Infant male circumcision: An evidence-based policy statement

Abstract

Here we review the international evidence for benefits and risks of infant male circumcision (MC) and use this to develop an evidence-based policy statement for a developed nation setting, focusing on Australia. Evidence from good quality studies that include meta-analyses and randomized controlled trials showed that MC provides strong protection against: urinary tract infections and, in infancy, renal parenchymal disease; phimosis; paraphimosis; balanoposthitis; foreskin tearing; some heterosexually transmitted infections including HPV, HSV-2, trichomonas, HIV, and genital ulcer disease; thrush; inferior hygiene; penile cancer and possibly prostate cancer. In women, circumcision of the male partner protects against HPV, HSV-2, cervical cancer, bacterial vaginosis, and possibly Chlamydia. MC has no adverse effect on sexual function, sensitivity, penile sensation or satisfaction and may enhance the male sexual experience. Adverse effects are uncommon (<1%), and virtually all are minor and easily treated. For maximum benefits, safety, convenience and cost savings, MC should be performed in infancy and with local anesthesia. A risk-benefit analysis shows benefits exceed risks by a large margin. Over their lifetime up to half of uncircumcised males will suffer a medical condition as a result of retaining their foreskin. The ethics of infant MC and childhood vaccination are comparable. Our analysis finds MC is beneficial, safe and cost-effective, and should optimally be performed in infancy. In the interests of public health and individual wellbeing, adequate parental education, and steps to facilitate access and affordability should be encouraged in developed countries.

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Morris, B. , Wodak, A. , Mindel, A. , Schrieber, L. , Duggan, K. , Dilley, A. , Willcourt, R. , Lowy, M. , Cooper, D. , Lumbers, E. , Russell, C. and Leeder, S. (2012) Infant male circumcision: An evidence-based policy statement. Open Journal of Preventive Medicine, 2, 79-92. doi: 10.4236/ojpm.2012.21012.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Circumcision Foundation of Australia (2010). http://www.circumcisionaustralia.org
[2] Cooper, D.A., Wodak, A.D. and Morris, B.J. (2010) The case for boosting infant male circumcision in the face of rising heterosexual transmission of HIV. The Medical Journal of Australia, 193, 318-319.
[3] Morris, B.J. (2007) Why circumcision is a biomedical imperative for the 21st Century. BioEssays, 29, 1147-1158. doi:10.1002/bies.20654
[4] Smith, D.K., Taylor, A., Kilmarx, P.H., et al. (2010) Male circumcision in the United States for the prevention of HIV infection and other adverse health outcomes: Report from a CDC consultation. Public Health Reports, 125, 72-82.
[5] Tobian, A.A., Gray, R.H. and Quinn, T.C. (2010) Male circumcision for the prevention of acquisition and transmission of sexually transmitted infections: The case for neonatal circumcision. Archives of Pediatrics & Adolescent Medicine, 164, 78-84. doi:10.1001/archpediatrics.2009.232
[6] Macdonald, A., Humphreys, J. and Jaffe, H.W. (2008) Prevention of HIV transmission in the United Kingdom: What is the role of male circumcision? Sexually Transmitted Infections, 84, 158-160. doi:10.1136/sti.2008.029934
[7] Morris, B.J. (2010) Circumcision: An evidence-based appraisal—Medical, health and sexual (a review with 1023 references). http://www.circinfo.net
[8] Darby, R. (2011) Infant circumcision in Australia: A preliminary estimate, 2000-2010. The Australian and New Zealand Journal of Public Health, 35, 391-392. doi:10.1111/j.1753-6405.2011.00746.x
[9] Harbour, R. and Miller, J. (2001) A new system for grading recommendations in evidence based guidelines. British Medical Journal, 323, 334-336. doi:10.1136/bmj.323.7308.334
[10] Wiswell, T.E. (1997) Circumcision circumspection. The New England Journal of Medicine, 36, 1244-1245. doi:10.1056/NEJM199704243361709
[11] Schoen, E.J., Colby, C.J. and Ray, G.T. (2000) Newborn circumcision decreases incidence and costs of urinary tract infections in the first year of life. Pediatrics, 105, 789-793. doi:10.1542/peds.105.4.789
[12] Koyle, M.A., Barqawi, A., Wild, J., et al. (2003) Pediatric urinary tract infections: The role of fluoroquinolones. The Pediatric Infectious Disease Journal, 22, 1133-1137. doi:10.1097/01.inf.0000101849.11912.8e
[13] Chon, C.H., Lai, F.C. and Shortliffe, L.M. (2001) Pediatric urinary tract infections. Pediatric Clinics of North America, 48, 1441-1459. doi:10.1016/S0031-3955(05)70385-0
[14] Wiswell, T.E., Smith, F.R. and Bass, J.W. (1985) Circumcised male infants. Pediatrics, 75, 901-903.
[15] Wiswell, T.E. and Geschke, D.W. (1989) Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics, 83, 1011-1015.
[16] Wiswell, T.E. and Hachey, W.E. (1993) Urinary tract infections and the circumcision state: An update. Clinical Pediatrics, 32, 130-134. doi:10.1177/000992289303200301
[17] Schoen, E.J., Wiswell, T.E. and Moses, S. (2000) New policy on circumcision—Cause for concern. Pediatrics, 105, 620-623. doi:10.1542/peds.105.3.620
[18] Singh-Grewal, D., Macdessi, J. and Craig, J. (2005) Circumcision for the prevention of urinary tract infections in boys: A systematic review of randomized trials and observational studies. Archives of Disease in Childhood, 90, 853-858. doi:10.1136/adc.2004.049353
[19] Nayir, A. (2001) Circumcision for the prevention of significant bacteriuria in boys. Pediatric Nephrology, 16, 1129-1134. doi:10.1007/s004670100044
[20] Craig, J.C., Knight, J.F., Sureshkumar, P., et al. (1996) Effect of circumcision on incidence of urinary tract infection in preschool boys. Journal of Pediatrics, 128, 23-27. doi:10.1016/S0022-3476(96)70423-7
[21] Zorc, J.J., Kiddoo, D.A. and Shaw, K.N. (2005) Diagnosis and management of pediatric urinary tract infections. Clinical Microbiology Reviews, 18, 417-422. doi:10.1128/CMR.18.2.417-422.2005
[22] Coulthard, M.G., Lambert, H.J. and Keir, M.J. (1997) Occurrence of renal scars in children after their first referral for urinary tract infection. British Medical Journal, 315, 918-919. doi:10.1136/bmj.315.7113.918
[23] Spach, D.H., Stapleton, A.E. and Stamm, W.E. (2012) Lack of circumcision increases the risk of urinary tract infections in young men. Journal of the American Medical Association, 267, 679-681. doi:10.1001/jama.1992.03480050083029
[24] Morris, B.J. and Cox, G. (2011) Current medical evidence favours male circumcision. In: Bolnick, D.A., Koyle, M.A. and Yosha, A. Eds., Surgical Guide to Circumcision, Springer, London.
[25] Zorc, J.J., Levine, D.A., Platt, S.L., et al. (2005) Clinical and demographic factors associated with urinary tract infection in young febrile infants. Pediatrics, 116, 644-648. doi:10.1542/peds.2004-1825
[26] Shaikh, N., Morone, N.E., Bost, J.E., et al. (2008) Prevalence of urinary tract infection in childhood: A meta-analysis. The Pediatric Infectious Disease Journal, 27, 302-308. doi:10.1097/INF.0b013e31815e4122
[27] Hsiao, A.L., Chen, L. and Baker, M.D. (2006) Incidence and predictors of serious bacterial infections among 57-to 180-day-old infants. Pediatrics, 117, 1695-1701. doi:10.1542/peds.2005-1673
[28] Rushton, H.G. (1997) Urinary tract infections in children. Epidemiology, evaluation, and management. Pediatric Clinics of North America, 44, 1133-1169. doi:10.1016/S0031-3955(05)70551-4
[29] Rushton, H.G. and Majd, M. (1992) Dimercaptosuccinic acid renal scintigraphy for the evaluation of pyelonephritis and scarring: A review of experimental and clinical studies. Journal of Urology, 148, 1726-1732.
[30] Wiswell, T.E. (2000) The prepuce, urinary tract infections, and the consequences. Pediatrics, 105, 8602. doi:10.1542/peds.105.4.860
[31] Jacobson, S.H., Eklof, O., Eriksson, C.G., et al. (1989) Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. British Medical Journal, 16, 703-706. doi:10.1136/bmj.299.6701.703
[32] Shim, Y.H., Lee, J.W. and Lee, S.J. (2009) The risk factors of recurrent urinary tract infection in infants with normal urinary systems. Pediatric Nephrology, 24, 309-312. doi:10.1007/s00467-008-1001-0
[33] Conway, P.H., Cnaan, A., Zaoutis, T., et al. (2007) Recurrent urinary tract infections in children: Risk factors and association with prophylactic antimicrobials. Journal of the American Medical Association, 298, 179-186. doi:10.1001/jama.298.2.179
[34] Rushton, H.G. (1997) The evaluation of acute pyelonephritis and renal scarring with technetium 99 mdimercaptosuccinic acid renal scintigraphy: Evolving concepts and future directions. Pediatric Nephrology, 11, 108-120. doi:10.1007/s004670050243
[35] Schoen, E.J. (2005) Circumcision for preventing urinary tract infections in boys: North American view. Archives of Disease in Childhood, 90, 772-773. doi:10.1136/adc.2004.066761
[36] Price, L.B., Liu, C.M., Johnson, K.E., et al. (2010) The effects of circumcision on the penis microbiome. PLoS One, 5, e8422. doi:10.1371/journal.pone.0008422
[37] Oster, J. (1968) Further fate of the foreskin: Incidence of preputial adhesions, phimosis and smegma among Danish schoolboys. Archives of Disease in Childhood, 43, 200-203. doi:10.1136/adc.43.228.200
[38] Schoen, E.J. (1993) Circumcision updated—Implicated? Pediatrics, 92, 860-861.
[39] Xu, B. and Goldman, H. (2008) Newborn circumcision in Victoria, Australia: Reasons and parental attitudes. Australian and New Zealand Journal of Surgery, 78, 1019-1022. doi:10.1111/j.1445-2197.2008.04723.x
[40] Kalcev, B. (1964) Circumcision and personal hygiene in school boys. Medical Officer, 112, 171-173.
[41] O’Farrell, N., Quigley, M. and Fox, P. (2005) Association between the intact foreskin and inferior standards of male genital hygiene behaviour: A cross-sectional study. International Journal of STD & AIDS, 16, 556-559. doi:10.1258/095646205467915
[42] O’Farrell, N., Chung, C.K. and Weiss, H.A. (2008) Foreskin length in uncircumcised men is associated with subpreputial wetness. International Journal of STD & AIDS, 19, 821-823. doi:10.1258/ijsa.2008.008106
[43] Wright, J. (1970) How smegma serves the penis? Sexology, 37, 50-53.
[44] Oh, S.-J., Kim, K.D., Kim, K.M., et al. (2002) Knowledge and attitudes of Korean parents towards their son’s circumcision: A nationwide questionnaire study. British Journal of Urology International, 89, 426-432. doi:10.1046/j.1464-4096.2001.01964.x
[45] Edwards, S. (1996) Balanitis and balanoposthitis: A review. Genitourinary Medicine, 72, 155-159.
[46] Herzog, L.W. and Alvarez, S.R. (1986) The frequency of foreskin problems in uncircumcised children. American Journal of Diseases of Children, 140, 254-256.
[47] Fergusson, D.M., Lawton, J.M. and Shannon, F.T. (1988) Neonatal circumcision and penile problems: An 8-year longitudinal study. Pediatrics, 81, 537-541.
[48] Fakjian, N., Hunter, S., Cole, G.W., et al. (1990) An argument for circumcision. Prevention of balanitis in the adult. Archives of Dermatology, 126, 1046-1047. doi:10.1001/archderm.1990.01670320070011
[49] Schoen, E.J. (2007) Male circumcision. In: Kandeel, F.R., Lue, T.F., Pryor, J.L. and Swerdloff, R.S. Eds., Male Sexual Dysfunction. Pathophysiology and Treatment, Informa, New York, 95-107.
[50] Kiss, A., Kiraly, L., Kutasy, B., et al. (2005) High incidence of balanitis xerotica obliterans in boys with phimosis: Prospective 10-year study. Archives of Dermatology, 22, 305-308. doi:10.1111/j.1525-1470.2005.22404.x
[51] Yardley, I.E., Cosgrove, C. and Lambert, A.W. (2007) Paediatric preputial pathology: Are we circumcising enough? Annals of the Royal College of Surgeons of England, 89, 62-65. doi:10.1308/003588407X160828
[52] Letendre, J., Barrieras, D., Franc-Guimond, J., et al. (2009) Topical triamcinolone for persistent phimosis. Journal of Urology, 182, 1759-1763. doi:10.1016/j.juro.2009.03.016
[53] Morris, B.J. and Castellsague, X. (2011) The role of circumcision in the preventing STIs. In: Gross, G.E. and Tyring, S.K. Eds., Sexually Transmitted Infections and Sexually Transmitted Diseases, Springer-Verlag, Berlin and Heidelberg, 715-739. doi:10.1007/978-3-642-14663-3_54
[54] Weiss, H.A., Thomas, S.L., Munabi, S.K., et al. (2006) Male circumcision and risk of syphilis, chancroid, and genital herpes: A systematic review and meta-analysis. Sexually Transmitted Infections, 82, 101-109. doi:10.1136/sti.2005.017442
[55] Larke, N., Thomas, S.L., Dos Santos Silva, I., et al. (2011) Male circumcision and human papillomavirus infection in men: A systematic review and meta-analysis. Journal of Infectious Diseases, 204, 1375-1390. doi:10.1093/infdis/jir523
[56] Fergusson, D.M., Boden, J.M. and Horwood, L.J. (2006) Circumcision status and risk of sexually transmitted infection in young adult males: An analysis of a longitudinal birth cohort. Pediatrics, 118, 1971-1977. doi:10.1542/peds.2006-1175
[57] Dickson, N.P., van Roode, T., Herbison, P., et al. (2008) Circumcision and risk of sexually transmitted infections in a birth cohort. Journal of Pediatrics, 152, 383-387. doi:10.1016/j.jpeds.2007.07.044
[58] Dickson, N., van Roode, T. and Paul, C. (2005) Herpes simplex virus type 2 status at age 26 is not related to early circumcision in a birth cohort. Sexually Transmitted Diseases, 32, 517-519. doi:10.1097/01.olq.0000161296.58095.ab
[59] Dickson, N.P., Ryding, J., van Roode, T., et al. (2009) Male circumcision and serologically determined human papillomavirus infection in a birth cohort. Cancer Epidemiology, Biomarkers & Prevention, 18, 177-183. doi:10.1158/1055-9965.EPI-08-0353
[60] Lu, B., Wu, Y., Nielson, C.M., et al. (2009) Factors associated with acquisition and clearance of human papillomavirus infection in a cohort of US men: A prospective study. Journal of Infectious Diseases, 199, 362-371. doi:10.1086/596050
[61] Gray, R.H., Serwadda, D., Kong, X., et al. (2010) Male circumcision decreases acquisition and increases clearance of high-risk human papillomavirus in HIV-negative men: A randomized trial in Rakai, Uganda. Journal of Infectious Diseases, 201, 1455-1462. doi:10.1086/652184
[62] Hernandez, B.Y., Shvetsov, Y.B., Goodman, M.T., et al. (2010) Reduced clearance of penile human papillomavirus infection in uncircumcised men. Journal of Infectious Diseases, 201, 1340-1343. doi:10.1086/651607
[63] Sobngwi-Tambekou, J., Taljaard, D., Lissouba, P., et al. (2009) Effect of HSV-2 serostatus on acquisition of HIV by young men: Results of a longitudinal study in Orange Farm, South Africa. Journal of Infectious Diseases, 199, 958-964. doi:10.1086/597208
[64] Tobian, A.A.R., Charvat, B., Ssempijja, V., et al. (2009) Factors associated with the prevalence and incidence of herpes simplex virus type 2 infection among men in Rakai, Uganda. Journal of Infectious Diseases, 199, 945-949. doi:10.1086/597074
[65] Tobian, A.A.R., Serwadda, D., Quinn, T.C., et al. (2009) Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. The New England Journal of Medicine, 360, 1298-1309. doi:10.1056/NEJMoa0802556
[66] Tobian, A.A.R., Kong, X., Gravitt, P.E., et al. (2011) Male circumcision and anatomic sites of penile human papillomavirus in Rakai, Uganda. International Journal of Cancer, 129, 2970-2975. doi:10.1002/ijc.25957
[67] Gray, R.H. (2009) Infectious disease: Male circumcision for preventing HPV infection. Nature Reviews Urology, 6, 298-299. doi:10.1038/nrurol.2009.96
[68] Serwadda, D., Wawer, M.J., Makumbi, F., et al. (2010) Circumcision of HIV-infected men: Effects on high-risk human papillomavirus infections in a randomized trial in Rakai, Uganda. Journal of Infectious Diseases, 201, 1463-1469. doi:10.1086/652185
[69] Viscidi, R.P. and Shah, K.V. (2010) Adult male circumcision: will it reduce disease caused by human papillomavirus? Journal of Infectious Diseases, 201, 1447-1449. doi:10.1086/652186
[70] Auvert, B., Sobngwi-Tambekou, J., Cutler, E., et al. (2009) Effect of male circumcision on the prevalence of high-risk human papillomavirus in young men: Results of a randomized controlled trial conducted in orange farm. South Africa. Journal of Infectious Diseases, 199, 14-19. doi:10.1086/595566
[71] Backes, D.M., Bleeker M.C., Meijer C.J., et al. (2011) Male circumcision is associated with a lower prevalence of human papillomavirus-associated penile lesions among Kenyan men. International Journal of Cancer [Epub ahead of print]. doi:10.1002/ijc.26196
[72] Van Wagoner, N.J., Geisler, W.M., Sizemore Jr., J.M., et al. (2010) Herpes simplex virus in African American heterosexual males: The roles of age and male circumcision. Sexually Transmitted Diseases, 37, 217-222. doi:10.1097/OLQ.0b013e3181c17b65
[73] Bailey, R.C. and Mehta, S.D. (2009) Circumcision’s place in the vicious cycle involving herpes simplex virus type 2 and HIV. Journal of Infectious Diseases, 199, 923-925. doi:10.1086/597209
[74] Gray, R.H., Kigozi, G., Serwadda, D., et al. (2007) Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial. Lancet, 369, 657-666. doi:10.1086/597209
[75] Gray, R.H., Serwadda, D., Tobian, A.A.R., et al. (2009) Effects of genital ulcer disease and herpes simplex virus type 2 on the efficacy of male circumcision for HIV prevention: Analyses from the Rakai trials. PLoS Medicine, 6, e1000187. doi:10.1371/journal.pmed.1000187
[76] Waskett, J.H., Morris, B.J. and Weiss, H.A. (2009) Errors in meta-analysis by Van Howe. International Journal of STD & AIDS, 20, 216-218. doi:10.1258/ijsa.2009.008126
[77] Cunningham, A.L., Taylor, R., Taylor, J., et al. (2006) Prevalence of infection with herpes simplex virus types 1 and 2 in Australia: A nationwide population-based survey. Sexually Transmitted Infections, 82, 164-168. doi:10.1136/sti.2005.016899
[78] Ferris, J.A., Richters, J., Pitts, M.K., et al. (2010) Circumcision in Australia: Further evidence on its effects on sexual health and wellbeing. The Australian and New Zealand Journal of Public Health, 34, 160-164. doi:10.1111/j.1753-6405.2010.00501.x
[79] Agius, P.A., Pitts, M.K., Smith, A.M., et al. (2010) Sexual behaviour and related knowledge among a representative sample of secondary school students between 1997 and 2008. The Australian and New Zealand Journal of Public Health, 34, 467-481. doi:10.1111/j.1753-6405.2010.00593.x
[80] Kang, M., Rochford, A., Johnston, V., et al. (2006) Prevalence of Chlamydia trachomatis infection among “high risk” young people in New South Wales. Sexual Health, 3, 253-254. doi:10.1071/SH06025
[81] Baldwin, S.B., Wallace, D.R., Papenfuss, M.R., et al. (2004) Condom use and other factors affecting penile human papilloma virus detection in men attending a sexually transmitted disease clinic. Sexually Transmitted Diseases, 31, 601-607. doi:10.1097/01.olq.0000140012.02703.10
[82] Nielson, C.M., Harris, R.B., Dunne, E.F., et al. (2007) Risk factors for anogenital human papillomavirus infection in men. Journal of Infectious Diseases, 196, 1137-1145. doi:10.1086/521632
[83] Castellsague, X., Bosch, F.X., Munoz, N., et al. (2002) Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. The New England Journal of Medicine, 346, 1105-1112. doi:10.1056/NEJMoa011688
[84] Mugo, N., Dadabhai, S.S., Bunnell, R., et al. (2011) Prevalence of herpes simplex virus type 2 infection, human immunodeficiency virus/herpes simplex virus type 2 coinfection, and associated risk factors in a national, population-based survey in Kenya. Sexually Transmitted Diseases, 38, 1059-1066. doi:10.1097/OLQ.0b013e31822e60b6
[85] Low, N., Broutet, N., Adu-Sarkodie, Y., et al. (2006) Global control of sexually transmitted infections. Lancet, 368, 2001-2016. doi:10.1016/S0140-6736(06)69482-8
[86] Sanchez, T., Finlayson, T., Drake, A., et al. (2006) Human immunodeficiency virus (HIV) risk, prevention, and testing behaviors—United States, National HIV Behavioral Surveillance System: Men who have sex with men, November 2003-April 2005. MMWR Surveillance Summaries, 55, 1-16.
[87] Beckman, L.J., Harvey, S.M. and Tiersky, L.A. (1996) Attitudes about condoms and condom use among college students. The Journal of American College Health, 44, 243-249. doi:10.1080/07448481.1996.9936851
[88] Anderson, J.E., Wilson, R., Doll, L., et al. (1999) Condom use and HIV risk behaviors among US adults: Data from a national survey. Family Planning Perspectives, 31, 24-28. doi:10.2307/2991553
[89] Jadack, R.A., Yuenger, J., Ghanem, K.G., et al. (2006) Polymerase chain reaction detection of Y-chromosome sequences in vaginal fluid of women accessing a sexually transmitted disease clinic. Sexually Transmitted Diseases, 33, 22-25. doi:10.1097/01.olq.0000194600.83825.81
[90] Auvert, B., Taljaard, D., Lagarde, E., et al. (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 Trial. PLoS Medicine, 2, 1112-1122. doi:10.1371/journal.pmed.0020298
[91] Bailey, R.C., Moses, S., Parker, C.B., et al. (2007) Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. Lancet, 369, 643-656. doi:10.1016/S0140-6736(07)60312-2
[92] Siegfried, N., Muller, M., Deeks, J.J., et al. (2009) Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database of Systematic Reviews, CD003362, 38.
[93] Weiss, H.A., Halperin, D., Bailey, R.C., et al. (2008) Male circumcision for HIV prevention: From evidence to action? AIDS, 22, 567-574. doi:10.1097/QAD.0b013e3282f3f406
[94] Mills, E., Cooper, C., Anema, A., et al. (2008) Male circumcision for the prevention of heterosexually acquired HIV infection: A meta-analysis of randomized trials involving 11,050 men. HIV Medicine, 9, 332-335. doi:0.1111/j.1468-1293.2008.00596.x
[95] Byakika-Tusiime, J. (2008) Circumcision and HIV infection: Assessment of causality. AIDS and Behavior, 12, 835-841. doi:10.1007/s10461-008-9453-6
[96] Gebremedhin, S. (2010) Assessment of the protective effect of male circumcision from HIV infection and sexually transmitted diseases: Evidence from 18 demographic and health surveys in sub-Saharan Africa. African Journal of Reproductive Health, 14, 105-113.
[97] Morris, B.J. and Wamai, R.G. (2011) Biological basis for the protective effect conferred by male circumcision against HIV infection. International Journal of STD & AIDS (in press).
[98] Hill, B.A. (1965) The environment and disease: Association or causation? Proceedings of the Royal Society of Medicine, 58, 295-300.
[99] Bailey, R.C., Moses, S., Parker, C.B., et al. (2008) The protective effect of male circumcision is sustained for at least 42 months: Results from the Kisumu, Kenya Trial. XVII International AIDS Conference, 2008, THAC05.
[100] Bailey, R.C., Moses, S., Parker, C.B., et al. (2010) The protective effect of adult male circumcision against HIV acquisition is sustained for at least 54 months: Results from the Kisumu, Kenya trial. XVIII International AIDS Conference, Vienna, 18-23 July 2010.
[101] Gray, R., Kigozi, G., Kong, X., et al. (2012) The effectiveness of male circumcision for HIV prevention and effects on risk behaviors in a post-trial follow up study in Rakai, Uganda. AIDS [Epub ahead of print].
[102] Fiore, A.E., Shay, D.K., Penina Haber, P., et al. (2007) Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention—Mortality and Morbidity Weekly Report, 56, 1-54.
[103] Kelly, H., Carville, K., Grant, K., et al. (2009) Estimation of influenza vaccine effectiveness from routine surveillance data. PLoS One, 4, e5079. doi:10.1371/journal.pone.0005079
[104] World Health Organization and UNAIDS (2007) New data on male circumcision and HIV prevention: Policy and programme implications. http://who.int/hiv/mediacentre/MCrecommendations_en.pdf.
[105] Auvert, B., Taljaard, D., Rech, D., et al. (2011) Effect of the Orange Farm (South Africa) male circumcision roll-out (ANRS-12126) on the spread of HIV. 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention, Rome, 17-20 July.
[106] Telzak, E.E., Chiasson, M.A., Bevier, P.J., et al. (1993) HIV-1 seroconversion in patients with and without genital ulcer disease: A prospective study. Annals of Internal Medicine, 119, 1181-1186.
[107] Warner, L., Ghanem, K.G., Newman, D.R., et al. (2009) Male circumcision and risk of HIV infection among heterosexual African American men attending Baltimore sexually transmitted disease clinics. Journal of Infectious Diseases, 199, 59-65. doi:10.1086/595569
[108] Sullivan, P.S., Kilmarx, P.H., Peterman, T.A., et al. (2007) Male circumcision for prevention of HIV transmission: What the new data mean for HIV prevention in the United States. PLoS Medicine, 4, 1162-1166. doi:10.1371/journal.pmed.0040223
[109] Centers for Disease Control and Prevention (2011) Diagnoses of HIV infection and AIDS in the United States and Dependent Areas. http://www.cdc.gov/hiv/surveillance/resources/reports/2008report/
[110] National Centre for HIV Eidemiology and Clinical Research. HIV, viral hepatitis and sexually transmissible infections in Australia. Annual Surveillance Report. http://www.med.unsw.edu.au/NCHECRweb.nsf/resources/2011/$file/KIRBY_ASR2011.pdf.
[111] Centers for Disease Control and Prevention (2008) HIV/AIDS science facts. Male circumcision and risk for HIV transmission and other health conditions: Implications for the United States. http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm
[112] Sansom, S.L., Prabhu, V.S., Hutchinson, A.B., et al. (2010) Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among US males. PLoS One, 5, e8723. doi:10.1371/journal.pone.0008723
[113] Templeton, D.J., Jin, F., Mao, L., et al. (2009) Circumcision and risk of HIV infection in Australian homosexual men. AIDS, 23, 2347-2351. doi:10.1097/QAD.0b013e32833202b8
[114] Millett, G.A., Flores, S.A., Marks, G., et al. (2008) Circumcision status and risk of HIV and sexually transmitted infections among men who have sex with men: A meta-analysis. JAMA, 300, 1674-1684. doi:10.1001/jama.300.14.1674
[115] Wiysonge, C.S., Kongnyuy, E.J., Shey, M., et al. (2011) Male circumcision for prevention of homosexual acquisition of HIV in men. Cochrane Database of Systematic Reviews, 6, CD007496. doi:10.1002/14651858.CD007496.pub2
[116] Anderson, J., Wilson, D., Templeton, D.J., et al. (2009) Cost-effectiveness of adult circumcision in a resource-rich setting for HIV prevention among men who have sex with men. Journal of Infectious Diseases, 200, 1803-1812. doi:10.1086/648472
[117] Virgin, H.W. and Walker, B.D. (2010) Immunology and the elusive AIDS vaccine. Nature, 464, 224-231. doi:10.1038/nature08898
[118] Morris, B.J. and Rose, B.R. (2007) Cervical screening in the 21st Century: The case for human papillomavirus testing of self-collected specimens. Clinical Chemistry and Laboratory Medicine, 45, 577-591. doi:10.1515/CCLM.2007.127
[119] Bosch, F.X., Albero, G. and Castellsagué, X. (2009) Male circumcision, human papillomavirus and cervical cancer: From evidence to intervention. Journal of Family Planning and Reproductive Health Care, 35, 5-7. doi:10.1783/147118909787072270
[120] Drain, P.K., Halperin, D.T., Hughes, J.P., et al. (2006) Male circumcision, religion, and infectious diseases: An ecologic analysis of 118 developing countries. BMC Infectious Diseases, 6, 172. doi:10.1186/1471-2334-6-172
[121] Wawer, M.J., Tobian, A.A.R., Kigozi, G., et al. (2011) Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: A randomised trial in Rakai, Uganda. Lancet, 377, 209-218. doi:10.1016/S0140-6736(10)61967-8
[122] Goldie, S.J., Kohli, M., Grima, D., et al. (2004) Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine. Journal of the National Cancer Institute, 96, 604-615. doi:10.1093/jnci/djh104
[123] Garnett, G.P., Kim, J.J., French, K., et al. (2006) Chapter 21: Modelling the impact of HPV vaccines on cervical cancer and screening programmes. Vaccine, 24, 178-186. doi:10.1016/j.vaccine.2006.05.116
[124] Choi, Y.H., Jit, M., Gay, N., et al. (2010) Transmission dynamic modelling of the impact of human papillomavirus vaccination in the United Kingdom. Vaccine, 28, 4091-4102. doi:10.1016/j.vaccine.2009.09.125
[125] Brisson, M., Van de Velde, N. and Boily, M.C. (2009) Economic evaluation of human papillomavirus vaccination in developed countries. Public Health Genomics, 12, 343-351. doi:10.1159/000214924
[126] Zelkowitz, R. (2009) Cancer. HPV casts a wider shadow. Science, 323, 580-581. doi:10.1126/science.323.5914.580
[127] Chaturvedi, A.K., Engels, E.A., Pfeiffer, R.M., et al. (2011) Human papillomavirus and rising oropharyngeal cancer incidence in the United States. Journal of Clinical Oncology, [Epub ahead of print].
[128] Cherpes, T.L., Meyne, L.A., Krohn, M.A., et al. (2003) Risk factors for infection with herpes simplex virus type 2: Role of smoking, douching, uncircumcised males, and vaginal flora. Sexually Transmitted Diseases, 30, 405-410. doi:10.1097/00007435-200305000-00006
[129] Mahanta, J., Borkakoty, B., Biswas, D., et al. (2010) Circumcision and herpes simplex virus-2 infection among spouses. Sexually Transmitted Infections, 86, 487. doi:10.1136/sti.2010.046359
[130] Castellsague, X., Peeling, R.W., Franceschi, S., et al. (2005) Chlamydia trachomatis infection in female partners of circumcised and uncircumcised adult men. American Journal of Epidemiology, 162, 907-916. doi:10.1093/aje/kwi284
[131] Gray, R.H., Kigozi, G., Serwadda, D., et al. (2009) The effects of male circumcision on female partners’ genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda. American Journal of Obstetrics & Gynecology, 200, e1-e7. doi:10.1016/j.ajog.2008.07.069
[132] Cherpes, T.L., Hillier, S.L., Meyn, L.A., et al. (2008) A delicate balance: Risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology. Sexually Transmitted Diseases, 35, 78-83. doi:10.1097/OLQ.0b013e318156a5d0
[133] Hallett, T.B., Alsallaq, R.A., Baeten, J.M., et al. (2011) Will circumcision provide even more protection from HIV to women and men? New estimates of the population impact of circumcision interventions. Sexually Transmitted Infections, 87, 88-93. doi:10.1136/sti.2010.043372
[134] Weiss, H.A., Hankins, C.A. and Dickson, K. (2009) Male circumcision and risk of HIV infection in women: A systematic review and meta-analysis. The Lancet Infectious Diseases, 9, 669-677. doi:10.1016/S1473-3099(09)70235-X
[135] Baeten, J.M., Donnell, D., Kapiga, S.H., et al. (2010) Male circumcision and risk of male-to-female HIV-1 transmission: A multinational prospective study in African HIV-1-serodiscordant couples. AIDS, 24, 737-744. doi:10.1097/QAD.0b013e32833616e0
[136] Kochen, M. and McCurdy, S. (1980) Circumcision and risk of cancer of the penis. A life-table analysis. American Journal of Diseases of Children, 134, 484-486.
[137] Morris, B.J., Gray, R.H., Castellsague, X., et al. (2011) The strong protection afforded by circumcision against cancer of the penis. Advances in Urology, Article ID 812368, 1-21. doi:10.1155/2011/812368
[138] Larke, N.L., Thomas, S.L., Dos Santos Silva, I., et al. (2011) Male circumcision and penile cancer: A systematic review and meta-analysis. Cancer Causes Control, 22, 1097-1110. doi:10.1007/s10552-011-9785-9
[139] Miralles-Guri, C., Bruni, L., Cubilla, A.L., et al. (2009) Human papillomavirus prevalence and type distribution in penile carcinoma. Journal of Clinical Pathology, 62, 870-878. doi:10.1136/jcp.2008.063149
[140] Morris, B.J., Waskett, J. and Bailis, S.A. (2007) Case number and the financial impact of circumcision in reducing prostate cancer. British Journal of Urology International, 100, 5-6. doi:10.1111/j.1464-410X.2007.06875.x
[141] Masters, W.H. and Johnson, V.E. (1966) Human sexual response. Little Brown, Boston.
[142] Collins, S., Upshaw, J., Rutchik, S., et al. (2002) Effects of circumcision on male sexual function: Debunking a myth? Journal of Urology, 167, 2111-2112. doi:10.1016/S0022-5347(05)65097-5
[143] Bleustein, C.B., Fogarty, J.D., Eckholdt, H., et al. (2005) Effect of neonatal circumcision on penile neurological sensation. Urology, 65, 773-777. doi:10.1016/j.urology.2004.11.007
[144] Schober, J.M., Meyer-Bahlburg, H.F. and Dolezal, C. (2009) Self-ratings of genital anatomy, sexual sensitivity and function in men using the “Self-Assessment of Genital Anatomy and Sexual Function, Male” questionnaire. British Journal of Urology International, 103, 1096-1103. doi:10.1111/j.1464-410X.2008.08166.x
[145] Payne, K., Thaler, L., Kukkonen, T., et al. (2007) Sensation and sexual arousal in circumcised and uncircumcised men. The Journal of Sexual Medicine, 4, 667-674. doi:10.1111/j.1743-6109.2007.00471.x
[146] Fink, K.S., Carson, C.C. and de Vellis, R.F. (2002) Adult circumcision outcomes study: Effect on erectile function, penile sensitivity, sexual activity and satisfaction. Journal of Urology, 167, 2113-2116. doi:10.1016/S0022-5347(05)65098-7
[147] Son, H., Song, S.H., Kim, S.W., et al. (2010) Self- reported premature ejaculation prevalence and characteristics in Korean young males: Community-based data from an internet survey. Journal of Andrology, 31, 540-546. doi:10.2164/jandrol.110.010355
[148] Waldinger, M.D., Quinn, P., Dilleen, M., et al. (2005) A multinational population survey of intravaginal ejaculation latency time. The Journal of Sexual Medicine, 2, 492-497. doi:10.1111/j.1743-6109.2005.00070.x
[149] Waldinger, M.D., McIntosh, J. and Schweitzer, D.H. (2009) A five-nation survey to assess the distribution of the intravaginal ejaculatory latency time among the general male population. The Journal of Sexual Medicine, 6, 2888-2895. doi:10.1111/j.1743-6109.2009.01392.x
[150] Laumann, E.O., Maal, C.M. and Zuckerman, E.W. (1997) Circumcision in the United States. Prevalence, prophyactic effects, and sexual practice. Journal of the American Medical Association, 277, 1052-1057. doi:10.1001/jama.1997.03540370042034
[151] Richters, J., Smith, A.M., de Visser R.O., et al. (2006) Circumcision in Australia: Prevalence and effects on sexual health. International Journal of STD & AIDS, 17, 547-554. doi:10.1258/095646206778145730
[152] Masood, S., Patel, H.R.H., Himpson, R.C., et al. (2005) Penile sensitivity and sexual satisfaction after circumcision: Are we informing men correctly? Urologia Internationalis, 75, 62-66. doi:10.1159/000085930
[153] Kigozi, G., Watya, S., Polis, C.B., et al. (2008) The effect of male circumcision on sexual satisfaction and function, results from a randomized trial of male circumcision for human immunodeficiency virus prevention, Rakai, Uganda. British Journal of Urology International, 101, 65-70. doi:10.1111/j.1464-410X.2007.07369.x
[154] Krieger, J.N., Mehta, S.D., Bailey, R.C., et al. (2008) Adult male circumcision: Effects on sexual function and sexual satisfaction in Kisumu, Kenya. The Journal of Sexual Medicine, 5, 2610-2622. doi:10.1111/j.1743-6109.2008.00979.x
[155] Senol, M.G., Sen, B., Karademir, K., et al. (2008) The effect of male circumcision on pudendal evoked potentials and sexual satisfaction. Acta Neurologica Belgica, 108, 90-93.
[156] Senkul, T., Iseri, C., Sen, B., et al. (2004) Circumcision in adults: Effect on sexual function. Urology, 63, 155-158. doi:10.1016/j.urology.2003.08.035
[157] Willcourt, R. (2007) Critique of: “The effect of male circumcision on sexuality” by Kim, K.D., Pang, M. British Journal of Urology International, 99, 619-622. British Journal of Urology International, 99, 1169-1170. doi:0.1111/j.1464-410X.2007.06895_3.x
[158] Waskett, J.H. and Morris, B.J. (2007) Fine-touch pressure thresholds in the adult penis. British Journal of Urology International, 99, 1551-1552. doi:10.1111/j.1464-410X.2007.06970_6.x
[159] Morris, B.J., Waskett, J.H. and Gray, R.H. (2011) Does sexual function survey in Denmark offer any support for male circumcision having an adverse effect? International Journal of Epidemiology, E-pub ahead of print Nov 28.
[160] Aydur, E., Gungor, S., Ceyhan, S.T., et al. (2007) Effects of childhood circumcision age on adult male sexual functions. International Journal of Impotence Research, 19, 424-431. doi:10.1038/sj.ijir.3901545
[161] Mao, L.M., Templeton, D.J., Crawford, J., et al. (2008) Does circumcision make a difference to the sexual experience of gay men? Findings from the Health in Men (HIM) Cohort. The Journal of Sexual Medicine, 5, 2557-2561. doi:10.1111/j.1743-6109.2008.00845.x
[162] Cortés-González, J.R., Arratia-Maqueo, J.A. and Gómez-Guerra, L.S. (2008) Does circumcision has an effect on female’s perception of sexual satisfaction? Revista de Investigacion Clinica, 60, 227-230.
[163] Kigozi, G., Lukabwe, I., Kagaayi, J., et al. (2009) Sexual satisfaction of women partners of circumcised men in a randomized trial of male circumcision in Rakai, Uganda. British Journal of Urology International, 104, 1698-1701. doi:10.1111/j.1464-410X.2009.08683.x
[164] Williamson, M.L. and Williamson, P.S. (1988) Women’s preferences for penile circumcision in sexual partners. Journal of Sex Education & Therapy, 14, 8-12.
[165] Wildman, R.W., Wildman, R.W., Brown, A., et al. (1976) Note on males’ and females’ preferences for opposite sex body parts, bust sizes, and bust-revealing clothing. Psychological Reports, 38, 485-486. doi:10.2466/pr0.1976.38.2.485
[166] Morris, B.J. and Eley, C. (2011) Male circumcision: An appraisal of current instrumentation. In: Fazel-Rezai, R. Ed., Biomedical Engineering, University of Rijeka, Rijeka, 315-354. http://www.intechopen.com/articles/show/title/male-circumcision-an-appraisal-of-current-instrumentation
[167] Schoen, E.J. (2007) Should newborns be circumcised? Yes. Canadian Family Physician, 53, 2096-2097.
[168] Mancuso, T. and Burns, J. (2009) Ethical concerns in the management of pain in the neonate. Pediatric Anesthesia, 19, 953-957. doi:10.1111/j.1460-9592.2009.03144.x
[169] Russell, C.T. and Chaseling J. (1996) Topical anaesthesia in neonatal circumcision: A study of 208 consecutive cases. Australian Family Physician, 25, 30-34.
[170] Lehr, V.T., Cepeda, E., Frattarelli, D.A., et al. (2005) Lidocaine 4% cream compared with lidocaine 2.5% and prilocaine 2.5% or dorsal penile block for circumcision. American Journal of Perinatology, 22, 231-237. doi:10.1055/s-2005-871655
[171] Kirya, C. and Werthmann, M. (1978) Neonatal circumcision and penile dorsal nerve block: A painless procedure. Journal of Pediatrics, 92, 998-1000. doi:10.1016/S0022-3476(78)80386-2
[172] Sandeman, D.J. and Dilley, A.V. (2007) Ultrasound guided dorsal penile nerve block in children. Anaesth Intensive Care, 35, 266-269.
[173] Broadman, L., Hannallah, R., Belman, B., et al. (1987) Post-circumcision analgesia; a prospective evaluation of subcutaneous ring block of the penis. Anesthesiology, 67, 399-402. doi:10.1097/00000542-198709000-00019
[174] Ross, A.K., Eck, J.B. and Tobias, J.D. (2000) Pediatric regional anesthesia: Beyond the caudal. Anesthesia & Analgesia, 91, 16-26.
[175] van Dijk, M., de Boer, J.B., Koot, H., et al. (2001) The association between physiological and behavioral pain measures in 0- to 3-year-old infants after major surgery. Journal of Pain and Symptom Management, 22, 600-609. doi:10.1016/S0885-3924(01)00288-3
[176] Bergqvist, L.L., Katz-Salamon, M., Herteg?rd, S., et al. (2009) Mode of delivery modulates physiological and behavioral responses to neonatal pain. Journal of Perinatology, 29, 44-50. doi:10.1038/jp.2008.129
[177] Sternberg, W.F., Scorr, L., Smith, L.D., et al. (2005) Long-term effects of neonatal surgery on adulthood pain behavior. Pain, 113, 347-353. doi:10.1016/j.pain.2004.11.013
[178] Laprairie, J.L. and Murphy, A.Z. (2009) Neonatal injury alters adult pain sensitivity by increasing opioid tone in the periaqueductal gray. Frontiers in Behavioral Neuroscience, 3, 1-11. doi:10.3389/neuro.08.031.2009
[179] Taddio, A., Stevens, B., Craig, K., et al. (1997) Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. The New England Journal of Medicine, 336, 1197-1201. doi:10.1056/NEJM199704243361701
[180] Cilento, B.G.J., Holmes, N.M. and Canning, D.A. (1999) Plastibell complications revisited. Clinical Pediatrics, 38, 239-242. doi:10.1177/000992289903800406
[181] Christakis, D.A., Harvey, E., Zerr, D.M., et al. (2000) A trade-off analysis of routine newborn circumcision. Pediatrics, 105, 246-249.
[182] Ben Chaim, J., Livne, P.M., Binyamini, J., et al. (2005) Complications of circumcision in Israel: A one year multicenter survey. Israel Medical Association Journal, 7, 368-370.
[183] Schoen, E.J., Colby, C.J. and To, T.T. (2006) Cost analysis of neonatal circumcision in a large health maintenance organization. Journal of Urology, 175, 1111-1115. doi:10.1016/S0022-5347(05)00399-X
[184] Frank, R. (2000) Comment on “Christakis D.A. et al. A trade-off analysis of routine newborn circumcision. Pediatrics 2000; 105 (Part 3): 246-249”. Pediatrics, 106, 954.
[185] Griffiths, D.M., Atwell, J.D. and Freeman, N.V. (1985) A prospective survey of the indications and morbidity of circumcision in children. European Urology, 11, 184-187.
[186] Kaplan, G.W. (1983) Complications of circumcision. Urologic Clinics of North America, 10, 543-549.
[187] Weiss, H.A., Larke, N., Halperin, D., et al. (2010) Complications of circumcision in male neonates, infants and children: A systematic review. BMC Urology, 10, 13. doi:10.1186/1471-2490-10-2
[188] Krieger, J.N., Bailey, R.C., Opeya, J.C., et al. (2007) Adult male circumcision outcomes: Experience in a developing country setting. Urologia Internationalis, 78, 235-240. doi:10.1159/000099344
[189] Walter, G. and Streimer, J. (1990) Genital self-mutilation: Attempted foreskin reconstruction. The British Journal of Psychiatry, 156, 125-127. doi:10.1192/bjp.156.1.125
[190] Rennie, S., Muula, A.S. and Westreich, D. (2007) Male circumcision and HIV prevention: Ethical, medical and public health tradeoffs in low-income countries. Journal of Medical Ethics, 33, 357-361. doi:10.1136/jme.2006.019901
[191] Benatar, M. and Benatar, D. (2003) Between prophylaxis and child abuse: The ethics of neonatal male circumcision. The American Journal of Bioethics, 3, 35-48. doi:10.1162/152651603766436216
[192] Perera, C.L., Bridgewater, F.H., Thavaneswaran, P., et al. (2009) Nontherapeutic male circumcision: Tackling the difficult issues. The Journal of Sexual Medicine, 6, 2237-2243. doi:10.1111/j.1743-6109.2009.01306.x
[193] MacDonald, N. (2011) Male circumcision: Get the timing right. Canadian Medical Association Journal, 183, 872. doi:10.1503/cmaj.101425
[194] Clark, P.A., Eisenman, J. and Szapor, S. (2007) Mandatory neonatal male circumcision in Sub-Saharan Africa: Medical and ethical analysis. Medical Science Monitor, 12, RA205-RA213.
[195] Vawda, Y.A. and Maqutu, L.N. (2011) Neonatal circumcision-violation of children’s rights or public health necessity? South African Journal of Bioethics and Law, 4, 36-42.
[196] Morris, B.J. (2010) Why medical bodies and others should not advise that circumcision should be delayed until the boy can make the decision for himself. http://www.circinfo.net/circumcision_why_you_should_not_delay.html
[197] Westercamp, N. and Bailey, R.C. (2007) Acceptability of male circumcision for prevention of HIV/AIDS in sub-Saharan Africa: A review. AIDS and Behavior, 11, 341-355. doi:10.1007/s10461-006-9169-4
[198] Leibowitz, A.A., Desmond, K. and Belin, T. (2009) Determinants and policy implications of male circumcision in the United States. The American Journal of Public Health, 99, 138-145. doi:0.2105/AJPH.2008.134403
[199] Morris, B.J., Bailis, S.A., Waskett, J.H., et al. (2009) Medicaid coverage of newborn circumcision: A health parity right of the poor. American Journal of Public Health, 99, 969-971. doi:10.2105/AJPH.2009.161281

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