At What Age Range Should Children Be Circumcised?

Abstract

Background:Although male circumcision is a surgical intervention that is frequently performed in children, there is no consensus about the age at which it should be performed.Objectives:The purpose of this study was to determine the best age range for routine male circumcision with respect to a child’s health and the cost.Patients and Methods:This clinical trial was conducted in the affiliated hospital of the Erzincan University of Medical Sciences, Turkey, in 2014. The circumcised children were evaluated in 3 groups: < 1 year old (Group 1), 1-7 years old (Group 2), and > 7 years old (Group 3). To obtain a satisfactory Wilton sedation score, midazolam 0.1 mg/kg IV was administered first. If adequate sedation was not achieved, ketamine 2 mg/kg IV was also administered. If adequate sedation was still not achieved, general anesthesia was administered via a laryngeal mask. At the end of the surgery, the groups were compared in terms of post-anesthesia recovery duration, complications, discharging duration, and cost.Results:A total of 603 children were circumcised, 374 in Group 1, 94 in Group 2, and 135 in Group 3. Midazolam was sufficient for sedation in 364 Group 1 patients (97.3%), 6 Group 2 patients (6.3%), and 38 Group 3 patients (28.1%). The shortest post-anesthesia recovery duration after surgical intervention and time until discharge, the lowest cost, and the fewest anesthesia complications were observed in Group 1 (P < 0.05 for all).Conclusions:Although almost all of the < 1 year-old children could be sedated with midazolam alone, most of the > 1 year-old children required ketamine or general anesthesia. Performing circumcision when children are less than 1 year old decreases the risk of complications due to anesthesia and lowers the costs compared with performing the procedure on older children.

Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC) among a Sample of Health Care Providers in Haiti

“…Performing MMC during infancy is also ideal for clinicians as infants are less mobile and therefore, administration of local anesthesia is easier. Post-operative suturing is also not required in infant MMC, leading to faster wound healing and less complications[ 51 ]. Other advantages of infant MMC include prevention of urinary tract infections and other inflammatory foreskin conditions [ 50 ].…”

Circumcision in Neonates and Infants Using Different Techniques: A Comparative Study

“…Additionally, because infants are less active than adults, the treatment may be done on them while they are under local anesthetic (11) . Additionally, male circumcision during the first year of life was advised by El Bcheraoui et al (19) and Bicer et al (20) because to the very low occurrence of adverse effects, which may increase up to 10-20 folds when performed beyond infancy.…”

Males and females have different anatomy: is this relevant to circumcision? A reply to ‘The prosecution of Dawoodi Bohra women’ by Richard Shweder

“…Infant male circumcision is minimally harmful, but such evidence is lacking for girls. Infancy is the safest time to circumcise the penis (Morris et al, 2019;El Bcheraoui et al, 2014;Bicer et al, 2015). However, given current knowledge, circumcising the clitoral hood would best be deferred until after puberty.…”