CIRCUMCISION
What is circumcision?
Circumcision in males is the surgical removal of the foreskin (prepuce). This is a layer of skin covering the head of the penis
Why is circumcision performed?
Male circumcision is one of the oldest known surgical procedures. Egyptian records show that male circumcision was being performed as early as 2300 BC. The procedure has been adopted independently by different cultures all over the world for various reasons including religious, cultural, social and medical. The World Health Organisation (WHO) estimates that 1 in 3 males worldwide are circumcised. Neonatal circumcision is common in the Middle East, Central Asia, West Africa, the United States of America, Israel, Canada and Australia. Various studies have consistently estimated the rate of male circumcision in the USA, to range from 42- 80%.
What are the health benefits of circumcision?
The health benefits of male circumcision are well established. Various clinical studies have demonstrated immediate and lifelong protection against numerous medical conditions. Benefits include reductions in the risk of urinary tract infections, HIV acquisition and transmission of other sexually transmitted infections. The United States’ Centers for Disease Control and Prevention (CDC) in its policy recommendation released in December 2014 affirmed “male circumcision as an important public health measure”. In 2007, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation (WHO) concluded that “the efficacy of male circumcision in reducing female to male transmission of HIV had been proved beyond reasonable doubt”.
HIV
Male circumcision has been proven to help prevent female to male transmission of HIV, reducing the risk of transmission by 60−70%.
Sexually transmitted infections (STI)
Male circumcision has been shown to help protect against contracting various STIs including genital herpes simplex virus (HSV), human papillomavirus (HPV) and syphilis.
Although not sexually transmitted, male circumcision resulted in decreased vaginal infections caused by Trichomonas vaginalis and bacterial vaginosis in female sexual partners.
Urinary tract infections (UTI)
Male circumcision decreases the risk of UTI in infants and adult men. Uncircumcised male infants are estimated to have a 1% chance of acquiring a UTI. This is 10 times less common in circumcised male infants, who have an estimated 0.1% risk of UTI. This is thought to be due to the almost complete elimination of bacteria that can live under the foreskin.
Cervical cancer
Male circumcision reduces the risk of cervical cancer in female sexual partners. This is thought to be due to the significantly reduced risk of HPV transmission associated with male circumcision.
Foreskin problems
Removal of the foreskin eliminates the risk of:
- Phimosis – inability to retract a tight scarred foreskin
- Paraphimosis – inability to return a retracted foreskin to its original position. This can cause swelling and obstruct blood flow to the tip of the penis and would require emergency surgery.
- Balanitis & Posthitis – painful inflammation of the glans (head) of the penis and foreskin due to irritants becoming trapped under the foreskin.
Penile cancer
Although rare, penile cancer is much more common in men who are uncircumcised. Male circumcision markedly reduces the risk of developing this type of cancer
