Circumcision. Widely practiced as religious rite since ancient times. Earliest evidence of the practice dates from ancient Egypt. Commonly practiced by Jewish, Muslims, and Christians. Jewish Religious Tradition. Initiatory rite of Judaism part of Abraham’s covenant with God Levitical Law:
every Jewish male infant had to be circumcised on the eight day after birth, under penalty of ostracism from the congregation of Israel
circumcision is mandatory (wajib).
it is recommended to have the circumcision done on the seventh day of the child’s birth (including day of birth) but it can be done sooner or later
No scientifically valid or methodologically sound evidence that the foreskin is responsible for UTI or kidney failure, either in children or in adults. If a casual relationship were to be proven, male UTI are relatively rare, and can be effectively prevented or treated by other conservative methods.
-Male Health and Genital Care: Previous
Circumcision Rationale and Modern Alternatives (1994)
uncircumcised males were 10-20x more
likely to develop UTI than circumcised male
-Decreased incidence of urinary tract infections in circumcised male infants. Pediatrics, 1985
uncircumcised males had 12 fold increased risk of UTI compared with circumcised infant males.
-Urinary tract infections and the uncircumcised state; an update. Clin Pediatr, 1993
-Urinary tract infections in febrile infants younger that 8 weeks of age. Pediatrics, 1990
-Urinary tract infections and circumcision: a case control study. Am J Dis Child, 1989
-Effect of circumcision on incidence of urinary tract infection in preschool boys. J. Pediatr, 1996
Foreskin continues to develop through adolescence. A diagnosis of penile phimosis is premature and invalid until late adolescence. Ballooning of the foreskin upon urination is not an indication for circumcision, as long as there is adequate urine stream.
-Newborns: Care of the Uncircumcised
Penis Penis. American Academy of Pediatrics 1994
-Treatment of Childhood Phimosis with Topical Steroid. Australia-New Zealand Journal of Surgery, 1994
- Treatment of Phimosis in Boys with a Potent Topical Steroid. Acta Dermato- Venereologica, 1993
-American Cancer Society letter, 1996
-Circumcision in the United States. Journal of the American Medical Association, 1997
Evidence regarding the relationship of circumcision to STD in general is complex and conflicting.
-Circumcision and sexually transmitted diseases. Am J Pub Health, 1994
Plausible biologic examination that link non-circumcision in men with risk for HIV infection, mucous surface of the uncircumcised penis allows for viral attachment to lymphoid cells at or near the surface of the mucous membrane, as well as an increased likelihood of minor abrasions resulting in increased HIV access to target tissues
Several case series noted strong association between uncircumcised status and increased risk of penile cancer
-Carcinoma of the Penis: analysis of therapy in 100 consecutive cases. J. Urol, 1946
- Carcinoma of the penis. J Urol
Appropriate hygiene decreased significantly the incidence of phimosis, adhesions, and inflammation, but did not eliminate all problems.
Genital hygiene needs to be emphasized as a preventive health topic throughout a patent’s lifetime
-Effect of hygiene among the uncircumcised.
J. Fam Pract., 1986
No difference in extroceptive and light tactile discrimination on the ventral or dorsal surfaces of the glans penis between circumcised and uncircumcised men.
-Masters and Johnson, Human Sexual Response, 1956
- The prepuce: specialized mjucosa of the penis and its loss to circumcision. British Journal of Urology 1996.
Complication of Circumcision. British Journal of Surgery. 1993
Circumcision: Male effects upon human sexuality. Human Sexuality: An Encyclopedia 1994
Complication rate is between 0.2% - 0.6%. Most complications are minor.
Most frequent complication is bleeding, followed by infection.
-Complications of circumcision. Urol Clin North Am. 1983
-Neonatal circumcision; a ten year overview with comparison of Gomco clamp and the Plastibell device. Pediatrics. 1976
-The circumcision debate. Pediatrics.
recurrent phimosis, wound separation, concealed penis, meatal stenosis, chordee, inclusion cysts, and retained Plastibell devices.
-Management of foreskin provlems. Arch. Dis