Neonatal and infant circumcision: Safe in the right hands

Feb 15, 2010

How safe is circumcision? A systematic review, published in the open access journal BMC Urology has found that neonatal and infant circumcision by trained staff rarely results in problems. Risks can be higher among older boys, especially when undertaken by untrained providers with inappropriate equipment.

Dr Helen Weiss, from the London School of Hygiene & Tropical Medicine, UK, studied the medical literature relating to circumcision. Dr Weiss said, "We identified 52 studies from 21 countries which included sufficient information to estimate frequency of adverse events following neonatal, infant and child circumcision. This forms a systematic review of the published literature on complications associated with the procedure at young ages."

The researchers found that among infants aged less than one year old, the frequency of relatively minor adverse events such as excessive bleeding, swelling and infection was low (median 1.5% for any adverse event) and severe complications were very rare. Circumcisions by medical providers on children aged one year or older tended to be associated with more complications (median 6%), although there were still few serious adverse events. However, more complications, including severe complications, were seen when the procedure was undertaken by inexperienced providers, or with inadequate equipment and supplies.

Dr Weiss said, "Male circumcision is commonly practiced and will continue to occur for religious, cultural and medical reasons. There is a clear need to improve safety of male circumcision at all ages through improved training or re-training for both traditional and medically trained providers, and to ensure that providers have adequate supplies of necessary equipment and instruments for safe ".

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More information: Complications of circumcision in male neonates, infants and children: a systematic review, Helen A Weiss, Natasha Larke, Daniel Halperin and Inon Schenker, BMC Urology (in press), www.biomedcentral.com/bmcurol/

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ml66uk
5 / 5 (2) Feb 15, 2010
It depends on what you count as a problem. Meatal stenosis is a frequent side-effect of circumcision, but commonly ignored. Some people aren't happy about the fact that part of their penis was cut off without their consent, but I doubt that's counted as a problem here.

Even when a child appears to have died from circumcision, it generally gets blamed on something else eg blood loss. There was a death in the UK in 2006 where the GMC found that "the wound where the circumcision had taken place may well have been the portal for entry of infection into the child's body", but also found "no causal link between the circumcision and what subsequently happened to that child".
ml66uk
5 / 5 (2) Feb 15, 2010
Has anyone written a systematic review of the complications from removal of the *female* prepuce?

I would imagine that when performed by trained staff, that probably rarely results in "problems" either.
Caliban
not rated yet Feb 15, 2010
@ml66uk,
You should try a quick web search on the subject of "female circumcision"- still practiced the world round, and upon(almost exclusively) young women whon don't have the option of refusing. Given the relative scope of the two "procedures", I'm sure that you will be glad to thank your lucky stars, that(assuming that you are circumcised)anything like the same didn't happen to you. Or, that you didn't suffer one of the more radical, extensive forms of male circumcision still in use today. I'm not judging- just saying.
ml66uk
5 / 5 (1) Feb 16, 2010
@Caliban:
Some forms of female circ do less damage than the usual form of male circ. Sometimes there's just an incision with nothing actually removed. One form just removes the clitoral hood (the female foreskin), so it's the exact equivalent of cutting off a boy's foreskin. In some countries, female circ is performed by doctors in operating theatres with pain relief. Conversely, male circ is often performed as a tribal practice. When circumstances are similar, so are outcomes, and 79 boys died of circ in just one province of South Africa last year.

Are you aware the USA also used to practise female circ? Fortunately, it never caught on the same way as male circ, but there are middle-aged white US American women walking round today with no external clitoris because it was removed. There are frequent references to the practice in medical literature up until at least 1959. Most of them point out the similarity with male circ, and suggest that it should be performed for the same reasons.
ml66uk
5 / 5 (2) Feb 16, 2010
Nowadays, it's illegal even to make an incision on a girl's genitals though, even if no tissue is removed. Why don't boys get the same protection?

Don't get me wrong. I'm totally against female circ, and I probably spend a lot more time and money trying to stop it than most people. If people are serious about stopping female circ though, they also have to be against male circ. Even if you see a fundamental difference, the people that cut girls don't (and they get furious if you call it "mutilation"). There are intelligent, educated, articulate women who will passionately defend it, and as well as using the exact same reasons that are used to defend male circ in the US, they will also point to male circ itself, as evidence of western hypocrisy regarding female circ. The sooner boys are protected from genital mutilation in the west, the sooner those peoples that practice FGM will interpret western objections as something more than cultural imperialism.
bhiestand
5 / 5 (1) Feb 16, 2010
Dr Weiss said, "Male circumcision is commonly practiced and will continue to occur for religious, cultural and medical reasons.

I'm curious what their medical reasons are now. Last I heard they had all been debunked.
Mauricio
5 / 5 (1) Feb 16, 2010
circumcision = non-consensual (irreversible) mutilation of functioning reproductive sexual tissues.

They used to castrate boys so they could sing better. Today, that would be a monstrosity. In few centuries, civilized societies will look back at the barbarians in the XXI century with their very, very, very, small intelligence and their great capacity for hatred. Socrates said few thousand years ago: "humans associate very easily to do harm". The "doctors" associate easier to hurt children, than the ones who are protective of children: the fight between the beast and the academic, will be a victory for the beast, every time - Nietzsche.

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