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Response to Green_Lantern (Reply #200)

Fri Aug 24, 2012, 02:29 PM

205. From your link:

 

The American Academy of Pediatrics (1999) stated: "Circumcision has been suggested as an effective method of maintaining penile hygiene since the time of the Egyptian dynasties, but there is little evidence to affirm the association between circumcision status and optimal penile hygiene."

Oops.

But what do they know? I don't take medical advice from doctors. I take it from religious figures practicing a tradition they picked up as stone age desert wanderers.

Circumcision is associated with a reduced risk of urinary tract infections (UTIs) however the magnitude of this benefit is likely to outweigh the risk only in those at high risk of UTIs.[20]

Some UTI studies have been criticized for not taking into account a high rate of UTI's among premature infants, who are usually not circumcised because of their fragile health status.[7] The AMA stated that "depending on the model employed, approximately 100 to 200 circumcisions would need to be performed to prevent 1 UTI," and noted one decision analysis model that concluded that circumcision was not justified as a preventative measure against UTI

. . .

A meta-analysis by Van Howe in 2006 found no significant association between circumcision status and HPV infection and that "the medical literature does not support the claim that circumcision reduces the risk for genital HPV infection".

. . .

Two studies have shown that circumcised men report, or were found to have, a higher prevalence of genital warts than uncircumcised men.[121][122]

. . .


The role of male circumcision in female infection with HPV remains controversial. As Castellsagué (2002) said, "…it would not make sense to promote circumcision as a way to control cervical cancer in the United States, where Pap smears usually detect it at a treatable stage."[131]
. . .

Cadman et al.'s (1984) study said that using routine infant circumcision to prevent penile cancer would not be cost-effective; the costs of circumcising everyone would be over a hundred times the savings achieved.[153]

. . .


The American Academy of Pediatrics (1999) stated that studies suggest that neonatal circumcision confers some protection from penile cancer, but circumcision at a later age does not seem to confer the same level of protection. They stated further that penile cancer is a rare disease in developed countries and that the risk of penile cancer developing in an uncircumcised man, although increased compared with a circumcised man, remains low.[18] Similarly, the American Medical Association states that although neonatal circumcision seems to lower the risk of contracting penile cancer, because it is rare and occurs later in life, the use of circumcision as a preventive practice is not justified.[15]

The Royal Australasian College of Physicians stated that the use of infant circumcision to prevent penile cancer alone in adulthood is not justified.[155][dead link]

The American Cancer Society stated:

Circumcision seems to protect against penile cancer when it is done shortly after birth. Men who were circumcised as babies have less than half the chance of getting penile cancer than those who were not. The reasons for this are not entirely clear, but may be related to other known risk factors. For example, men who are circumcised cannot develop a condition called phimosis. Men with phimosis have an increased risk of penile cancer (see below). Also, circumcised men seem to be less likely to be infected with HPV, even after adjusting for differences in sexual behavior.
In weighing the risks and benefits of circumcision, doctors consider the fact that penile cancer is one of the least common forms of cancer in the United States. Neither the American Academy of Pediatrics nor the Canadian Academy of Pediatrics recommends routine circumcision of newborns (for medical reasons). In the end, decisions about circumcision are highly personal and depend more on social and religious factors than on medical evidence.[156]

. . .

Lerman and Liao (2001) state that apart from its effects on UTI rates, "Most of the other medical benefits of circumcision probably can be realized without circumcision as long as access to clean water and proper penile hygiene are achieved."[179] (where would we, in the United States possibly get access to clean water?)


And now for the complications:

Williams & Kapila state: "the literature abounds with reports of morbidity and even death as a result of circumcision."[39] Complications may be immediate or delayed, and complications from bleeding, infection and poorly carried out circumcisions can be catastrophic.[40] The immediate complications may be classified as surgical mishap, hemorrhage, infection and anesthetic risk.

The American Medical Association quotes a complication rate of 0.2%–0.6%,[15] based on the studies of Gee[41] and Harkavy.[42] These same studies are quoted by the American Academy of Pediatrics.[18] The American Academy of Family Physicians quotes a range of anywhere between 0.1% and 35%.[43] The Canadian Paediatric Society cites these results in addition to other figures ranging anywhere between 0.06% to 55%, and remark that Williams & Kapila[39] suggested that 2-10% is a realistic estimate.[44] A study quoted by the National Institute of Health reported that 1 complication occurs for every 476 circumcisions.[45] The RACP states that the penis is lost in 1 in 1,000,000 circumcisions.[46]

Deaths have been reported.[47][48] The American Academy of Family Physicians states that death is rare. It estimates a death rate from circumcision of 1 infant in 500,000.[43] Gairdner's 1949 study reported that an average of 16 children per year out of about 90,000 died following circumcision in the UK. He found that most deaths had occurred suddenly under anaesthesia and could not be explained further, but hemorrhage and infection had also proven fatal. Deaths attributed to phimosis and circumcision were grouped together, and Gairdner argued that such deaths were probably due to the circumcision operation.[49]

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