Wednesday, May 1, 2013

Routine Infant Circumcision - What's the real deal here?



In many western cultures, routine infant circumcision (RIC) in boys is commonplace. Some cite aesthetic, religious, or hygiene as the reason for its widespread practice. In modern discourse, the lines have been drawn in the sand. Those who are staunchly against RIC liken it to female genital mutilation, a practice in some African cultures where a young girl's clitoris is cut or removed. Others against it feel that it is taking the choice away from the boy with an unnecessary and risky procedure. Those for RIC are typically in the hygiene camp - the CDC recommends RIC to help prevent urinary tract infections, and the spread of some sexually transmitted infections, including HIV.

Scientific literature is also somewhat divided. In an article published in the Cochrane Database of Systematic Reviews in 2012, the authors found no information that would lead a doctor to believe that RIC help prevent UTI's in boys, and according to the most recent recommendations from the American Academy of Pediatrics, there is not enough data to advise parents to have their sons routinely circumcised. 


On the flip side, information published in the Journal of Urologic Nursing in 2012 cited an increased risk of penile cancer in uncircumcised males, as well as a decreased risk in contracting HIV from a heterosexual partner. There is also recent evidence to suggest that circumcision offers protection against HIV transmission in homosexual relations as well. This is important because, according to the CDC, homosexual males are in a high risk category for HIV transmission.

So it appears that the jury is still out on this debate, and there are good points on either side of the argument. I'd love to hear your thoughts - on which side of the argument do you find yourself, and why?

(Urol Nurs. 2012 Jan-Feb;32(1):10-8; quiz 19. To circ or not: a reappraisal. Ahmed A, Ellsworth P. Source Providence VA Medical Center, Providence, RI, USA.

and

Jagannath VA, Fedorowicz Z, Sud V, Verma AK, Hajebrahimi S. Routine neonatal circumcision for the prevention of urinary tract infections in infancy. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD009129. DOI: 10.1002/14651858.CD009129.pub2.)

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