Letter to Editor regarding: Referrals from primary care with foreskin symptoms: Is there really room for improvement?

Cox, Guy; Morris, Brian J.

doi:10.1016/j.jpedsurg.2022.12.012

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…An article by Sutton et al [ 163 ] argued that general practitioners (GPs) in the United Kingdom were guilty of referring too many uncircumcised males with foreskin problems to their regional pediatric surgery clinic. A critique pointed out that “circumcision as soon as a problem becomes apparent is by far the most cost-effective solution”[ 164 ]. In a reply to the criticisms, the article’s co-authors Corbett et al [ 165 ] cited dated guidelines in 2006 by the British Association of Pediatric Urologists that has a disclaimer that “this statement is not evidence based”[ 166 ].…”

Section: Claims By Other Ntmc Opponents In the Ukmentioning

confidence: 99%

Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health

Moreton,

Cox,

Sheldon

et al. 2023

World J Clin Pediatr

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The British Medical Association (BMA) guidance on non-therapeutic circumcision (NTMC) of male children is limited to ethical, legal and religious issues. Here we evaluate criticisms of the BMA’s guidance by Lempert et al . While their arguments promoting autonomy and consent might be superficially appealing, their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits. Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies, as well as risk-benefit analyses, have found that the medical benefits of infant NTMC greatly exceed the risks, and there is no reduction in sexual function and pleasure. The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom. The consequence is higher prevalence of preventable infections, adverse medical conditions, suffering and net costs to the UK’s National Health Service for treatment of these. Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based. Indeed, that document called for a review by others of the medical issues surrounding NTMC. While societal factors apply, ultimately, NTMC can only be justified rationally on scientific, evidence-based grounds. Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision. Their decision either for or against NTMC should then be respected.

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Section: Claims By Other Ntmc Opponents In the Ukmentioning

confidence: 99%