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Is neonatal circumcision clinically beneficial? Argument against

Nature Clinical Practice Urology volume 6, pages 74–75 (2009)Cite this article

Clinical benefit is only one facet of clinical decision making; medical risks and financial costs also need to be considered. For example, many of the benefits espoused by advocates of circumcision would be more effectively achieved by penectomy, which has the additional benefit of preventing unwanted pregnancies. Of course, penectomy is too invasive, and is not a practical solution. Many of the “clinical benefits” lauded by advocates of circumcision include reduced risk of phimosis, balanitis, urinary tract infections (UTIs), genital cancer and sexually transmitted infections (STIs); however, evidence for these benefits are weak or nonexistent, and several alternatives to circumcision are available that are more effective, less invasive, and less expensive.

Phimosis is as common in circumcised newborns as it is in boys who are not circumcised. Topical steroids are effective in approximately 85% of patients,1 and could eliminate the need for newborn circumcision to avoid phimosis. Balanitis is more common in circumcised than uncircumcised boys under age 3 years, but may be more common in uncircumcised older boys. The only published adult study of balanitis showed that a referral bias occurred among circumcised men: the control group had a 47.8% circumcision rate,2 but the participants were from the UK, where the circumcision rate is around 21%. Balanitis can typically be treated with topical antimicrobials.

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  1. Department of Pediatrics and Human Development, Michigan State University, College of Human Medicine, 1414 West Fair Avenue, Suite 226, Marquette, MI 49855, USA rsvanhowe@mgh.org

Authors and Affiliations

  1. RS Van Howe is a Clinical Professor in the Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Marquette, MI, USA.,

    Robert S Van Howe

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Van Howe, R. Is neonatal circumcision clinically beneficial? Argument against. Nat Rev Urol 6, 74–75 (2009). https://doi.org/10.1038/ncpuro1292

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