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The ABCs of STIs: An update on sexually transmitted infections. MC was also regarded as a
landmark for manhood, protection from disease and a stimulant for women’s sexual desire as
circumcised men were thought to be able to last longer before ejaculation. Male circumcision and risk
of syphilis, chancroid, and genital herpes: A systematic review and meta-analysis. However, not all
health authorities actually agree and the recommendation is somewhat controversial. The articles of
male circumcision techniques were investigated from October 2018 to December 2018 through
Google Scholar and Proquest. Random effects model was employed to calculate a pooled relative
risk (RR) and its associated 95% confidence interval (CI). Circumcision in HIV-infected men and its
effect on HIV transmission to female partners in Rakai, Uganda: A randomised controlled trial. The
Lancet. 2009; 374 (9685):229-237 47. My biggest problem is that it does not adequately cover adult
circumcision, which is massively on the rise (especially in Africa) as an HIV prevention tool.
Arguments and Meta-Analyses to the Contrary Fail to Withstand Scrutiny Does Male Circumcision
Protect against Sexually Transmitted Infections. Chlamydia and gonorrhea are associated with
serious short- and long-term conditions such as pelvic inflammatory disease, ectopic pregnancy,
infertility, chronic pelvic pain and arthritis. Five of the studies were in developing countries and one
was in the U.S. suggesting greater global generalizability. Moreover, I cast doubt on the interest
calculus that Dr Mazor employs to arrive at his conclusions about circumcision. Male circumcision
and human papillomavirus infection in men: A systematic review and meta-analysis. Most sexually
active persons will contract HPV infection at some time in their lives but in most cases, the infection
will be asymptomatic and clear spontaneously. Although based on a series of epidemiological
investigations, culminating in RCTs, the benefits of MC are a controversial subject in the medical
and scientific community. A key data gap is how demand generation cost differs across age groups
and over time as VMMC coverage increases. The three African RCTs also reported associations
between MC and gonorrhea, chlamydia, trichomonas, and bacterial vaginosis ( Table 1 ). That is as
far from voluntary as it is possible to be. Association between male circumcision and incidence of
syphilis in men and women: A prospective study in HIV-1 serodiscordant heterosexual African
couples. New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications.
HSV-1 is mainly transmitted by oral contact to cause infection in or around the mouth (oral herpes).
As the precursor of cervical cancer, reducing high-risk HPV transmission is a critical part of disease
prevention. First estimates of the global and regional incidence of neonatal herpes infection.
Katharine JL, Amalia SM, Katherine MET, Peter V, Sami LG, Lori MN. Conversely, the
immunocompromised state of HIV infection makes syphilis acquisition more likely. In January, 2010,
he was elected “on merit” as Fellow of the Royal College of Surgeons for his contributions to
urology, pediatric surgery, and pediatric urology in the internationally, and in particular in the British
Isles. Journal of Pediatric Urology. 2014; 10 (6):982-998 33. The compelling HIV reductions in 3
African randomized control trials in circumcised men have prompted use of male circumcision as a
key part of HIV prevention in developing nations. Most circumcisions are forced on innocent minors
when they cannot say no. To browse Academia.edu and the wider internet faster and more securely,
please take a few seconds to upgrade your browser.
That is as far from voluntary as it is possible to be. AIDS Research and Therapy. 2017; 14 (1):49 22.
Sheerin NS. Urinary tract infection. Medicine. 2015; 43 (8):435-439 23. The Journal of Infectious
Diseases. 2011; 204 (9):1375-1390 64. High-consistency evidence exists that male circumcision
protects women against cervical cancer, cervical dysplasia, herpes simplex virus type 2, chlamydia,
and syphilis. Serwadda D, Wawer M, Makumbi F, Kong X, Kigozi G, Gravitt P, et al. Global
Health: Science and Practice. 2016; 4 (Suppl 1):S76-S86 87. Mielke RT. Counseling parents who are
considering newborn male circumcision. Note that a high circumcision would often involve removing
more of the loose shaft, which would result in the scar line to be closer to the middle area of the
penile shaft. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and
ClinicalTrials. In developing countries, cervical cancer ranks second (breast cancer is first) in
incidence and mortality. In this commentary, originally published at the University of Oxford’s
Practical Ethics website, I argue that the AAP is on less secure footing than it seems to think. Grund
JM, Bryant TS, Jackson I, Curran K, Bock N, Toledo C, et al. Regardless of the case, it is advisable
that you consult your adult circumcision doctor for the best guidance. Safety and efficacy of the
PrePex device for rapid scale-up of male circumcision for HIV prevention in resource-limited
settings. Circumcision status and risk of HIV acquisition during heterosexual intercourse for both
males and females: A meta-analysis. PLoS One. 2015; 10 (5):e0125436 46. The patients who have a
particular preference for a style can feel free to discuss their options with their doctor during the
consultation. Geneva, Switzerland: World Health Organization; 2018. Earp In 2012, the American
Academy of Pediatrics (AAP) updated its policy on infant male circumcision, arguing that the
benefits of the procedure outweigh the risks. Surgical Guide to Circumcision is a fully illustrated,
step-by-step guide to the most common techniques of circumcision and addresses aspects such as
informed consent, religious and cultural sensitivities, pre-exam, post-care, pain control, and
prevention and management of potential complications. Circumcision Methods. 2015. Available
from: (accessed Dec 03, 2018). Demand generation interventions varied across the countries, from
advocacy with community leaders. To browse Academia.edu and the wider internet faster and more
securely, please take a few seconds to upgrade your browser. Download Free PDF View PDF
Frontiers in pediatrics Commentary: Do the Benefits of Male Circumcision Outweigh the Risks. You
can download the paper by clicking the button above. Family physicians should also be ready and
prepare themselves to advise their patients about the possible indications for the adult circumcision
surgery. The New England Journal of Medicine. 2009; 361 (14):1376-1385 74. Claims that MC
impairs sexual function and pleasure were contradicted by high-quality studies finding no adverse
effect. Circumcision has many medical benefits such as minimizing urinary tract infection, reduces
the incidence of balanitis and enhances of penile hygiene, prevents of penile cancer.
Lymphogranuloma venereum 2015: Clinical presentation, diagnosis, and treatment: Table 1. In any
case, this does not influence the scaling up of MC, which depends on both scientific evidence and
the personal beliefs of the actors —researchers, decision makers and the public.
The likelihood of the child choosing circumcision in the religious case also reduces the extent to
which infant circumcision violates his interest in self-determination. Acta Paediatrica. 1974; 63:1-20
24. Rasouly HM, Lu W. Lower urinary tract development and disease. Frequency tables and pie
charts were used for data presentation. Prevalence of the human papillomavirus (HPV) expression of
the inner prepuce in asymptomatic boys and men. The cultural importance of male circumcision has
weakened over the last century and when it is done it is often by a medical practitioner. Klinglmair
G, Pichler R, Zelger B, Dogan H, Becker T, Esterbauer J, et al. However, it’s not actually tight
enough to lead to some discomfort. Laway M, Wani M, Patnaik R, Kakru D, Ismail S, Shera A, et al.
In marked contrast to thecdc, Adler’s criticisms depend on speculative claims and obfuscation of the
scientific data. In the current decade, a substantial body of research suggests that male circumcision
is effective as a prophylactic measure against HIV and other sexually transmitted infections. Both
men and women felt that sex was important to maintain the relationship. The Journal of Urology.
2013; 189 (6):2118-2124 27. Progress towards Ending the HIV Epidemic in the United Kingdom:
2018 Report. Dr. Yosha also serves the greater Rochester region as a mohel to reform and
conservative families. In theory, removal of the foreskin HIV reduces target cells, eliminates the
sticky medium for viruses, exposes the more keratinized penile shaft and eliminates the sub-preputial
space which collectively diminishes pathogen exposure. The dorsal slit is useful in those patients
who struggle with problems like phimosis. High-risk HPV infection has a considerable role in penile
cancer, but with less consistency than in cervical cancer. In case of any emergency, You must consult
with any medical expert. A Japanese view on circumcision: Nonoperative management of normal and
abnormal prepuce. Urology. 2010; 76 (1):21-24 15. Herpes simplex virus 2 infection increases HIV
acquisition in men and women: Systematic review and meta-analysis of longitudinal studies. AIDS.
2006; 20 (1):73-83 67. Articles published on MC in scientific journals over nearly two decades and
the reactions they elicited, both inside and outside the medical community are analysed. Does
circumcision alter the periurethral uropathogenic bacterial flora. Routine neonatal circumcision for the
prevention of urinary tract infections in infancy. Systems Biology and Medicine. 2013; 5 (3):307-342
25. Adjusted HIV incidence rate ratios (aIRR) and prevalence ratios (aPR) were calculated using
Poisson regression. The Lancet Infectious Diseases. 2007; 7 (7):453-459 58. More attention has been
on HPV infection in women because of its association with cervical cancer. Risk factors for febrile
urinary tract infection in children with prenatal hydronephrosis: A prospective study. Our Authors
and Editors We are a community of more than 103,000 authors and editors from 3,291 institutions
spanning 160 countries, including Nobel Prize winners and some of the world’s most-cited
researchers. Information for Providers Counseling Male Patients and Parents Regarding Male
Circumcision and the Prevention of HIV Infection, STIs, and Other Health Outcomes.
However, not all health authorities actually agree and the recommendation is somewhat controversial.
Circumcision status and risk of HIV acquisition during heterosexual intercourse for both males and
females: A meta-analysis. PLoS One. 2015; 10 (5):e0125436 46. Internal Medicine Journal. 2012; 42
(7):822-828 12. About the Author Dr. Bolnick is an amalgam of scholar, scientist, technology design
guru, media producer, and photographer. Note that a high circumcision would often involve removing
more of the loose shaft, which would result in the scar line to be closer to the middle area of the
penile shaft. Neither study reported an association between MC and gonorrhea in men. Boston
Medical Surgical Journal. 1856; 55:77-78 2. Wolbarst AL. Universal circumcision as a sanitary
measure. Effect of circumcision of HIV-negative men on transmission of human papillomavirus to
HIV-negative women: A randomised trial in Rakai, Uganda. The Lancet. 2011; 377 (9761):209-218
61. Dr Koyle is past president of the Rocky Mountain Urology Society, the Society for Pediatric
Urology, and the American Association of Pediatric Urologists. Regardless of the case, it is advisable
that you consult your adult circumcision doctor for the best guidance. In other countries like the UK,
the percentage of circumcised males was about 8%. Atlanta, Georgia: Department of Health and
Human Services; 2018 13. Results The response rate was 73.9%. Most respondents agreed that
circumcised men could become HIV infected and needed to use condoms, although 19.3% (95%CI:
17.1% to 21.6%) asserted that AMC protected fully against HIV. Grund JM, Bryant TS, Jackson I,
Curran K, Bock N, Toledo C, et al. International Journal of Cancer. 1989; 44 (2):199-203 62.
Adjusted HIV incidence rate ratios (aIRR) and prevalence ratios (aPR) were calculated using
Poisson regression. Penile cancer—Prevention and premalignant conditions. Urology. 2010; 76 (2
Suppl 1):S24-S35 66. Download Free PDF View PDF See Full PDF Download PDF Loading
Preview Sorry, preview is currently unavailable. Journal of Paediatrics and Child Health. 2009; 45
(3):87-97 26. In terms of content this claims to be a comprehensive, balanced, neutral book.
Available from: 41. Fink A. A possible explanation for heterosexual male infection with AIDS. There
are some non-medical reasons, including cultural, social, religious, and personal. Re-Examining the
Case for Non- Therapeutic Infant Circumcision Robert Darby Recent restatements of the case for
routine circumcision of normal male infants and boys typically base their arguments on a range of
medical evidence showing circumcision to have a protective effect against certain pathological
conditions. During pregnancy, the immunosuppression of pregnancy increases risk of syphilis
acquisition and if untreated or undertreated, there is great risk for adverse infant consequences.
Lymphoid areas of mucosal surfaces are primary sites for HIV infection. You can download the paper
by clicking the button above. Further, developed countries have access to antivirals for prevention as
well as for treatment of HIV infection which keep prevalence of new infections and AIDs mortality
low. A Japanese view on circumcision: Nonoperative management of normal and abnormal prepuce.
Urology. 2010; 76 (1):21-24 15. You can download the paper by clicking the button above. More
recently, the use of male circumcision as a public health measure in developed nations is a topic of
international discussion.
Method: A sequential explanatory mixed study was used. In developed countries, access to HPV
vaccination along with early identification and treatment of cervical dysplasia is a well-established
part of preventive health care for women. PubMed, Embase, Cochrane Central Register of
Controlled Trials (CENTRAL) and ClinicalTrials. Therefore, the evidence it brings should put an end
to controversies. Prodger JL, Kaul R. The biology of how circumcision reduces HIV susceptibility:
Broader implications for the prevention field. Download Free PDF View PDF Perceptions and
knowledge of voluntary medical male circumcision for HIV prevention in traditionally non-
circumcising communities in South Africa Lauraine M H Vivian, Naomi Johnson, Carl Larbi, Kirsten
Arendse Voluntary medical male circumcision (VMMC) has been recommended for the prevention
of HIV transmission, particularly in sub-Saharan Africa. Conclusion: In general, the circumcision
method using shield and clamp devices is more beneficial and more practical than conventional
methods. Rutz By the end of 2014, an estimated 8.5 million men had undergone voluntary medical
male circumcision (VMMC) for HIV prevention in 14 priority countries in eastern and southern
Africa, representing more than 40% of the global target. Furthermore, we review the extent to which
VMMC programs have reached adolescents, addressed their specific needs, and can be linked to
their sexual and reproductive health and other key services. Content Alerts Brief introduction to this
section that descibes Open Access especially from an IntechOpen perspective How it Works Manage
preferences Contact Want to get in touch. In addition, it is possible that circumcision of HIV-infected
men may protect female partners from infection and potentially from cervical neoplasia. Second, I
consider the interest in self-determination. McQuillan G, Kruszon-Moran D, Flagg EW, Paulose-Ram
R. In most cases, adult patients opt for this procedure because of medical indications, but the
common reason why men opt for it is personal and social reasons. Therefore, the procedure of MC
itself removes a reservoir for viruses, such as HPV, thus reducing exposure over the long-term. You
can download the paper by clicking the button above. Note that a high circumcision would often
involve removing more of the loose shaft, which would result in the scar line to be closer to the
middle area of the penile shaft. Download Free PDF View PDF Circumcision A Medical or a Human
Rights Issue Marilyn Milos Download Free PDF View PDF A 'snip' in time: what is the best age to
circumcise. Atlanta, Georgia: Department of Health and Human Services; 2018 13. HSV-1 is mainly
transmitted by oral contact to cause infection in or around the mouth (oral herpes). Absent of such
health resources, MC in their partners provides a means of HPV prevention and exposure reduction
for women. Please try again. Not in a club? Learn more Join or create book clubs Choose books
together Track your books Bring your club to Amazon Book Clubs, start a new book club and invite
your friends to join, or find a club that’s right for you for free. I conclude by asking how this tension
might begin to be resolved. During his almost 3 decades in academic urology, Dr. Koyle has been
known for his multiple innovations and contributions to the fields of pediatric urology and
transplantation. Risk factors for febrile urinary tract infection in children with prenatal
hydronephrosis: A prospective study. Bolnick's contributions have been recognized by numerous
achievement awards including 7 US Patents (most recent, March 2010), United Nations Outstanding
Achievement Award, US Vice President Gore's Hammer Award, 7 Telly Awards, California
Governor’s Media Access Award, Easter Seals’ Special EDI Award, 2 Aurora Awards, AEGIS Award
of Excellence, and many others. You can download the paper by clicking the button above. In this
editorial I address the AAP's claims as well as evaluate religious motivations more specifically. This
chapter will discuss the impact of male circumcision in the context of the health promotion and
health prevention specific to genitourinary and sexually transmitted infections. Male circumcision,
penile human papillomavirus infection, and cervical cancer in female partners.
Two reviews and meta-analyses analyzed the effect of male circumcision on genital HPV infection in
men. A challenge to ascertaining associations between a woman’s HPV risk and her partner’s
circumcision status is the reality that she may have numerous partners in her lifetime. Hayashi Y,
Kojima Y, Mizuno K, Nakane A, Kamisawa H, Maruyama T, et al. There are some non-medical
reasons, including cultural, social, religious, and personal. Using your mobile phone camera - scan
the code below and download the Kindle app. He is a Fellow of the American College of Surgeons,
Fellow of the American Academy of Pediatrics, and Fellow of the Society for Pediatric Urology.
The effects of male circumcision on female partners’ genital tract symptoms and vaginal infections in
a randomized trial in Rakai, Uganda. Based on statistical results from the CDC, about 58 of newborn
American male children went through circumcision back in 2010. It is also useful to the parent or
adult to educate themselves about the issues surrounding circumcision so that they can make an
informed decision. International Journal of Urology. 2012. Available from: (accessed Dec 05, 2019).
Worldwide, cervical cancer is the fourth most frequent cancer in women and fourth leading cause of
death in women. Hyattsville, MD: National Center for Health Statistics; 2018 75. The New England
Journal of Medicine. 2002; 346:1105-1112 20. In a study of HIV-positive men in Uganda, MC
reduced the prevalence and incidence of multiple HR-HPV infections. Incidence of penile cancer
worldwide: Systematic review and meta-analysis. VMMC for adolescents has several advantages:
uptake of services among adolescents is culturally and socially more acceptable than for adults; there
are fewer barriers regarding sexual abstinence during healing or female partner pressures; VMMC
performed before the age of sexual debut has maximum long-term impact on reducing HIV risk at
the individual level and consequently reduces the risk of transmission in the population. Braga LH,
Farrokhyar F, D’Cruz J, Pemberton J, Lorenzo AJ. Randomized, controlled intervention trial of male
circumcision for reduction of HIV infection risk: The ANRS 1265 trial. Rowley J, Vander Hoorn S,
Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. This study assesses the acceptability of
MC in four districts in Malawi, a country with high HIV-1 prevalence and low prevalence of MC.
Boston Medical Surgical Journal. 1856; 55:77-78 2. Wolbarst AL. Universal circumcision as a
sanitary measure. Fitzgerald L, Benzerga W, Mirira M, Adamu T, Shissler T, Bitchong R, et al. The
significant reduction (28%) in high-risk HPV that was observed in women whose partners were
circumcised earlier suggests that MC has a role in reducing HPV exposure to women in areas where
HPV vaccine is not readily available. On the other hand, the low circumcision involves removal of
less of the shaft skin, but more foreskin and this results in the scar line to be closer to the penis tip.
In resource poor countries without such preventive care programs, the protective effect of MC on
cervical dysplasia and cancer offers a critical means of preventing morbidity and mortality in
women. 4.2.2 HPV in men HPV is the most common STI in the world. Male circumcision for
prevention of homosexual acquisition of HIV in men. Acceptability was lower in the north where the
practice was little known, higher in younger participants and higher in central and southern districts
where MC is practiced by a minority Muslim group (Yao). In other countries like the UK, the
percentage of circumcised males was about 8%. An intervention that would include male
circumcision seems feasible in communities such as the one where this study was conducted but
needs to be carefully planned in order to ensure that participants understand that circumcision
probably reduces, but certainly does not eliminate, the risk of HIV infection. Please try again. Not in
a club? Learn more Join or create book clubs Choose books together Track your books Bring your
club to Amazon Book Clubs, start a new book club and invite your friends to join, or find a club
that’s right for you for free.