Male babies are born with skin covering the end of the penis, called the foreskin. Circumcision is a procedure in which the foreskin is removed, exposing the tip of the penis. Circumcision is often performed on healthy babies within the first few days after birth.
Circumcision has often been a controversial issue that places parents in the position of balancing personal, cultural, and health issues when deciding whether to circumcise a son. In the past, medical evidence was insufficient to fully support circumcision's health benefits. More research has provided increasing evidence for health benefits of circumcision. An article in this month's issue of the Archives reviews studies evaluating male circumcision and sexually transmitted diseases. These studies found the following with regard to circumcision:
Human immunodeficiency virus (HIV) was reduced by 53% to 60%.
Herpes simplex virus type 2 (HSV-2) was reduced by 28% to 34%.
Human papillomavirus (HPV) was reduced by 32% to 35%.
Among female partners of circumcised men, bacterial vaginosis was reduced by 40% and Trichomonas vaginalis infection was reduced by 48%.
As many of these studies were done in developing countries, it is possible that the protective effects of circumcision may be lower in the United States. Additional health benefits of circumcision include the following:
Lower risk of getting cancer of the penis, a rare type of cancer.
Lower risk of urinary tract infections during the first year of life. Urinary tract infections during the first year of life can be serious and may lead to hospitalization. An uncircumcised baby boy has a 1 in 100 chance of getting a urinary tract infection during the first year of life, compared with a 1 in 1000 chance for a circumcised baby boy.
Prevention of foreskin infections.
Prevention of phimosis, a painful condition in which the foreskin retracts. Circumcised males do not get this condition.
Easier genital hygiene.
Like any medical procedure, circumcision is not without risks, although complications are rare and usually minor. These complications may include bleeding, infection, improper healing, or cutting the foreskin too long or too short.
Some families decide not to circumcise their sons. Some families are concerned that the foreskin is needed for identity reasons, sexual pleasure reasons, or other reasons linked to family, culture, religion, or tradition. Circumcision is also an important part of some religions.
Parents can learn about potential risks and benefits of circumcision from their physician. Particularly because the topic of circumcision can be linked to strong opinions, parents should be cautious in interpreting stories or information from unvalidated Internet sources. The ultimate decision regarding circumcision of a baby boy is the parents’. Parents should feel both informed and supported in this decision.
American Academy of Pediatrics http://www.aap.org/publiced/BR_Circumcision.htm
To find this and other Advice for Patients articles, go to the Advice for Patients link on the Archives of Pediatrics & Adolescent Medicine Web site at http://archpedi.ama-assn.org/.
Source: Centers for Disease Control and Prevention, http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm
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