The Article in Brief

Safety and Efficacy of Nontherapeutic Male Circumcision: A Systematic Review

Guy J. Maddern , and colleagues

Background Male circumcision, a commonly performed surgical procedure, can be performed for therapeutic (medical) reasons or nontherapeutic (religious, cultural, or social) reasons. This study examines existing research to determine the safety and effectiveness of nontherapeutic male circumcision.

What This Study Found There is little evidence showing clinical benefit from nontherapeutic male circumcision. Although evidence does show that adult male circumcision is effective in preventing HIV/AIDS in sub-Saharan African men, these findings cannot necessarily be applied to men in other countries. Current evidence is unclear on the effectiveness of adult circumcision in preventing sexually transmitted infections, urinary tract infections, and penile cancer. Furthermore, there is no current evidence that circumcision in infants prevents HIV/AIDS, sexually transmitted infections, urinary tract infections, and penile cancer.

Implications

• Patients who request circumcision for clinical reasons should be informed of the lack of consensus surrounding the procedure, the lack of strong evidence regarding its benefits, and the potential medical and psychosocial harms of the procedure.
• The authors call for additional research to strengthen the evidence base and allow for more informed conclusions on nontherapeutic male circumcision.