Abstract
BackgroundCircumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves.DiscussionWe show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring), reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis and paraphimosis. When the boy later becomes sexually active he has substantial protection against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s) is also reduced. Circumcision in adolescence or adulthood may evoke a fear of pain, penile damage or reduced sexual pleasure, even though unfounded. Time off work or school will be needed, cost is much greater, as are risks of complications, healing is slower, and stitches or tissue glue must be used.SummaryInfant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.
Highlights
Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age
In the present article we consider whether this applies to medical male circumcision (MC) - referred to colloquially as a “snip”
Is infancy the best time medically? an abundance of evidence exists about the benefits of MC [9,12,13,18], it is reasonable to ask whether these dictate infant MC rather than MC later in life when a boy can make up his own mind [19,20]
Summary
Is infancy the best time medically? an abundance of evidence exists about the benefits of MC [9,12,13,18], it is reasonable to ask whether these dictate infant MC rather than MC later in life when a boy can make up his own mind [19,20]. Since men circumcised later were less likely to engage in insertive anal intercourse, psychological effects after MC for medical need, at an age where the male has cognitive awareness of his previous painful penile problems, as well as the surgery itself, seemed a probable explanation. It has been suggested that neonatal MC may reduce the chances of a change in behavior due to circumcision status, as the male will not perceive any change in risk compared to what might transpire if the circumcision had taken place at an age when he might be sexually active [181] While these various psychological problems should be mitigated by making MC normative in a community, just as with most fears and anxieties, the prospect of such concerns would be largely eliminated if MC were performed in infancy. Given the high infection and disease risk overall to the male and his female partners (Table 1) there would be few populations in the world that would not benefit from MC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
