Abstract
Background: Male Circumcision (MC) has been a surgical intervention for thousands of years but only recently have randomised controlled trials (RCTs) been available to demonstrate a protective effect from sexually transmitted infections (STIs) most notably including HIV.
Aims: To analyse current available literature on neonatal MC and evaluate its routine implementation in infants and neonates.
Methods: Publications dealing with routine male circumcision using PubMed were reviewed. MeSH terms “male circumcision” were searched with additional terms “neonate”, “infant”, “newborn” and “routine”.
Results: Recent evidence clarifies that MC is completely protective against specific prepucial disease including phimoses and genital dermatoses. There is also strong RCT-based literature that MC is efficacious in the reduction of risk associated with female-to-male/insertive STIs. The protection may extend to female partners of circumcised men but this is observational and not unequivocal. Evidence for MC relating to genital malignancy in both men and women is also of limited power but appears to favour circumcision as protective. Studies demonstrate that MC is not however without a small risk of minor complications (∼0.2%) and there remains questions over the mechanism of protection as well as longterm bio-psycho-social sequelae.
Conclusions: The advantages for routine MC in the young include easily treatable diseases in the developed world. Penile cancer and HIV are some of the more serious illnesses associated but these are modifiable by genital hygiene and sexual behaviour. Unless there is a definitive reason for MC there is no case for a change in conservative practice as a result of recent literature.
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Liu, D., Patil, A., Ariyanayagam, T. et al. 886 Routine Male Circumcision in the Young: Is it Time to Reconsider the Benefits?. Pediatr Res 68 (Suppl 1), 444 (2010). https://doi.org/10.1203/00006450-201011001-00886
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DOI: https://doi.org/10.1203/00006450-201011001-00886