RT Journal Article
SR Electronic
T1 Safety and Efficacy of Nontherapeutic Male Circumcision: A Systematic Review
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 64
OP 72
DO 10.1370/afm.1073
VO 8
IS 1
A1 Caryn L. Perera
A1 Franklin H. G. Bridgewater
A1 Prema Thavaneswaran
A1 Guy J. Maddern
YR 2010
UL http://www.annfammed.org/content/8/1/64.abstract
AB PURPOSE We wanted to assess the safety and efficacy of nontherapeutic male circumcision through a systematic review of the literature. METHODS We systematically searched The York Centre for Reviews and Disseminations, Cochrane Library, PubMed, and EMBASE databases for randomized controlled trials published between January 1997 and August 2008. Studies reporting on circumcision in an operative setting in males of any age with no contraindications to or medical indications for circumcision were eligible for inclusion. The main comparator was intact genitalia. From 73 retrieved studies, 8 randomized controlled trials were ultimately included for analysis. RESULTS Severe complications were uncommon. Analgesia/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; 95% confidence interval [CI], 0.43–0.64; P<.001). 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, 95% CI, 0.32–0.59; P <.001). The evidence suggests that adult circumcision does not affect sexual satisfaction and function. CONCLUSIONS 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.