BMJ  2007;335:1206-1290 (8 December), doi:10.1136/bmj.39385.382708.AD

Clinical review

Medical aspects of male circumcision

¹ Southampton University Hospital, Department of Paediatric Urology, Southampton SO16 6YD

doi:10.1136/bmj.39406.520498.ADdoi:10.1136/bmj.39406.523762.AD

The first 150 words of the full text of this article appear below.

Summary points 1 in 6 males in the world ends up being circumcised The medical indications to circumcise prepubertal boys are rare There are many relative indications for circumcision in childhood, but the evidence of benefit needs to be carefully appraised The medical indications to circumcise adults are similarly rare Controversy continues about the health risks of preserving an intact foreskin because of lack of evidence and of clear randomised trials Complications of circumcision are well documented and can be drastic Nearly all circumcisions are carried out for cultural or religious reasons

Why should I read this review?

Circumcision is the commonest surgical procedure in males, because routine infant circumcision is practised in many countries for religious and cultural reasons. It originated over 15 000 years ago, being performed for religious, ritualistic, and cultural reasons, and it was not until the 19th century that the procedure was "medicalised." It is one of the most controversial surgical interventions: proponents claim . . . [Full text of this article]

What is the normal anatomy of the penis and foreskin?

Preputial adhesions and physiological phimosis

What are the relative indications for circumcision?

Paraphimosis
Balanoposthitis and balanitis
Preputial "pearls" and redundant foreskin
Phimosis
When is a phimosis physiological?
When is a phimosis pathological?
Does having a physiological phimosis at a certain age lead to a pathological phimosis later?
Prevention of sexually transmitted infections
Prevention of HIV infection
Prevention of penile cancer
Prevention of urinary tract infection in boys with urological abnormalities
Trauma
Hypospadias surgery and its variants

What are the absolute medical indications for circumcision?

Complications of circumcision

Conclusions

Methods
Additional educational resources
Tips for non-specialists

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