Male circumcision has long been a debate with decisions based on cultural, ethnic, religious and social preference of the parent. There are both benefits and risks associated with the procedure of male circumcision. The procedure involves the removal of some or, the entire foreskin around the penis. Neonatal circumcision is rising among English speaking countries and it is known now that more than 80% of the male population has been circumcised. (CDC, 2006) This number is rising however; studies show that there is insufficient evidence to recommend neonatal circumcision as a routine decision. AAP, 2006). Many debates of this procedure relate to the benefits versus the risk and medical costs that the procedure entails. This paper will discuss the benefits and risks of this procedure and will portray my position on this debated decision. Although questionable by many researchers, benefits of this procedure include better hygiene reducing the incident of infant UTI, reduction of sexually transmitted disease, and reduction in the spreading of the HIV virus in heterosexual relations.
A study was conducted on 1000 circumcised infants and 1000 uncircumcised infants within 1 year of birth to determine which cohort had more incidents of UTI. The results of this study show that in the circumcised group, 1 or 2 of the 1000 infants developed a UTI and of the 1000 uncircumcised group, 7 to 14 infants developed a UTI. (AAP, 2006) This study shows that circumcision reduces the risk of UTI after circumcision within the first year of life.
Although this study does show an increase in risk of UTI in uncircumcised infants, I question the validity of this study due to the fact that there are uncontrolled variables such as, samples of infants studied, determination of circumcision status, method of urine collection, and UTI definition. All of these variables can affect the study, making it not valid. Another study was conducted that claims male circumcision significantly reduces the risk of acquiring HIV among heterosexual male relationships.
The study included 1391 circumcised and uncircumcised men between the ages of 18 and 24. The results of this study show that after 2 years there was a 53% less change of acquiring HIV in the circumcised males. (Science Daily, 2007) This study does not seem valid to me due to the fact that the age gap is very wide, the sexual practice and preference were not stated, doesn’t include number of partners, whether sex was protected or unprotected, and doesn’t state whether these men were sharing needles if using drugs.
There were several other studies conducted that showed an increase in risk of STD’s with uncircumcised males and I also question the validity of these studies due to the same questionable variables in the HIV studies. The most common risks associated with neonatal circumcision include loss of penile sensation, bleeding, infection, unsatisfactory cosmesis because of excess skin, skin bridges, and urinary retention. Most complications are minor and studies show that there is a 0. 2% to 0. 6% complication rate. WHO, 2009) More drawbacks of circumcision can include different elements that effect sexual function. The removed foreskin is erogenous tissue that contains a number of nerve endings that can contribute to the sexual response of the penis. When retracted, the foreskin provides loose skin on the shaft of the penis, which facilitates sexual intercourse. Also, the foreskin is a protector of the sensitive glans that can lose sensitivity from constant exposure to clothing. (NOCIRC, 2000) Another controversy surrounding the procedure of neonatal circumcision is the idea of social acceptability.
The United States has a very high rate of neonatal circumcisions and is becoming less socially acceptable to be uncircumcised. I feel that this pressure greatly attributes to a parents decision to lean more towards circumcision than not. A survey was conducted among parents of 124 newborn males at an American hospital. The results of this survey showed the parents decisions were based more on social concerns than medical concerns. The parents were pro circumcision based on the fact that they wanted their child to look like their fathers, family and friends.
The survey showed that 90% of circumcised fathers had circumcised sons. (CIRP, 2000) Although this is a survey and not a research study, I feel that it reveals the fact the most decisions today are based more on emotional, socially acceptable decision rather than rational decision. After reading literature and research studies on the subject of circumcision I feel that there is definitely not enough medical evidence and insufficient information to recommend routine neonatal male circumcision.
Understanding that the newborn infant doesn’t have the chance to make this decision, I feel that parents should be more educated on the risks versus the benefits of this procedure. There seems to be more evidence recently to support the fact that this procedure is not medically necessary and can affect sexual function as well. After reading the studies and writing this paper I would definitely agree that there is insufficient evidence to believe it be medically advantageous to circumcise an infant. At this time I would decide against circumcision on my newborn child.
http://whqlibdoc.who.int/publications/2007/9789241595988_eng.pdf. (2007). Retrieved November 28, 2010 from www.who.net: http://whqlibdoc.who.int/?publications/?2007/?9789241595988_eng.pdf.
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686. (2008). Retrieved November 28, 2010 from htt/://aap.net: http://aappolicy.aappublications.org/?cgi/?content/?full/?pediatrics;103/?3/686.
http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm. (2007). Retrieved November 28, 2010 from www.cdc.gov: http://www.cdc.gov/?hiv/?resources/?factsheets/?circumcision.htm.
http://www.nocirc.org/articles/. (2000). Retrieved November 29, 2010 from http://www.nocirc.org: http://www.nocirc.org/?articles/.
http://www.sciencedaily.com/releases/2007/02/070223103150.htm. (2007). Retrieved November 29, 2010 from http:www//.sciencedaily.com: http://www.sciencedaily.com/?releases/?2007/?02/?070223103150.htm.