Newborn Male Circumcision: AAP Guidelines Revisited

Links to articles:  http://pediatrics.aappublications.org/content/130/3/585.full.pdf+html


 
                               http://aapnews.aappublications.org/content/33/9/1.2.full.pdf+html


 
Article Review:

 
In 1999 and 2005, the American Academy of Pediatrics reviewed data on hundreds of studies on circumcision but did not make a definitive recommendation.  That is, the AAP stated that there are health benefits to circumcision, but these benefits do not outweigh a parent's choice to leave their baby's foreskin intact.  Now in 2012, after reviewing over 1,000 studies dating back to 1995, the AAP maintains their position in leaving this decision up to parents, allowing their decision to be predicated on cultural, religious and personal reasons.  However, this report documents an increasing amount of data showing circumcision offers more health benefits than previously recognized.


 
Studies in Africa have shown a 40 to 60% reduction in HIV in circumcised heterosexual males.  Overall in the United States, the incidence of herpes simplex virus type II was reduced by 28 to 34 % in circumcised males as well as a 30 to 40% reduction in male human papilloma virus infection.  And, there was no data in this study to support the current belief that circumcision reduces sexual satisfaction due to decreased sensitivity.  In many studies, circumcised men report a higher degree of sexual sensitivity and satisfaction.  And, a significantly reduced incidence of urinary tract infection in the first year of life in circumcised boys was reconfirmed in this report.


 

 
Editor's Commentary:

 
In September 2011, the Centers for Disease Control reported a decline in rates of in-hospital male circumcisions in the United States.  Rates reported from 1997 to 2000 at 61.1% declined to 54.7% in 2010.  These rates do not account for out of hospital circumcisions performed.   Many families are deciding to forego circumcising their male newborns.  However, the pediatrician is often faced with questions from families asking their opinion.  While circumcised males have a lower incidence of sexually transmitted diseases and a lower incidence of urinary tract infections in the first year of life, the AAP does not feel that these benefits are compelling enough to routinely recommend the procedure for parents.  Pediatricians should share this objective data with families who are undecided about the procedure, and encourage them to make a decision for their baby they personally feel is best.

 

References:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_e%0D0a