Mr. Ibrahem/Circumcision
A circumcision performed in Central Asia, c. 1865–1872
SpecialtyUrology
ICD-10-PCS0VBT
ICD-9-CMV50.2
MeSHD002944
OPS-301 code5–640.2
MedlinePlus002998
eMedicine1015820

Circumcision is the removal of the foreskin from the human penis.[1][2] In the most common procedure, the foreskin is opened, adhesions are removed, and the foreskin is separated from the glans. After that, a circumcision device may be placed, and then the foreskin is cut off. Topical or locally injected anesthesia is used to reduce pain and physiologic stress.[3] The procedure is most often an elective surgery performed on babies and children for religious or cultural reasons.[4] Medically, circumcision is a treatment option for problematic cases of phimosis and balanoposthitis that do not resolve with other treatments, and for chronic urinary tract infections (UTIs).[5][6] It is contraindicated in cases of certain genital structure abnormalities or poor general health.[1][6]

The positions of the world's major medical organizations range from a belief that elective circumcision of babies and children carries significant risks and offers no medical benefits to a belief that the procedure has a modest health benefit that outweighs small risks.[7] No major medical organization recommends circumcising all males, and no major medical organization recommends banning the procedure.[7] Ethical and legal questions regarding informed consent and human rights have been raised over the circumcision of babies and children for non-medical reasons; for these reasons, the procedure is controversial.[8][9]

Male circumcision reduces the risk of HIV infection among heterosexual men in sub-Saharan Africa.[10][11] Consequently, the World Health Organization (WHO) recommends consideration of circumcision as part of a comprehensive HIV prevention program in areas with high rates of HIV.[12] The effectiveness of using circumcision to prevent HIV in the developed world is unclear;[13] however, there is some evidence that circumcision reduces HIV infection risk for men who have sex with men.[14] Circumcision is also associated with reduced rates of cancer-causing forms of human papillomavirus (HPV),[15][16] and UTIs.[3] It also decreases the risk of cancer of the penis via effectively curing phimosis.[3] Prevention of these conditions is not seen as a justification for routine circumcision of infants in the Western world.[5] Studies of other sexually transmitted infections also suggest that circumcision is protective, including for men who have sex with men.[17] A 2010 review found circumcisions performed by medical providers to have a typical complication rate of 1.5% for babies and 6% for older children, with few cases of severe complications.[18] Bleeding, infection, and the removal of either too much or too little foreskin are the most common acute complications.[18] Meatal stenosis is the most common long term complication.[19] Complication rates are higher when the procedure is performed by an inexperienced operator, in unsterile conditions, or in older children.[18] Circumcision does not appear to have a negative impact on sexual function.[20][21]

An estimated one-third of males worldwide are circumcised.[4][18][22] Circumcision is most common among Muslims and Jews (among whom it is near-universal for religious reasons), and in the United States, parts of Southeast Asia, and Africa.[4][23] It is relatively rare for non-religious reasons in Europe, Latin America, parts of Southern Africa, and most of Asia.[4] The origin of circumcision is not known with certainty; the oldest documented evidence for it comes from ancient Egypt.[4][24] Various theories have been proposed as to its origin including as a religious sacrifice and as a rite of passage marking a boy's entrance into adulthood.[25] It is part of religious law in Judaism[26] and is an established practice in Islam, Coptic Christianity, and the Ethiopian Orthodox Church.[4][27][28] The word circumcision is from Latin circumcidere, meaning "to cut around".[4]

References edit

  1. ^ a b Rudolph C, Rudolph A, Lister G, First L, Gershon A (18 March 2011). Rudolph's Pediatrics, 22nd Edition. McGraw-Hill Companies, Incorporated. p. 188. ISBN 978-0-07-149723-7. Archived from the original on 18 January 2016.
  2. ^ Sawyer S (November 2011). Pediatric Physical Examination & Health Assessment. Jones & Bartlett Publishers. pp. 555–556. ISBN 978-1-4496-7600-1. Archived from the original on 2016-01-18.
  3. ^ a b c American Academy of Pediatrics Task Force on Circumcision (2012). "Technical Report". Pediatrics. 130 (3): e756–e785. doi:10.1542/peds.2012-1990. ISSN 0031-4005. PMID 22926175. Archived from the original on 2012-09-20.
  4. ^ a b c d e f g "Male circumcision: Global trends and determinants of prevalence, safety and acceptability" (PDF). World Health Organization. 2007. Archived (PDF) from the original on 2015-12-22.
  5. ^ a b Lissauer T, Clayden G (October 2011). Illustrated Textbook of Paediatrics, Fourth edition. Elsevier. pp. 352–353. ISBN 978-0-7234-3565-5. Although routine neonatal circumcision is still common in some Western countries such as the USA, the arguments generally used to justify on medical grounds have been discredited and no national or international medical association currently advocates routine neonatal circumcision.
  6. ^ a b Hay W, Levin M (25 June 2012). Current Diagnosis and Treatment Pediatrics 21/E. McGraw Hill Professional. pp. 18–19. ISBN 978-0-07-177971-5. Archived from the original on 18 January 2016.
  7. ^ a b Jacobs, Micah; Grady, Richard; Bolnick, David A. (2012). "Current Circumcision Trends and Guidelines". In Bolnick, David A.; Koyle, Martin; Yosha, Assaf (eds.). Surgical Guide to Circumcision. London: Springer. pp. 3–8. doi:10.1007/978-1-4471-2858-8_1. ISBN 978-1-4471-2857-1. Outside of strategic regions in sub-Saharan Africa, no call for routine circumcision has been made by any established medical organizations or governmental bodies. Positions on circumcision include "some medical benefit/parental choice" in the United States, "no medical benefit/parental choice" in Great Britain, and "no medical benefit/physical and psychological trauma/parental choice" in the Netherlands.
  8. ^ Pinto K (August 2012). "Circumcision controversies". Pediatric Clinics of North America. 59 (4): 977–986. doi:10.1016/j.pcl.2012.05.015. PMID 22857844.
  9. ^ Caga-anan EC, Thomas AJ, Diekema DS, Mercurio MR, Adam MR (8 September 2011). Clinical Ethics in Pediatrics: A Case-Based Textbook. Cambridge University Press. p. 43. ISBN 978-0-521-17361-2. Archived from the original on 18 January 2016.
  10. ^ Krieger JN (May 2011). "Male circumcision and HIV infection risk". World Journal of Urology. 30 (1): 3–13. doi:10.1007/s00345-011-0696-x. PMID 21590467.
  11. ^ Siegfried, N; Muller, M; Deeks, JJ; Volmink, J (2009). Siegfried, Nandi (ed.). "Male circumcision for prevention of heterosexual acquisition of HIV in men". Cochrane Database of Systematic Reviews (2): CD003362. doi:10.1002/14651858.CD003362.pub2. PMID 19370585.
  12. ^ "WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention". World Health Organization. March 2007. Archived from the original on 2013-03-12.
  13. ^ Kim, Howard H; Li, Philip S; Goldstein, Marc (November 2010). "Male circumcision: Africa and beyond?". Current Opinion in Urology. 20 (6): 515–9. doi:10.1097/MOU.0b013e32833f1b21. PMID 20844437. S2CID 2158164.
  14. ^ Sharma, SC; Raison, N; Khan, S; Shabbir, M; Dasgupta, P; Ahmed, K (12 December 2017). "Male Circumcision for the Prevention of HIV Acquisition: A Meta-Analysis". BJU International. 121 (4): 515–526. doi:10.1111/bju.14102. PMID 29232046.
  15. ^ Larke N, Thomas SL, Dos Santos Silva I, Weiss HA (November 2011). "Male circumcision and human papillomavirus infection in men: a systematic review and meta-analysis". J. Infect. Dis. 204 (9): 1375–90. doi:10.1093/infdis/jir523. PMID 21965090.
  16. ^ Rehmeyer C, CJ (2011). "Male Circumcision and Human Papillomavirus Studies Reviewed by Infection Stage and Virus Type". J Am Osteopath Assoc. 111 (3 suppl 2): S11–S18. PMID 21415373.
  17. ^ Yuan, Tanwei; Fitzpatrick, Thomas; Ko, Nai-Ying; Cai, Yong; Chen, Yingqing; Zhao, Jin; Li, Linghua; Xu, Junjie; Gu, Jing (April 2019). "Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data". The Lancet Global Health. 7 (4): e436–e447. doi:10.1016/S2214-109X(18)30567-9. ISSN 2214-109X. PMID 30879508.
  18. ^ a b c d Weiss, HA; Larke, N; Halperin, D; Schenker, I (2010). "Complications of circumcision in male neonates, infants and children: a systematic review". BMC Urol. 10: 2. doi:10.1186/1471-2490-10-2. PMC 2835667. PMID 20158883.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  19. ^ Selekman, Rachel; Copp, Hillary (2020). "Urologic Evaluation of the Child". In Partin, Alan (ed.). Campbell Walsh Wein Urology (12th ed.). Elsevier. pp. 388–402. ISBN 9780323672276.
  20. ^ The American Academy of Pediatrics Task Force on Circumcision "Technical Report" (2012) addresses sexual function, sensitivity and satisfaction without qualification by age of circumcision. Sadeghi-Nejad et al. "Sexually transmitted diseases and sexual function" (2010) addresses adult circumcision and sexual function. Doyle et al. "The Impact of Male Circumcision on HIV Transmission" (2010) addresses adult circumcision and sexual function. Perera et al. "Safety and efficacy of nontherapeutic male circumcision: a systematic review" (2010) addresses adult circumcision and sexual function and satisfaction.
  21. ^ Morris, BJ; Krieger, JN (November 2013). "Does male circumcision affect sexual function, sensitivity, or satisfaction?--a systematic review". The Journal of Sexual Medicine. 10 (11): 2644–57. CiteSeerX 10.1.1.693.6628. doi:10.1111/jsm.12293. PMID 23937309.
  22. ^ "Neonatal and child male circumcision: a global review" (PDF). World Health Organization. 2010. Archived (PDF) from the original on 2016-01-18. Retrieved 12 April 2015.
  23. ^ Owings, Maria. "Products - Health E Stats - Trends in Circumcision Among Male Newborns Born in U.S. Hospitals: 1979–2010". www.cdc.gov. The Centers for Disease Control. Archived from the original on 23 January 2014. Retrieved 1 May 2019.
  24. ^ Doyle D (October 2005). "Ritual male circumcision: a brief history". The Journal of the Royal College of Physicians of Edinburgh. 35 (3): 279–285. PMID 16402509.
  25. ^ Alanis MC, Lucidi RS (May 2004). "Neonatal circumcision: a review of the world's oldest and most controversial operation". Obstet Gynecol Surv. 59 (5): 379–95. doi:10.1097/00006254-200405000-00026. PMID 15097799.
  26. ^ Glass JM (January 1999). "Religious circumcision: a Jewish view". BJUI. 83 Suppl 1: 17–21. doi:10.1046/j.1464-410x.1999.0830s1017.x. PMID 10349410.
  27. ^ "Circumcision". Columbia Encyclopedia. Columbia University Press. 2011. Archived from the original on 2015-09-24.
  28. ^ Clark M (10 March 2011). Islam For Dummies. John Wiley & Sons. p. 170. ISBN 978-1-118-05396-6. Archived from the original on 18 January 2016.