Letter from Eileen Marie Wayne, MD,
to the British Journal of Urology

[Printed in August 1997 issue]

"... the wrong procedure on the wrong organ,
of the wrong patient, for the wrong diagnosis"

I have serious concerns for a 9-year-old child and subject of the case report "Secondary megaprepuce" [1]. The child was irrevocably circumcised for reasons the authors clearly admit were neither medical or surgical. They chose to surgically deprive the child of a priceless source of ecstatic sexual pleasure. The authors denigrate his sexual birthright into what they label a habit, which they proceded to wilfully abolish along with a treasured part of his penis. The circumcisers ignored the documented adverse psychological outcome of circumcision. Canserver [2] documented that circumcision "is perceived by the child as an act of aggression and castration. It has detrimental effects on the child's functioning and adaptation, particularly on his ego strength ... What is expressed after the operation is primitive, archaic, and unsocialized in character ... the ego of the child seeks safety in total withdrawal thus isolates and insulates itself from disturbing stimuli."

Secondary megaprepuce is not a recognized legitimate diagnosis listed in the International Classification of Diseases [3]. Recognized legitimate diagnoses include sexual abuse of a child, mental abuse, emotional abuse, physical abuse and types of perpetrators. Recognized legitimate diagnoses listed in the Diagnostic and Statistics Manual of Psychiatry include fetish, penis envy and voyeurism [4].

According to the authors, adults inspected the child's penis for 6 to 9 years of his life. In the operating theatre, the circumcisers masturbated the child's penis to a full erection. They sustained the child's erection and made close-up, colour photographs of the child's erect intact penis between the fingers of his circumciser. Perhaps the circumcisers have a full-length video showing this technique that they might enjoy sharing. I doubt the parents or the child gave signed, legal, informed consent or refusal to publish the colour photographs of the child's erect, intact penis in an international journal. The circumciser's erection photographs have now gained international attention. The sight of his penis in the grip of his circumciser would certainly repulse and enrage the disendowed child.

This report demonstrates a case of the wrong procedure on the wrong organ, of the wrong patient, for the wrong diagnosis. The child's parents need family and sexual counselling. The wounded child needs the intervention of child protection services. Child circumcisers Gomez, Puyol, and Menendez need a circumcision of their professional permits to perpetrate irreversible surgical sexual acts upon unwilling children under the legal age of informed consent or informed refusal. Please publish a denunciation of this inappropriate childhood non-consensual surgical sexual act.

Eileen Marie Wayne, MD
Rock Island [Moline], IL

1 Gomez J, Puyol M, Menendez V. Secondary megaprepuce. Br J Urol 1996:78:959-60.
2 Cansever G. Psychological effects of circumcision. Br J Med Psychol 1965:38:321-31
3 International Classification of Diseases 1997
4 American Psychiatric Association. Diagnosis and Statistical Manual

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