Systematic review does not endorse widespread non-theraputic circumcision

January 01, 0001

Systematic review does not endorse widespread non-theraputic circumcision

These Australian authors wanted to assess the safety and efficacy of nontherapeutic male circumcision through a systematic review. They searched Pubmed, Embase, The York Centre for Reviews and Disseminations, and the Cochrane Library for randomized controlled trials published between January 1997 and August 2008. Of 73 retrieved studies, 8 randomized controlled trials were included.

The authors found: "Severe complications were uncommon. Analgesia or anesthesia during circumcision was promoted. The prevalence of self-reported genital ulcers was significantly lower in circumcised men than uncircumcised men (3.1% vs 5.8%, prevalence risk ratio 0.53). Circumcised sub-Saharan African men were at significantly lower risk of acquiring human immunodeficiency virus-acquired immune deficiency syndrome than were uncircumcised men (random effects odds ratio = 0.44). The evidence suggests that adult circumcision does not affect sexual satisfaction and function."

They concluded: "Strong evidence suggests circumcision can prevent human immunodeficiency virus-acquired immune deficiency syndrome acquisition in sub-Saharan African men. These findings remain uncertain in men residing in other countries. The role of adult nontherapeutic male circumcision in preventing sexually transmitted infections, urinary tract infections, and penile cancer remains unclear. Current evidence fails to recommend widespread neonatal circumcision for these purposes."

This systematic review found some clear health benefits to circumcision, but it is unclear how broadly applicable they are. As such, the decision to circumcise or not still depends significantly on non-medical factors.

For the full abstract, click here.

Annals of Family Medicine 8(1):64-72, January 2010 © 2010 Annals of Family Medicine, Inc.
Safety and Efficacy of Nontherapeutic Male Circumcision-A Systematic Review. Caryn L. Perera, Grad Cert, Franklin H. G. Bridgewater, Prema Thavaneswaran, and Guy J. Maddern. Correspondence to: Guy J. Maddern: [email protected]

Category: Y. Male Genital System. Keywords: male circumcision, sexually transmitted diseases, HIV, penile cancer, urinary tract infections, systematic review with meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 26 January 2009

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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