DEAR DR. DONOHUE: I recently got into a discussion about circumcision with my granddaughter, who recently gave birth to our great-granddaughter. She mentioned that if her next child were a boy, she would choose not to have him circumcised. She claims her husband made a study of the procedure and says it is mutilation, the same as is practiced on women in some countries. She states it is a religious ritual only.

Is circumcision of males considered the same as mutilation of females? — P.H.

ANSWER: The debate on male circumcision is one that generates heat on both sides. It is not the same as female circumcision. That is truly a mutilating procedure.

Male circumcision for cultural and religious purposes is one thing, and I’m not talking about the procedure in those circumstances.

The benefits of male circumcision include a reduction in urinary-tract infection in infancy. It is said to reduce the transmission and acquisition of sexually transmitted diseases. It has been shown convincingly to decrease the transmission of the HIV virus, the virus that causes AIDS; the male acquisition of herpes virus; and the transmission of human papillomavirus, the cause of genital warts in men and women and cervical cancer in women. If readers want a reference for these claims, they can find it in the Journal of the American Medical Association, October 5, 2011, page 1,479.

The arguments against male circumcision are that it is unnecessary, doesn’t markedly affect the health of men or women in developed countries and can lead to serious complications, rare but possible. The actual complication rate is 0.2 percent to 0.6 percent, and most of the complications are minor. Furthermore, some feel strongly that it is a mutilating procedure. It is not on a par with female circumcision.

I believe the parents of infant boys are the ones to make the decision.

DEAR DR. DONOHUE: What are the symptoms a person should look for if your kidneys are not working properly? How do you know if you have chronic kidney failure? My brother is on dialysis. — M.T.

ANSWER: The signs and symptoms of chronic kidney failure are many: fatigue, lethargy, fluid retention with swollen ankles, and loss of appetite. Anemia is almost always present, and anemia signs add to those of kidney signs; breathlessness and pallor are examples.

You don’t want to wait for the onset of symptoms and signs to discover kidney malfunction. You want kidney failure detected early through lab tests so that treatment can be given well before signs occur. Protein in the urine, blood tests called BUN (blood urea nitrogen) and creatinine, and a determination through lab tests of how well the kidneys are filtering the blood (glomerular filtration rate) are tests that show if kidneys are failing. Most of these are routine tests obtained during exams.

High blood pressure, diabetes and heart disease are the three illnesses most responsible for kidney failure. People with these ills should have their kidney function tested on a regular basis.

DEAR DR. DONOHUE: I’m 38 and have been suffering from pelvic pain for more than a year. My gynecologist believes it’s due to the large fibroid I have. He has suggested treatment by cutting off the fibroid’s blood supply. I don’t understand this. Will you describe what happens? Is it safe? — R.R.

ANSWER: Uterine fibroid embolization (clot formation) is a safe and successful technique for getting rid of a fibroid or fibroids that are causing trouble. Fibroids are noncancerous growths of the uterine muscle.

The doctor advances a soft, pliable tube, a catheter, through an artery in the groin to the artery that provides the fibroid with its blood.

When that site is reached, the doctor releases from the catheter tiny particles that stop blood flow to the fibroid. The size of the fibroid is greatly reduced. It’s a way of preserving the uterus while minimizing symptoms caused by the fibroid. The technique has been around for quite a while.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.