull if off. It will 
also cause
bleeding and may result in infection and scarring of the inner lining of the 
foreskin
and the glans. The wounds that are created by this forced separation can 
fuse together,
causing true adhesions. There is no medical justification for this procedure 
because
the foreskin is not supposed to be separated from the glans in childhood. If 
any
doctor suggests this procedure for your son, firmly refuse, stating, "Leave 
it alone!"
-Your son's foreskin is getting tighter. It no longer retracts. Something is 
wrong.
He will have to be circumcised.
Sometimes, in childhood, a previously retractable foreskin will become 
resistant
to retraction for reasons that are unrelated to impending puberty. In these 
cases,
the opening of the foreskin may look chapped and sting when your son 
urinates. This
is not an indication for surgery any more than chapped lips. This is just 
the foreskin
doing its job. If the foreskin were not there, the glans and urinary opening 
would
be chapped instead. Chapping is most often caused by ov erly chlorinated 
swimming
pools, harsh soap, bubble baths, or a diet that is too high in sugar, all of 
which
destroy the natural balance of skin bacteria and should be avoided if 
chapping occurs.
The foreskin becomes resistant to retraction until a natural and healthy 
bacterial
balance is reestablished.
You can aid healing by having your son apply a little barrier cream or some 
ointment
to the opening of the foreskin. Acidophilus culture (which can be purchased 
from
a health food store) can be taken internally and also applied to the 
foreskin several
times a day to assist healing, and should be given any time a child is 
taking antibiotics.
-Your son's foreskin is red, inflamed, itching, and uncomfortable. It has an 
infection
and needs to be cut off.
Sometimes the tip of the foreskin does become reddened. During the 
diaper-wearing
years, this is usually ammoniacal dermatitis, commonly known as diaper rash. 
When
normal skin bacteria and feces react with urine, they produce ammonia, which 
burns
the skin and causes inflammation and discomfort. If the foreskin were 
amputated,
the inflammation would be on the glans itself and could enter the urethra. 
When the
foreskin becomes reddened, it is doing its job of protecting the glans and 
urinary
meatus.
Circumcision will have no effect on diaper rash. Change your baby's diapers 
more
frequently and use a barrier cream until the rash clears. Harsh bath soaps 
can also
cause inflammation of the foreskin. Use only the gentlest and purest of soap 
on your
child's tender skin. Resist the temptation to give your child bubble baths, 
because
these are harmful to the skin. Never use soap to wash the inner foreskin 
because
it is mucous membrane, just like the inner lining of the eyelid.
Foreskin infections are extremely rare, but if they occur, one of the many 
simple
treatment options is antibiotic ointment along with bacterial replacement 
therapy
(Acidophilus culture). We don't amputate body parts because of an infection. 
Most
infections of the foreskin are actually caused by washing the foreskin with 
soap.
Leave the foreskin alone, remembering that it doesn't need any special 
washing, and
infections will be unlikely to occur.
-Your son is always pulling on his foreskin. He should be circumcised.
I can assure you that, whether circumcised or not, all little boys touch and 
pull
on their penis. It is perfectly normal. Intact boys pull on the foreskin 
because
it is there to pull on. Circumcised boys pull on the glans because that is 
all they
have to pull on. Little boys sometimes will adjust the position of their 
penis in
their underpants. They will also sometimes explore the interior of the 
foreskin with
their fingers--a perfectly normal curiosity and nothing to worry about. It 
is important
for parents to cultivate an enlightened and tender congeniality about such 
matters,
otherwise they risk transferring unhealthy attitudes to their children.
Sometimes a boy will pull on his foreskin because it itches. All parts of 
the body
itch occasionally. Even a circumcised boy has to scratch his penis. Just as 
you don't
worry every time your child scratches his knee, so you should not worry when 
he scratches
his penis. If the itch is caused by dry skin, then have your son avoid using 
soap
on his penis. Treat the foreskin just as you would any other part of the 
body.
If the real fear is of masturbation, calmly remind yourself of the simple, 
natural
fact that all children will explore their bodies, including their genitals. 
Touching
their genitals gives children a pleasant feeling and relaxes them. Classic 
anatomical
studies demonstrate that the foreskin is the most pleasurably sensitive part 
of the
penis. You can congratulate yourself for having protected your child from a 
surgical
amputation that would have permanently denied him normal sensations.
-Your son's foreskin is too long. It should be cut off.
There is tremendous variation in foreskin length. In some boys, the foreskin 
represents
over half the length of the penis. In others, it barely reaches the end of 
the glans.
All variations are normal. The foreskin is never "just extra skin" or 
"redundant."
It is all there for a reason.
-Your child should be circumcised now because it will hurt more if it has to 
be done
later, or worse, when he is an adult.
This excuse is tragically wrong and has resulted in a very serious crisis in 
American
medical practice. It's based on the false idea that infants and young 
children don't
feel pain. Babies can see, hear, taste, smell, and feel. In fact, babies 
feel pain
more acutely than adults, and the younger the baby, the more acutely the 
pain is
felt. If an adult needed to be circumcised, he would be given anesthesia and 
postoperative
pain relief. Doctors almost never give babies either of these. The only 
reason doctors
get away with circumcising babies without anesthesia is because the baby is 
defenseless
and cannot protect himself. His screams of pain, terror, and agony are 
ignored. In
any event, this all too common excuse is merely a scare tactic, one with 
tragic consequences
for any baby forced to endure a surgical amputation without the benefit of 
anesthesia.
-Since your son is having anesthesia for another operation, we'll just go 
ahead and
circumcise him.
Most parents are never told that their son is in danger of being circumcised 
during
a tonsillectomy or surgery for a hernia or an undescended testicle. It would 
never
occur to them. If your child is going into the hospital for any reason, be 
certain
that you tell the physician, surgeon, and nurse that under no circumstances 
is your
child to be circumcised. Write "No Circumcision" on the consent form, too. 
Then if
your child is circumcised against your wishes, remember that you do have 
legal recourse.
-Your son has cysts under his foreskin. He needs to be circumcised.
During the period when the foreskin is undergoing the slow process of 
detaching itself
from the glans, sloughed skin cells (smegma) may collect into small pockets 
of white
"pearls." These are not cysts. Some doctors mistakenly think that the smegma 
under
the foreskin is an infection, even though it is white rather than red, is 
cold to
the touch, and is painless. As the foreskin proceeds with detachment, the 
body will
do its job, and these pearls will pass out of the foreskin all by 
themselves. These
collected pockets of cells are nothing to worry about. They are simply an 
indication
that the natural process of detachment is occurring.
-Your son has a urinary tract infection (UTI) and needs to be circumcised to 
prevent
it from happening again.
The belief that the foreskin slightly increases the chances of a boy having 
a UTI
is highly controversial and, more importantly, unproven. Members of the 
medical profession
in Europe do not accept it. Medical research proves that UTIs are most often 
caused
by internal congenital deformities of the urinary tract. 2,3,4 The foreskin 
has nothing
to do with this. Even if it could be proven that circumcision slightly 
reduces the
risk of UTI, it is an absurd proposal because UTIs in boys are extremely 
rare and
are easily treated with antibiotics. Breastfeeding, too, helps prevent UTIs. 
Child-friendly
doctors advocate breastfeeding not penile surgery.
-Your son sprays when he urinates. Circumcision will correct this.
In almost every intact boy, the urine stream flows out of the urinary 
opening in
the glans and through the foreskin in a neat stream. During the process of 
penile
growth and development, some boys go through a period where the urine stream 
is diffused.
Undoubtedly, many of these boys take great delight in this phase, while 
mothers,
understandably, find it less amusing. If your boy has entered a spraying 
phase, simply
instruct him to retract his foreskin enough to expose the meatus when he 
urinates.
He will soon outgrow this phase.
-Your son's foreskin balloons when he urinates. He needs to be circumcised 
or else
he will suffer kidney damage.
Ballooning of the foreskin during urination is a normal and temporary 
condition in
some boys. It results in no discomfort and is usually a source of great 
delight for
little boys. Ballooning comes as a surprise only to those adults who have no 
experience
with this phase of penile development. It certainly does not cause kidney 
damage;
it has nothing to do with the kidneys. Ballooning disappears as the foreskin 
and
glans separate and the opening of the foreskin increases in diameter. It 
requires
no treatment.
-Your son caught his foreskin in the zipper of his trousers; we will have to 
cut
it off.
There have been rare cases where a boy has accidentally caught part of the 
skin of
his penis in the zipper of his trousers. This is painful and can cause a lot 
of bleeding.
Cutting off the foreskin, however, is illogical in this situation. By 
cutting across
the bottom of the zipper with scissors, the zipper can easily be opened to 
release
the penile tissue. Any lacerations in the skin can then be closed with 
either sutures
or surgical tape, depending on the situation. The proper standard of care in 
this
situation is to minimize and repair the injury, not make it worse by cutting 
off
the foreskin and creating a larger and more painful surgical wound.
-Your son has phimosis. He needs to be circumcised to correct this problem.
Phimosis is often used as a diagnosis when a doctor does not understand that 
the
child's foreskin is supposed to be long, narrow, attached to the glans, and 
resistant
to retraction. Some doctors are prescribing steroid creams for phimosis, but 
this
is unnecessary in children, since the foreskin does not need to be 
retractable in
young boys. The hormones of puberty will do the same thing at the 
appropriate time
that a steroid cream is doing prematurely. In adults who still have a 
foreskin that
is attached to the glans or a foreskin with such a narrow opening that the 
glans
cannot easily pass through it, steroid creams are a conservative therapy. 
This is
if the adult wants a foreskin that fully retracts. Many males don't, 
preferring a
foreskin that remains securely over the glans. It is purely a matter of 
personal
choice, one that only each male can decide for himself.
-Your son has paraphimosis and must be circumcised to prevent it from 
happening again.
Paraphimosis is a rare dislocation of the foreskin. It is caused by the 
foreskin
being prematurely retracted and becoming stuck behind the glans. The 
dislocation
can most often be corrected by applying firm but gentle pressure on the 
glans with
the thumbs, as if you were pushing a cork into a bottle. To reduce the 
swelling,
an injection of hyaluronidase may be effective. Doctors in Britain have also 
reported
good results from packing the penis in granulated sugar.5 Ice packs work 
well, too.
-Your son has BXO and will have to be circumcised.
Some doctors equate phimosis with an extremely rare skin disorder called 
balanitis
xerotica obliterans (BXO), which is also called lichen sclerosus et 
atrophicus (LSA).
BXO can appear anywhere on the body, but if this disorder affects the 
foreskin, it
may turn the opening of the foreskin hard, white, sclerotic, and make 
retraction
almost impossible. BXO is usually painless and progresses very slowly. Many 
times,
it goes away by itself. To an experienced dermatologist, there is no 
mistaking BXO,
but a diagnosis must be confirmed by a biopsy. The good news is that BXO can 
almost
always be successfully cured with steroid creams, carbon dioxide laser 
treatment,
or even antibiotics. Circumcision should be considered only after every 
other treatment
option has failed. Just as we do not amputate the labia of females with BXO 
or the
glans of circumcised boys with BXO, it is logical that we should not 
amputate the
foreskin of intact boys with BXO.
-Your son needs to be circumcised or else he won't enjoy oral sex as an 
adult.
I'm afraid that doctors really have said such inappropriate things to 
parents. Such
a statement is evidence of ignorance of the normal functions and sensations 
of the
intact penis. Classic anatomical investigations have proven that the 
foreskin is
the most richly innervated part of the penis. It has specialized nerve 
receptors
that are directly connected to the pleasure centers of the brain. Your 
intact son
is far better equipped to enjoy all aspects of lovemaking than his 
circumcised peers.
The myth that American women prefer the circumcised penis is, in my opinion, 
demeaning
to women. It may be true that American women of a certain generation and 
social background
were more likely to be familiar with the circumcised penis than the intact 
penis,
but this was the result of the mass circumcision campaigns of the 1950s not 
personal
preference. I suspect that what women prefer in men is more related to the 
personal
qualities of consideration, gentleness, sensitivity, warmth, and 
supportiveness.
It is very unlikely that circumcision increases a male's capacity to develop 
these
qualities.
-Your son needs to be circumcised so that he looks like his father.
A child is a mixture of both his mother's and his father's genetic heritage. 
He doesn't
need to look like his father, nor will he ever look like his father in every 
way.
Each child is a unique gift, and that uniqueness should be cherished. The 
idea that
a boy will be disturbed if his penis does not look like his father's was 
invented
to manipulate people into letting doctors circumcise their children. It has 
no basis
in medical fact.
There are no published reports of an intact boy being disturbed because part 
of his
penis was not cut off when he realized that part of his father's penis had 
been cut
off. When intact boys with circumcised fathers express their feelings on the 
matter,
they consistently report their immense relief and gratitude that they were 
spared
penile surgery. They express sadness, as well, for the suffering their dads 
experienced
as infants.6
Occasionally, a circumcised father will state that he wants his child 
circumcised
because he thinks that it will create a bond between him and his son. It is 
a wonderful
thing for a father to want to establish such a bond, but circumcision cannot 
accomplish
this worthy goal. If a father wants to establish a lasting and meaningful 
bond with
his son, the very best way, and perhaps the only way, he can achieve this is 
by spending
quality time with him and by showing him much affection.
Sadly, some fathers who have been circumcised have an unhealthy attitude and 
may
look for any excuse to schedule the child for circumcision. Putting a child 
in a
position where he fears that part of his penis is going to be cut off is 
abusive.
When fathers demand that their sons be circumcised, I suspect that they are 
desperately
trying to justify their own circumcised condition. The emotions that some 
fathers
feel when they are forced to confront the fact that part of their own penis 
is missing
can be so disturbing that they will do anything to block them out.
A father who forcibly circumcises his son will not win his son's gratitude, 
affection,
trust, or love. I am aware of instances where such events have permanently 
destroyed
the father-son bond and changed a son's love for his father into rage and 
bitter
resentment. In situations where the father suffers from an unhealthy 
attitude about
his son's normal penis, I think it is best for everyone 
concerned--especially the
son--for the father to receive compassionate psychological counseling to 
help him
overcome his problem. All children deserve the saf est, most nurturing, and 
most
loving home possible.
When physicians realize the important functions of the foreskin, they'll 
realize
that just about every problem with it can and should be solved without 
cutting it
off. Cutting off part of the body--especially part of the penis--is an 
extreme measure
that should be reserved for the most extreme of circumstances. The only 
legitimate
indications for cutting off any part of the body, including the foreskin, 
are life-threatening
disease, life-threatening deformity, or irreparable damage. These situations 
are
extremely rare.
The best advice for the care of the intact penis is simply to leave it 
alone. The
intact penis needs no special care. Let your boy take care of it himself, 
and when
he's old enough, he will enjoy taking care of his own body. After all, it's 
his business.
Just relax and avoid worrying about your son's intact penis. Remind yourself 
that
the foreskin is a normal and natural part of the body. If European boys grow 
up healthy
and unconcerned with their foreskins, so can your son.
NOTES
1. R. S. Van Howe, "Variability in Penile Appearance and Penile Findings: A 
Prospective
Study," British Journal of Urology 80, no. 5 (November 1997): 776-782.
2. J. Winberg, I. Bollgren, L. Gothefors, M. Herthelius, and K. Tullus, "The 
Prepuce:
A Mistake of Nature?" The Lancet 8638, no. 1 (March 1989): 598-599.
3. S. M. Downs, "Technical Report: Urinary Tract Infections in Febrile 
Infants and
Young Children," The Urinary Tract Subcommittee of the American Academy of 
Pediatrics
Committee on Quality Improvement, Pediatrics 103, no. 4 (April 1999): e54.
4. M. A. Gill and G. E. Schutze, "Citrobacter Urinary Tract Infections in 
Children,"
Pediatric Infectious Disease Journal 18, no. 10 (October 1999): 889-892.
5. R. Kerwat, A. Shandall, and B. Stephenson, "Reduction of Paraphimosis 
with Granulated
Sugar," British Journal of Urology 82, no. 5 (November 1998): 755.
6. Rosemary Romberg, Circumcision: The Painful Dilemma (South Hadley, Mass.: 
Bergan
& Garvey, 1985).
FOR MORE INFORMATION
Organizations
If your physician or healthcare provider ever recommends that your child be 
circumcised,
get another opinion from a physician who understands the important functions 
of the
foreskin, no matter how "urgent" the situation may be. For help finding one 
in your
area, contact:
National Organization of Circumcision Information Resource Centers (NOCIRC). 
PO Box
2512, San Anselmo, CA 94979-2512.
               415-488-9883        . Fax: 415-488-9660.
www.nocirc.org/
Doctors are encouraged to contact and join:
Doctors Opposing Circumcision (DOC). 2442 NW Market Street #42, Seattle, WA 
98107.
360-385-1882
. Fax: 360-385-1948. faculty.washington.edu/gcd/DOC/
Another resource especially for nurses:
Nurses for the Rights of the Child. 369 Montezuma #354, Santa Fe, NM 87501.
505-989-7377        .
www.cirp.org/nrc/
For information about alternative bris for Jewish parents:
Circumcision Resource Center. Ronald Goldman, PhD. PO Box 232, Boston, MA 
02133.
617-523-0088        .
www.circumcision.org/
One of the best sources of information on the Internet:
The Circumcision Information and Resource Pages.
www.cirp.org/
Books
Denniston, G. C., F. M. Hodges, and M. F. Milos, eds. Male and Female 
Circumcision:
Medical, Ethical, and Legal Issues in Pediatric Practice. Kluwer 
Academic/Plenum
Press, 1999.
Goldman, Ronald. Circumcision: The Hidden Trauma. Vanguard, 1996.
Illingworth, Ronald S. The Normal Child: Some Problems of the Early Years 
and Their
Treatment. Tenth edition. Churchill Livingstone, 1991.
O'Mara, Peggy, ed. Circumcision: The Rest of the Story. Mothering, 1993.
Ritter, Thomas, and George C. Denniston. Say No to Circumcision! Second 
edition.
Hourglass, 1996.
Books of special interest for Jewish parents: Goldman, Ronald. Questioning 
Circumcision:
A Jewish Perspective. Vanguard, 1997.
Hoffman, Lawrence A. Covenant of Blood: Circumcision and Gender in Rabbinic 
Judaism.
University of Chicago Press, 1996.
Weiner, Kayla. Jewish Women Speak Out: Expanding the Boundaries of 
Psychology. Canopy
Press, 1995.
Important medical journal articles: DeVries, C. R., A. K. Miller, and M. G. 
Packer.
"Reduction of Paraphimosis with Hyaluronidase." Urology 48 (1996): 464-465.
Fleiss, P. M., F. M. Hodges, and R. S. Van Howe. "Immunological Functions of 
the
Human Prepuce." Sexually Transmitted Infections 74 (1998): 364-367.
Jorgensen, E. T., and A. Svensson. "Problems with the Penis and Prepuce in 
Children:
Lichen Sclerosus Should Be Treated with Coricosteroids to Reduce Need for 
Surgery."
British Medical Journal 313 (September 14, 1996): 692.
Nolan, J. F., T. J. Stillwell, and J. P. Sands, Jr. "Acute Management of the 
Zipper-Entrapped
Penis." Journal of Emergency Medicine 8 (1990): 305-307.
Shaw, Angus. "Africa to Address AIDS at Conference." Science (September 10, 
1999).
Van Howe, R. S. "Circumcision and HIV Infection: Review of the Literature 
and Meta-analysis."
International Journal of STD & AIDS 10 (1999): 8-16.
Van Howe, R. S. "Does Circumcision Influence Sexually Transmitted Diseases? 
A Literature
Review." British Journal of Urology International 83, Supplement 1 (1999 ): 
52-62.