Sexual Effects of Circumcision

Sexual Effects Of Circumcision

Male circumcision (from Latin circumcidere, meaning "to cut around") is the surgical removal of the foreskin (prepuce) from the human penis. In a typical procedure, the foreskin is opened and then separated from the glans after inspection. The circumcision device (if used) is placed, and then the foreskin is removed. Topical or locally injected anesthesia may be used to reduce pain and physiologic stress. For adults, general anesthesia is an option, and the procedure is often performed without a specialized circumcision device. The procedure is most often elected for religious reasons or personal preferences, but may be indicated for both therapeutic and prophylactic reasons. It is a treatment option for pathological phimosis, refractory balanoposthitis and chronic urinary tract infections (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.

The positions of the world's major medical organizations range from considering neonatal circumcision as having a modest health benefit that outweighs small risks to viewing it as having no benefit and significant risks. No major medical organization recommends either universal circumcision for all infant males (aside from the recommendations of the World Health Organization for parts of Africa), or banning the procedure. Ethical and legal questions regarding informed consent and autonomy have been raised over non-therapeutic neonatal circumcision.

A 2009 Cochrane meta-analysis of studies done on sexually active men in Africa found that circumcision reduces the infection rate of HIV among heterosexual men by 38–66% over a period of 24 months. The WHO recommends considering circumcision as part of a comprehensive HIV program in areas with high endemic rates of HIV, such as sub-Saharan Africa, where studies have concluded it is cost-effective against HIV. Circumcision reduces the incidence of HSV-2 infections by 28%, and is associated with reduced oncogenic HPV prevalence and a reduced risk of both UTIs and penile cancer, but routine circumcision is not justified for the prevention of those conditions. Studies of its protective effects against other sexually transmitted infections have been inconclusive. A 2010 review of literature worldwide found circumcisions performed by medical providers to have a median complication rate of 1.5% for newborns and 6% for older children, with few severe complications. Bleeding, infection and the removal of either too much or too little foreskin are the most common complications cited. Circumcision does not appear to have a negative impact on sexual function.

About one-third of males worldwide are circumcised. The procedure is most prevalent in the Muslim world and Israel (where it is near-universal), the United States and parts of Southeast Asia and Africa; it is relatively rare in Europe, Latin America, parts of Southern Africa and most of Asia. The origin of circumcision is not known with certainty; the oldest documentary evidence for it comes from ancient Egypt. 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. It is part of religious law in Judaism and is an established practice in Islam, Coptic Christianity and the Ethiopian Orthodox Church.