Does circumcision influence sexually transmitted diseases?: A literature review

Howe, Robert S. Van

doi:10.1046/j.1464-410x.1999.0830s1052.x

Cited by 40 publications

(32 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is no clear evidence that circumcision prevents sexually transmitted diseases. The only consistent trend is that uncircumcised men are more susceptible to genital ulcer disease, while circumcised men are more prone to urethritis [14]. Recently, there have been reports on the possible correlation between HIV infection and circumcision status [15±17].…”

Section: Discussionmentioning

confidence: 99%

Extraordinarily high rates of male circumcision in South Korea: history and underlying causes

Pang¹,

Kim²

2002

BJU Int

View full text Add to dashboard Cite

Objective To investigate the high circumcision rate in South Korea and its rapid increase in the short period since its introduction. Subjects and methods From January to December 2000, 5434 South Korean males (or their parents) aged 0±92 years were interviewed in detail about their circumcision status, their age at circumcision, and the possible effect of circumcision on their sexuality. In addition, 267 practising medical doctors were surveyed about their basic understanding of circumcision and phimosis. Results Currently the circumcision rate for high-school boys is >90% and for those >70 years old is <10%. The circumcision rate in 1945 was <0.1%. When averaged over the whole population, the present South Korean circumcision rate is <60%; the rate has increased dramatically with time and particularly in the past 20 years, when the estimated number of male circumcisions has exceeded the number of male births. Although circumcision in South Korea has been strongly in¯uenced by American culture, it has never been predominantly neonatal. The age at circumcision has continued to decrease and boys are now circumcised at <12 years old. Of those who were circumcised long after they had been sexually active, >80% reported no noticeable difference in sexuality, but a man was twice as likely to have experienced diminished sexuality than improved sexuality. Of the doctors who were surveyed, 41% carried out circumcision but, unlike in America, gynaecologists and paediatricians rarely did so. Among the doctors, basic knowledge on circumcision and phimosis was generally lacking, regardless of whether they practised circumcision or not. Amongst the factors contributing to the high circumcision rate was the mistaken notion held by both doctors and the general public that circumcision is directly correlated with industrialization and general progress of living standards. Many doctors believe the out-dated and sometimes controversial bene®ts of circumcision, i.e. prevention of cervical cancer and sexually transmitted diseases, and improved sexuality. Thus the vast majority of doctors recommend circumcision regardless of the patient's age. Peer pressure was also an important contributing factor. Conclusion South Korea has an unusual history of circumcision. The mistaken and out-dated notions about circumcision and lack of knowledge of phimosis by physicians seem to be a leading contributory factor to the extraordinarily high circumcision rate.

show abstract

Section: Discussionmentioning

confidence: 99%

Extraordinarily high rates of male circumcision in South Korea: history and underlying causes

Pang¹,

Kim²

2002

BJU Int

View full text Add to dashboard Cite

show abstract

“…By removing this source of Langerhans cells, circumcision could potentially reduce the risk of HIV/AIDS acquisition and transmission. [25][26][27] The prepuce may be susceptible to mild trauma during intercourse, facilitating transmission of infection, 28 whereas the warm and moist environment under the prepuce is also thought to be conducive to prolonged viral survival. 27,28 Finally, the layer of keratin that develops in a circumcised penis may provide additional defense against infection.…”

mentioning

confidence: 99%

“…29 The immunological effects of subpreputial fl ora, secretory immunoglobulins, and lytic secretions from the prostate, urethra, and seminal residues are unclear. 28 Finally, the prepuce may reduce the likelihood of abrasions occurring during intercourse, thereby removing a potential site for viruses to enter the body. 28 The evidence did not show a decrease in sexual satisfaction and function after circumcision.…”

mentioning

confidence: 99%

Safety and Efficacy of Nontherapeutic Male Circumcision: A Systematic Review

Perera¹,

Bridgewater²,

Thavaneswaran³

et al. 2010

The Annals of Family Medicine

View full text Add to dashboard Cite

PURPOSE We wanted to assess the safety and effi cacy of nontherapeutic male circumcision through a systematic review of the literature. METHODSWe 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. RESULTSSevere complications were uncommon. Analgesia/anesthesia during circumcision was promoted. The prevalence of self-reported genital ulcers was signifi cantly lower in circumcised men than uncircumcised men (3.1% vs 5.8%; prevalence risk ratio 0.53; 95% confi dence interval [CI], 0.43-0.64; P <.001). Circumcised sub-Saharan African men were at signifi cantly lower risk of acquiring human immunodefi ciency virus/acquired immune defi ciency 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 immunodefi ciency virus/acquired immune defi ciency syndrome acquisition in subSaharan African men. These fi ndings 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. Ann Fam Med 2010;8:64-72. doi:10.1370/afm.1073. INTRODUCTIONM ale circumcision is the most commonly performed surgical procedure in the world. 1 The procedure may be performed to treat an underlying pathological process (therapeutic circumcision) or for prophylactic, religious, cultural, or social reasons (nontherapeutic circumcision). This systematic review seeks to assess the safety and effi cacy of nontherapeutic male circumcision through a systematic review of the literature.The prepuce may protect the glans by acting as a barrier against contamination 2 and maintaining a moist environment for the glans, 3 and its complex innervation suggests that it may also enhance sexual pleasure. 2At birth the prepuce is usually not retractable. Growth of the penis, accumulation of epithelial dermis, and erectile activity during the fi rst 3 or 4 years of life eventually allows retraction.4 Circumcision (removal of the prepuce) usually takes place in a day-surgery setting. The surgical technique is determined by the social circumstances, together with the indication for the operation and the patient's age. Major complications associated with circumcision may include hemorrhage, sepsis, fi stula, 65NONT HER A PEU T IC M A L E CIRCU MCISION meatal stenosis, r...

show abstract

“…Uma revisão mais recente confirma o risco aumentado de sífilis e cancróide, mas não de outras IST nos incircuncisos. 42 O prepúcio também é um sitio favorável à aderên-cia bacteriana e está associado a um maior risco de infecções urinárias em crianças. 30 De acordo com uma meta-análise de nove estudos (três prospectivos e seis retrospectivos) sobre a associação entre circuncisão e infecções urinárias pediátricas, 30 o risco relativo de infecção urinária em crianças incircuncisas foi calculado em 12,0 (IC 95%: 10,6-13,6).…”

Section: O Prepúcio E As Origens Da Circuncisão Masculinaunclassified

A circuncisão masculina e a transmissão heterossexual do HIV

Eyer-Silva¹

2003

Rev. Saúde Pública

View full text Add to dashboard Cite

ResumoDesde os primeiros anos da epidemia de Aids, grandes diferenças geográficas na prevalência de infecção pelo HIV foram registradas entre países vizinhos e regiões vizinhas dentro de um mesmo país na África subsaariana. Tais diferenças não podiam ser completamente explicadas por fatores como o comportamento sexual e o uso de preservativos. Um acúmulo de dados epidemiológicos vem mostrando que a circuncisão masculina desempenha um efeito protetor contra a aquisição heterossexual do HIV pelo homem na África subsaariana e provavelmente contribui para as acentuadas diferenças de prevalência de HIV. Assim, realizou-se uma atualização dos estudos conduzidos em solo africano sobre a associação entre circuncisão masculina e infecção pelo HIV, as origens da prática da circuncisão entre as populações humanas, os mecanismos pelos quais a presença do prepúcio aumentaria a susceptibilidade de aquisição heterossexual do HIV pelo homem, sua associação com outras doenças infecciosas e também neoplásicas, o debate sobre a conveniência da adoção de práticas de circuncisão como estratégia de controle da epidemia de HIV na África, a escassa literatura brasileira sobre circuncisão masculina e as perspectivas de investigações futuras. Abstract Since the early years of the AIDS epidemic significant geographic differences in HIV prevalence were reported within neighboring countries and neighboring regions within the same country in sub-Saharan Africa. These differences could not be fully explained by factors such as sexual behavior and condom use. Mounting epidemiological data have demonstrated that male circumcision is a major protective factor against male heterosexual HIV infection in sub-Saharan Africa and probably contributes to these significant differences in HIV prevalence. This is a review of African studies on the association between male circumcision and HIV infection

show abstract

Does circumcision influence sexually transmitted diseases?: A literature review

Cited by 40 publications

References 22 publications

Extraordinarily high rates of male circumcision in South Korea: history and underlying causes

Extraordinarily high rates of male circumcision in South Korea: history and underlying causes

Safety and Efficacy of Nontherapeutic Male Circumcision: A Systematic Review

A circuncisão masculina e a transmissão heterossexual do HIV

Contact Info

Product

Resources

About