Potential Benefits of Circumcision

The benefits vastly outweigh risks. The enormous public health benefits include protection from urinary tract infections, sexually transmitted HIV, HPV, syphilis and chancroid, penile and prostate cancer, phimosis, thrush, and inflammatory dermatoses. In women circumcision of the male partner provides substantial protection from cervical cancer and chlamydia.

Given the convincing epidemiological evidence and biological support, routine circumcision should be highly recommended by all health professionals.

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The Benefits

1. Eliminates the risk of phimosis, which affects 1 in 10 older boys and men. This condition refers to a tight foreskin that cannot be pulled back fully, so making cleaning under it, and passing urine, difficult. Phimosis increases risk of penile cancer 12-fold, and is a cause of catheter problems in nursing homes.

2. Reduces by 3-fold the risk of inflammation and infection of the sking of the penis. One in 10 uncircumcised men get inflammation of the head of the penis which is covered by the foreskin. This rises to 1 in 3 if the uncircumcised man is diabetic. (Uncircumcised diabetic men also have other severe penile problems.) In contrast only 2% of circumcised men get this condition.

3. Over 10-fold decrease in risk of urinary tract infection. Whereas risk is only 1 in 50 uncircumcised males will get a urinary tract infection in infance and 1 in 3 over their lifetime. This very [ainful condition is particularly dangerous in infancy. 40% develop kidney inflammation and disease; sepsis and meningitis can also result.

4. Over 20-fold decrease in risk of invasive penile cancer, which has a high fatality rate. One in 1,000 uncircumcised men get penile cancer, which usually requires penile amputation or disfiguring surgery leading to impaired penile function.

5. Uncircumcised men have elevated risk of prostate cancer, which affects 1 in 9 Australian men over their lifetime.

The benefits vastly outweigh risks. The enormous public health benefits include protection from urinary tract infections, sexually transmitted HIV, HPV, syphilis and chancroid, penile and prostate cancer, phimosis, thrush, and inflammatory dermatoses. In women circumcision of the male partner provides substantial protection from cervical cancer and chlamydia.

American Academy of Pediatrics Position Statement

From the American Academy of Pediatrics Technical Report
Male Circumcision
Task Force on Circumcision

Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy’s 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement.
Full Article

Advantages of the plastibell technique for circumcision:

1. The skin compression cuts off the circulation to the foreskin so the bleeding risk is low.
2. Because the circulation is cut off, it is difficult for infection to ascend beyond that point, so the infection risk is low.
3. The skin compression also cuts off the nerve supply to minimize discomfort afterwards.
4. Because the plastibell is sitting over the head of the penis, it accurately defines the level at which the circumcision occurs and provides a template for a straight result.
5. The plastibell protects the head of the penis from damage during the procedure.
6. No dressings are necessary. You can bath him normally and the ring drops off of its own accord usually 5-10 days later for babies and 7-14 days later for older boys. Don’t worry too much, it will only come off when it is ready.
7. No general anaesthetic needed

Risks of Circumcision

1. Bleeding
2. Infection
3. Removing too much or too little skin
4. Unable to complete the procedure – including due to discovery of previously unseen penile abnormalities
5. Readhesions
6. Scar contracture
7. Inflammation
8. Skin bridges
9. Meatal stenosis
10. Damage to the penis
11. Pain
12. Respiratory depression due to pethidine
13. Bruising / swelling from local anaesthetic injection
14. Local reaction to anaesthetic cream

Circumcision confers a lifetime of medical benefits.

For 1 in 500 circumcisions there may be either a little bleeding-easily stopped by pressure or, less commonly, requiring stitches (1 in 1000), the need to repeat surgery (1 in 1000), or a generalized infection that will require antibiotics (1 in 4000). Although there can be a local infection, often what seems like a local infection is actually part of the normal healing process. A successful circumcision is extremely unlikely to have any long-term adverse consequences and cosmetic outcome is generally excellent.

If a bleeding disorder such as haemophilia runs in the family, then the doctor needs to be advised as circumcision may require special preoperative treatment.

Risks if uncircumcised:

1. May need to be circumcised at a later date
2. Paraphimosis
3. Penile infections
4. Urinary tract infections
5. Penile cancer
6. Cervical cancer in female partners
7. Human Papilloma Virus
8. HIV