Benefits and risks of circumcision - Toronto Safe Circumcision Clinic

By: Medically reviewed by Justin Choi, M.D. on September 21, 2017 — Written by Tim Newman

Source: Medical News Today

Website : www.medicalnewstoday.com

Circumcision is an operation to remove a male’s foreskin. It is one of the oldest and most common surgical procedures, often performed on infants, for religious, social, medical, and cultural reasons.

The Centers for Disease Control and Prevention (CDC) encourage male circumcision on the basis that it appears to reduce the risk of HIV infection. However, not all health authorities agree, and the recommendations remain somewhat controversial.

According to the CDC, 58.3 percent of American newborns were circumcised in 2010. In the United Kingdom (U.K.), around 8.5 percent of males are circumcised.
Fast facts on circumcision

Here are some key points about circumcision. More detail is in the main article.

The first circumcisions may have been carried out 15,000 years ago.
It is relatively common in the United States (U.S.) but less common in other western countries.
Circumcision of a newborn takes 5 to 10 minutes.
An adult circumcision procedure takes around 1 hour and recovery takes 2 to 3 weeks.
Circumcision may reduce the risk of developing HIV and other health problems.
Judaism, Islam, and a number of other religions advocate circumcision.

What is circumcision?
Circumcision is a relatively minor surgery that many families choose for newborn boys.

Circumcision involves the removal of the foreskin of the penis.

The foreskin is the shroud of skin that can be gently pulled back to uncover the head of the penis.

The surgery is relatively simple.

The foreskin is freed from the head of the penis and, in a child, it is clipped off, in a procedure taking 5 to 10 minutes in total. In adults, it is removed with a scalpel, and it takes around 1 hour.

The wound is then either cauterized or stitched with dissolvable sutures.
History

The first circumcisions may have taken place 15,000 years ago. It slowly spread across a variety of cultures, especially in the Middle East.

It may have become popular in the ancient world as a public health measure and a way of preventing balanitis. Balanitis leads to swelling and pain in the head of the penis. It may have been more common then due to sand building up under the foreskin.

Circumcision became popular in the Western world in the late 19th century, when it was carried out in an effort to prevent masturbation. This was believed to underlie a range of conditions, including epilepsy, paralysis, tuberculosis, and insanity.

However, there was little compelling evidence to support these claims. As the newly-formed national health care systems faced rising costs, it was dropped as a recommendation.

In the U.S., however, it has remained a relatively common practice, and some major health authorities encourage it.
Why circumcise newborns?

A number of factors are associated with neonatal circumcision.

The most common are:

religion
hygiene
health considerations

Some studies have suggested that circumcision reduces the risk of urinary tract infection (UTI), but more recent findings have contradicted this, with some suggesting it may increase the risk.

Evidence has indicated a lower risk of some sexually transmitted infections (STIs), including HIV. Circumcised men appear to be less likely to develop herpes or syphilis.

In very rare cases, balanitis or phimosis can occur in an uncircumcised male. With these conditions, the foreskin cannot be retracted. They require surgical treatment.

Cancer of the penis is extremely rare, but it appears to be slightly more common in men with a high body mass index (BMI), a history of smoking, men who are uncircumcised, or a combination of these factors. However, it has been estimated that 300,000 circumcisions may be required to prevent one penile cancer per year.
Circumcision and HIV

According to the World Health Organization (WHO) there is “compelling evidence” that circumcision reduces the risk of contracting HIV during heterosexual sex by 60 percent.

However, they point out that circumcision will offer only partial protection, and they urge men to use condoms as well.

The higher chance of infection may be because the foreskin becomes more prone to splits and ruptures during intercourse, leaving an open door for pathogens to enter the bloodstream.

Another possibility is that the space between the penis and the foreskin might provide an environment in which a virus can survive for a period of time, raising the risk of infection for the individual and their next partner.

Some argue that the U.S. has a relatively high rate of HIV, despite high circumcision rates. In addition, the results of studies in Africa and Asia associating circumcision with HIV prevention, mainly in heterosexual populations, may not translate to the U.S.

From 2008 to 2014, new infections with HIV fell from 45,700 to 37,600. Of these, 26,200 new cases were among men who were gay, bisexual, or other men who have sex with with men.
Adult circumcision

Circumcision is performed less often in adults than in children. It takes longer and is likely to involve more tissue trauma. It may also cause more psychological trauma than it does in newborns.

However, it may be recommended in some circumstances:

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Dr. Tahmoures Bahrami

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