Male
circumcision is the removal of the
foreskin from the
human penis.
[1][2][3]In the most common procedure, the foreskin is opened, adhesions are removed, and the foreskin is separated from the
glans. After that, the
circumcision device (if used) is placed, and then the foreskin is cut off. Topical or locally injected
anesthesia is occasionally used to reduce pain and
physiologic stress.
[4] For adults and children,
general anesthesia is an option, and the procedure may be performed without a specialized circumcision device. The procedure is most often an
elective surgery performed on babies and children for religious and cultural reasons.
[5] In other cases it may be done as a treatment for a condition or for
preventative reasons. Medically, it is a treatment option for problematic cases of
phimosis,
balanoposthitis that does not resolve with other treatments, and chronic
urinary tract infections(UTIs).
[1][6] It is contraindicated in cases of certain genital structure abnormalities or poor general health.
[2][6]
The positions of the world's major medical organizations range from considering elective circumcision of babies and children as having no benefit and significant risks to having a modest health benefit that outweighs small risks. No major medical organization recommends either universal circumcision for all males (aside from the recommendations of the
World Health Organization (WHO) for areas with high rates of HIV), or banning the procedure.
[7] Ethical and legal questions regarding
informed consent and human rights have been raised over the circumcision of babies and children for non-medical reasons, and for that reason the procedure is
controversial.
[8][9]
Evidence supports that male circumcision reduces the risk of
HIV infectionamong
heterosexual men in
sub-Saharan Africa.
[10][11] Therefore, the WHO recommends considering circumcision as part of a comprehensive
HIV prevention program in areas with high rates of HIV, such as Sub Saharan Africa.
[12] Evidence for a health benefit against HIV for
men who have sex with men is less clear.
[13][14] Additionally, the effectiveness of using circumcision to prevent HIV in the developed world is also unclear.
[15] Circumcision in general is associated with reduced rates of
cancer causing forms of
HPV[16][17] and risk of both
UTIs and
cancer of the penis.
[4] Prevention of those conditions is not a justification for routine circumcision of infants.
[1][18] Studies of its potential protective effects against other
sexually transmitted infections have been unclear. A 2010 review of literature found circumcisions performed by medical providers to have a typical
complication rate of 1.5% for babies and 6% for older children, with few cases of severe complications.
[19] Bleeding, infection and the removal of either too much or too little foreskin are the most common complications cited.
[19] Complication rates are higher when the procedure is performed by an inexperienced operator, in unsterile conditions, or when the child is at an older age.
[19] Circumcision does not appear to have a negative impact on sexual function.
[20][21]
An estimated one-third of males worldwide are circumcised.
[5][19][22] The procedure is most common in the
Muslim world and
Israel (where it is near-universal for religious reasons), the United States, and parts of Southeast Asia and Africa.
[5] It is relatively rare in Europe, Latin America, parts of Southern Africa, and most of Asia.
[5] The origin of circumcision is not known with certainty; the oldest documented evidence for it comes from
ancient Egypt.
[5]Various theories have been proposed as to its origin, including as a religious sacrifice and as a
rite of passage marking a boy's entrance into adulthood.
[23]It is part of
religious law in
Judaism[24] and is an established practice in
Islam,
Coptic Christianity, and the
Ethiopian Orthodox Church.
[5][25][26] The word circumcision is from Latin
circumcidere, meaning "to cut around".
[5]