Stephen Shei-Dei Yang, Cheng-Hsing Hsieh, Shang-Jen Chang
Department of Urology, Buddhist Tzu Chi General Hospital, Taipei Branch, and School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
Circumcision is one of the oldest surgical procedures in the world. Despite its history, the medical benefits and risks of circumcision remain controversial. Although neonatal circumcision reduces the development and recurrence rates of urinary tract infection (UTI) in children, routine circumcision is only recommended in children with high risk of UTI. Further large-scale studies are required to prove if topical steroid hormones are an alternative therapy to circumcision in the prevention of pediatric UTI. In men, it is well-established that circumcision can reduce the risks of transmitting sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), human papilloma virus, type 2 herpes simplex virus, and syphilis. The World Health Organization and the United nations Program on HIV/AIDS has recommended promotion of circumcision in areas with a high prevalence of heterosexually transmitted HIV. Since circumcision only partially prevents STD, opponents worry that risk compensation (not using a condom and increased sexual partners) may overwhelmingly reduce the protective effects of circumcision. Parents and patients need to weigh the benefits and risks of male circumcision to make well-informed decisions about this procedure.
Circumcision; Fhimosis; Sexually transmitted disease; Urinary tract infection