Should Boys Be Circumcised?

Circumcision refers to a common cultural (and in some cases religious) practice that deals with removal of skin from the tip of penis via micro-invasive surgery. Despite high prevalence and immense health benefits, there is a great deal of debate around the relevance of this surgery among general population.  A lot of people around the globe consider it a barbaric practice and believes that the surgery is unnecessary. But what does the research and clinical study say? Should you consider circumcision for your boy?

The answer is Yes!

The aim of this article is to answer your questions and queries with evidence-based research and scientific reasoning.

Why Is Circumcision Done?

In many Islamic and Jewish families as well as some tribes of Africa and Australia, circumcision is performed regularly as a religious and cultural ritual. Besides a ritual or family tradition, sometimes there is a medical indication of circumcision, such as when foreskin is too tight that it cannot be retracted over the glans and other similar reasons where normal functioning of penis is not possible unless circumcision is performed. Other common indications include:

• Circumcised penis is easier to clean and some people choose this procedure for personal hygiene reasons.
• Data indicates that circumcision prevents against serious medical and infectious diseases; therefore a lot of people today consider circumcision as part of preventive healthcare.

According to The American Academy of Pediatrics (AAP), the benefits of having circumcision are greater than the potential risks. AAP doesn’t recommend circumcision as a routine practice for all newborn boys; however, they leave the right to make the decision for parents. The procedure is ideally performed under local anesthesia.

Are There Any Statistically Proven Health Benefits Of Circumcision?

Circumcision has various health benefits which are statically proved by a number of research studies; a few are:

• Hygiene: Circumcised penis is easier to wash. It has been observed that secretions, sweat and dead cells tend to accumulate under the foreskin and may aggravate the risk of penile infections.
• Less chances of STDs: When you have a circumcised penis, your chances of getting sexually transmitted diseases (even AIDS) is reduced. However, practice of safe sex is still required to absolutely eliminate the risk of contracting STDs. According to a study conducted on a sub-Saharan Africa cohort of 3,274 young males (age range 18 to 24 years), investigators concluded that circumcision alone can reduce the risk of contracting HIV by 60% (3).
• Decreased risk of urinary tract infections: Although, risk of urinary tract infections is low in men as compared to females due to longer length of urethra; but circumcised men are at even lower risk due to minimal risk of bacterial colonization (4).
• Other diseases and infections: As compared to uncircumcised men, circumcised men are at lower risk of developing yeast infections, hypertension and balanitis– a disease of the foreskin.
• Less chances of developing penile cancer: Penile cancer is a rare malignancy and chances of developing this malignancy in circumcised men is even lower. According to a new study, uncircumcised men are 20-times more likely to develop penile cancer due to minimal risk of contracting human papillomavirus – a key risk factor in the pathogenesis of penile cancer. Moreover, female partners of circumcised men are at lower risk of developing cervical cancer for the same reason.
• Prevention of penile problems: Sometimes, retraction of foreskin of an uncircumcised penis is difficult or even impossible due to which the foreskin or head of the penis gets inflamed (a condition referred to as balanitis).

What Are Some Common Concerns With Circumcision?

Once circumcised, it is not possible to re-create the uncircumcised appearance. However, circumcision does not affects the fertility of a man nor does it reduces the sexual pleasure for the individual or his partner.

Are There Any Risks Associated With Circumcision Procedure?

The most common risk or complications of circumcision is bleeding. Therefore, it is not recommended in babies who are born with blood clotting disorders. Some genetically susceptible babies can also develop moderate to severe side effects from anesthesia given during the circumcision procedure; hence caution must be maintained. In addition, circumcision should not be performed on the premature babies who needs medical care in a hospital nursery.

Although very rarely but circumcision can cause foreskin problems, such as:

• Foreskin does not heal properly
• Foreskin can get cut either too short or too long
• Remaining foreskin can get reattached to the end of penis and this may require a minor penile surgery for repairing.

References

1. Earp, B. D. (2015). Do the benefits of male circumcision outweigh the risks? A critique of the proposed CDC guidelines. Frontiers in pediatrics, 3.

2. McBride, D. L. (2013). Circumcision benefits outweigh risks, but parents should choose according to revised AAP policy. Journal of pediatric nursing, 28(1), 89.

3.  Auvert, B., Taljaard, D., Lagarde, E., Sobngwi-Tambekou, J., Sitta, R., & Puren, A. (2005). Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLos med, 2(11), e298.

4. Lee, S. J., Cho, H., Yim, H. E., Kim, S., Lee, E. B., Song, I. H., … & Kim, K. G. (2015). Clinical Guideline for Childhood Urinary Tract Infection (Second Revision). Childhood Kidney Diseases, 19(2), 56-64.