Reduce the risk of HIV with Circumcision

“Circumcision also reduces the risk of HIV infection two to eight times.
HIV infection can appear during have sex and HIV transmission in men, usually through the penis”.

Said Director of Health Services Kusuma Buana Foundation, Adi Sasongko in meeting with the media in the Empu Sendok Restaurant, in Jakarta.

So far, various studies have been conducted to determine the extent to which male circumcision may reduce the risk of HIV infection.

According to Carlos R Estrada and colleagues from the Health Center Rush Presbyterian St. Lukes in Chicago, Illinois, about 80 percent of HIV infection usually appear during the intimate touch.

The World Health Organization (WHO) and the Secretariat for the World AIDS (UNAIDS) bring together international experts in a consultation to determine whether male circumcision should be recommended in the efforts for the prevention of HIV infection.

After the research is done, the results on circumcision men are able to reduce the risk of HIV infection through heteroseksual on 60 percent of men. Then, what the relationship with the circumcision reduced the risk of transmission of HIV / AIDS?

Head of the penis,is an important factor in viral transmission of HIV / AIDS. Epidermis or the tip of the penis head play an important role in the way the HIV virus.
On the outside skin of the head or the tip of the penis there are cells that are very sensitive to the HIV virus. The section cut in the process of circumcision is coated very thin skin. This section is easily injured during intercourse.

Therefore, the virus can spread from a wounded skin. Uncircumcised penis is more easily spread HIV virus to the spouse because the skin on the tip of the penis or prepuce is usually damp and wet, and the place is suitable for the HIV virus to live.

Wet foreskin also potential of other sexually transmitted diseases. With circumcision, skin will automatically open so can lower the risk of HIV infection.

According to data from research Halperin and Bailey, as quoted by Adi, countries of Asia and Africa with a population prevalence of circumcised male less than 20 percent have HIV prevalence several times higher than countries with a population of circumcised men that more than 80 percent.

Similar results,also found in research in South Africa, Kenya, and Uganda. In fact the risk of HIV transmission is lower in circvumcised men compared with uncircumcised men.
South Africa 76 percent lower, Kenya, 60 percent lower, while Uganda 55 percent lower. "Why Africa, because there are in the area of HIV / AIDS at most, the 22 million people," he said.

However, circumcision does not automatically make men immune to the HIV / AIDS. "Circumcision only reduces the risk of transmission of HIV / AIDS," specifically.

Circumcision is not the only method of prevention of HIV transmission that can be done. Prevention of HIV must also be done in various ways, one is through the use of condom promotion and activities that do not transmit HIV risk to others.

"Campaigns and the socialization of transmission and prevention of HIV / AIDS must be accompanied by an increase sustainable access of the examination and treatment for people with HIV," said program manager at the AIDS high-risk group Yayasan Kusuma Buana Rediscoveri, Nitta. High-risk group of contracting sexually transmitted diseases and HIV are sex workers and drug users with needle.

TaraKlamp

Dr. T. Gurcharan Singh invented the
Taraklamp. It was used widely around the
world in 1990's.


It is made of plastic designed for single use
only. It can be used for infants and adults
with varying sizes.
The tara klamp is a plastic with two parts which are uniting at the distal
end. Those are the tube and the outer clamp.

The tube is cylinder in shape. Its proximal end is a circular opening for
protecting the glans penis during circumcision.

Its distal end is also circular shape matching the distal part of the outer
clamp. It has two 'wings' that lock inside the hole provided by the outer
clamp.

The outer clamp has two distinct openings, two arms and two locks at
left and right sides of its distal end.
To lock the clamp, the upper part of the arm is pressed into the distal
part of the outer clamp until two clicks are heard and felt.
Same as plastibell, the size is important.
The correct size can avoid unnecessary
complications.

When the glans is cleared of adhesions,
insert the tube of the tara klamp into the
foreskin. The foreskin is pulled over the rim
of the tube underneath the clamp. Amount
of foreskin is adjusted.
The two arms are brought closer to the lock the clamp. The rim of the
clamp grips the foreskin on the tube. Further pressure applied to the
arms so two clicks are heard and felt. Lock is complete.

The skin has been clamp well to cut off any homeostasis. Use a tissue
cutter or scalpel to cut the excess foreskin.

It is a good practice to check the clamp and the penis before excise the
foreskin. Make sure the lock is fixed and position of the urethral meatus
is in the central of the tube.

When the clamp is locked and fixed, it cannot be undone. The Tara
klamp can be separated by cutting through the plastic in the hole at
distal end of the outer clamp. However, the clamp cannot be reused. To
continue circumcision, use a new tara klamp with the same size.
The clamp can be removed easily with some
discomfort. If the tube cannot be removed
from its attachment on the necrotic skin,
then it is better to let the boy home with the
tube intact. Advice for regular wash and
shower, the tube will be detached by a few
days.

Aftercare of circumcision is easy. Regular wash and shower with pain
killers whenever is necessary. Apply ointment or petroleum jelly over
the wound area.

The device is allowed to remain on the penis for the next few days.
Urine is easily voided through the distal opening.

Removing the device after 5-7 days:

Using a curve blade provided, the clamp is separated from the tube by
cutting the thin plastic at distal end of the tara klamp as shown.

The clamp can be removed easily with some
discomfort. If the tube cannot be removed
from its attachment on the necrotic skin,
then it is better to let the boy home with the
tube intact. Advice for regular wash and
shower, the tube will be detached by a few
days.

Does Circumcision Affect Your Sex Life?

Two studies present opposite findings, providing evidence to support both sides of the debate surrounding the procedure.


In one study, University of North Carolina researchers led by Dr. Kenneth Fink showed that adult men who underwent circumcision reported a decrease in both erectile functioning and penile sensitivity after the procedure.

In the other study, based on results from a much smaller group of patients, Dr. Sean Collins of Louisiana State University and his team found that newly circumcised adult men reported no difference in sexual functioning after the procedure.


Fink and his team also noted that, despite reporting a decrease in their sexual pleasure, 62% of men said they were satisfied with the results of the procedure.
In both studies, most of the men underwent the procedure for the treatment of a medical condition, such as phimosis, a condition in which the foreskin cannot be pulled back over the head of the penis.


Around 77% of American-born men in the US are circumcised, although that number appears to be declining rapidly in some regions of the country. In one Washington state study, only 37% of baby boys born between 1987 and 1996 were circumcised in the hospital.


In recent years, a debate has risen over the merits of the procedure, with one side citing the decreased rate of infections and sexually transmitted diseases among circumcised men, and the other stressing the pain and stress inflicted on a baby during circumcision, as well as the complications that can arise from the procedure.


The current policy of the American Academy of Pediatrics is that the potential medical benefits of male circumcision are not substantial enough to recommend that all boys become circumcised.
Despite anecdotal evidence that circumcised penises are less sensitive than uncircumcised penises, no studies have examined the effect of adult male circumcision on sexual functioning and pleasure--that is, until the appearance of these two studies, both published in the May issue of the Journal of Urology.


In the study conducted by Fink and his team, the authors asked 123 men who were already circumcised as adults to compare their sexual functioning and pleasure from before and after the procedure. The study by Collins and his colleagues was based on surveys of 15 men conducted both before and 12 weeks after the procedure.


Commenting on the Collins study to Reuters Health, Fink explained that talking to patients both before and after the procedure is a better way to measure changes, but that 15 patients is simply too small a group to detect anything other than large differences.


Fink added that both studies are flawed in that they examine sexual functioning changes in adults undergoing circumcision who, in most cases, opt for the procedure to correct medical problems. Consequently, Fink explained that a man's report of his sexual enjoyment and functioning could be influenced by the medical condition that prompted circumcision.


Based on this reasoning, Fink said, one would expect study participants to report an increase in sexual functioning after the procedure, which could be attributed to an improvement in the medical condition. However, a decrease in sexual functioning, as reported in Fink's study, shows there is likely some other factor influencing the change, he said.


As an explanation for why the men in his study reported high satisfaction despite a decrease in sexual functioning, Fink said that some were happy to have lower sensitivity, which enabled them to postpone orgasm, and better please their partners.


Fink noted that a man's report of sexual satisfaction depends on a number of factors.


"It means different things to different men," he said. "Overall, it looked like it was worth it to them to have the procedure."


Fink stressed that studies of circumcised adults cannot be directly applied to newborns, but that parents may wish to consider these findings when deciding whether to circumcise their children.

SmartKlamp Removal

Klamp removed after five days or according an advice from a doctor. We can do it by ourself or a doctor.


Step by step to release the klamp:

1. First is to open the klamp lock with the nail cutter.

2. After we cut both sides of the klamp we can start release the klamp fastener. When it is difficult we can put a few drops of baby oil on klamp.

3. Next is to release the tube. Usually it is stick to the head of the penis. To soften the necrotic tissue it is recommended to soak in warm water mixed with antiseptic solution for 30 minutes. Then we can turn the tubes left and right as we open a bottle cover.

4. After the tube can be moved left and right then we can remove the tube by making a movement such as “picking something”.

5. Do not pull the tube!.






The tube is removed


After the tube is removed we do not need to take special care because the injury has become dry. Circumcision scar will form a ring like black color and the dead tissue / necrotic will heal in a few days.

Keep the circumcision wounds remain clean and dry by taking a bath regularly and dry it well.

Use tight underwear and put the penis upwards. In some patients may arise a swelling or inflammation. This is normal if not accompanied by infection, swelling, and will heal by itself.

Try to reduce activities such as running and other activities that affect the swelling. Consult the doctor if the swelling persists in a few days.


The Art of Circumcision




What is circumcision?


Circumcision is the surgical removal (cutting off) of the fold of skin that normally covers the glans (head) of the penis. This double layer of skin, sometimes called the prepuce, is more commonly known as the foreskin.


Why is the foreskin there?


The foreskin has three known functions: protective, sensory, and sexual.


During infancy, the foreskin is attached to the glans and protects it from urine, feces, and abrasions from diapers. Throughout life, the foreskin keeps the glans soft and moist and protects it from trauma and injury. Without this protection, the glans becomes dry, calloused, and desensitized from exposure and chafing.

Specialized nerve endings in the foreskin enhance sexual pleasure. The foreskin may have functions not yet recognized or understood.


When and why did doctors in the US start circumcising babies?


Doctors in the English-speaking countries started cir-cumcising babies in the mid-1800s to prevent masturbation, which some doctors claimed caused many diseases, including epilepsy, tuber-culosis and insanity. Doctors have given other reasons since then, but all of them, including the claim that circumcision prevents cancer of the penis, cancer of the cervix and venereal diseases, have been disproven. Cutting off the foreskin to keep the rest of the penis clean is like pulling teeth instead of brushing them. We know that the foreskin is a normal, sensitive, functional part of the body.


The Pros and Cons


On the plus side, circumcised infants are less likely to develop urinary tract infections (UTIs), especially in the first year of life. UTIs are about 10 times more common in uncircumcised compared with circumcised infants. However, even with this increased risk of UTI, only 1% or less of uncircumcised males will be affected.


Circumcised men may also be at lower risk for penile cancer, although the disease is rare in both circumcised and uncircumcised males. Some studies indicate that the procedure might offer an additional line of defense against sexually transmitted diseases (STDs), including HIV.


Penile problems, such as irritation, inflammation, and infection, are more common in uncircumcised males. It's easier to keep a circumcised penis clean, although uncircumcised boys can learn how to clean beneath the foreskin once the foreskin becomes retractable (usually some time before age 5).


Some people claim that circumcision either lessens or heightens the sensitivity of the tip of the penis, decreasing or increasing sexual pleasure later in life. But neither of these subjective findings has been proved.


Although circumcision appears to have some medical benefits, it also carries potential risks — as does any surgical procedure. These risks are small, but you should be aware of both the possible advantages and the problems before you make your decision. Complications of newborn circumcision are uncommon, occurring in between 0.2% to 3% of cases. Of these, the most frequent are minor bleeding and local infection, both of which can be easily treated by your doctor.


Perhaps one of the hardest parts of the decision to circumcise is accepting that the procedure can be painful. In the past, it wasn't commonplace to provide pain relief for babies being circumcised, but because studies have indicated that it benefits the infant to receive anesthesia, most doctors will now provide it. Also, the American Academy of Pediatrics (AAP) recommends the use of pain relief measures for circumcision. Even up until recently, though, anesthesia hasn't been universally used, so it's important to ask your doctor ahead of time what, if any, pain relief will be utilized with your son.


SMART KLAMP


Smartklamp is circumcision methods and techniques introduced since 2001 in Germany. The founder is dr. Harrie van Baars, which at this time Smartklamp was developed and manufactured in Malaysia. Smart Klamp made from plastic materials such as working with the navel clamp strap on a new born baby.


This tool consists of 2 components, plastic tube and clamp ring. Tube consists of several sizes that can be used from the age of the baby until the age of consent. This tool is used one-time, with the benefits of more secure, fast and comfortable.


Benefits of using this tool are: to protect the head of the penis during circumcision, bleeding a little so that the risk of infection and does not require antibiotics, the tool is easy to use, to prevent injury at the time of the circumcision.


Circumcision process only take 7 minutes, with the "click" closing mechanism then does not need stitches, cosmetic results are better and more symmetrical, safe for the patient with diabetes, hemofilia, autism or hyperactive.


After circumcision, patients can do their activity as usual. However, it remains advisable to perform activities that are not excessive. After 5 days, the tool can be removed by the parents or go see your doctor.

The glans is first measured using the Size-O-Meter to determine which size device is required.















Any adhesions are broken down and the tube part is inserted between the glans and the foreskin, which is pulled up onto the tube.


The outer portion is passed over the tube and rotated half a turn to lock the tube to it. The locking arms are then half-closed to lightly hold the foreskin.


The foreskin is adjusted over the tube so that it will be clamped at the desired place.














The locking arms are clicked completely shut and the excess foreskin is removed from in front of the locking ring.


The device can be left to fall off by itself in about a week or the doctor can remove it after a few days.