Relegiously: While mandated in older forms of the bible, the New Testament states that the circumcision can be replaced with a good ole fashioned baptism. Relegion has nothing to do with one's influence.

Hygeine: There is little, if any, founded data on medical issues arising from improper cleaning procedures of either circumcised or un-circumcised boys. More dirt is probably found behind their ears than down there.

Different: Those who are afraid their little boy will feel "different" in the locker room shouldn't stress so hard on this. That same little boy will pierce his eyebrow, tongue, lip and ears, carve their first loves initials in their body with a razor blade, spike their hair up in bright neon pink mohawks and insist they can make that 40' jump on roller skates. Don't you remember trying to be "unique" during those tender years?

Like Father: This is the ONLY part of the circumcision debate that should hold any merit. The father will be the one showing him how to clean an uncircumcised penis, explaining to him why HE decided to or not to do it (let's face it, little boys don't want to hear about how mommy had a say so in matters of his wee wee.) If the father can make this decision, can sit in the room while the doctor does the deed and can STILL feel like he made the right decision while his son is quivering in his arms, then that's for HIM to decide.

Infant Death: There are several mentions of death involving circumcision, but NONE of them are directly related. Allergic reactions to drugs used during the process and loss of blood are the most common. The actual ration is much less than 1%. For some people, that's a risk they're not willing to take.

That's it. That's pretty much everything I've found over the years. HOURS I've spent looking up info on this, and these are the popular topics.

The decision to circumcise is based SOLELY on personal preference. Whatever justifications you have are yours and yours alone. They aren't backed up by medical fact. They aren't backed up by (common) relegions. They aren't backed up by filthy hygeine habits.

They are backed up by a fear that YOU think he'll have. Which is good to know, since you're the one making the decision.

I would like to say this now: Your preference is YOUR preference. If you find medical evidence I may have missed, if you have a research or dissertation that can weigh this debate, then please post it. Please don't use this thread to post your preferences. Thanks!

:thumbsup :yeehaw (about the religion part & hygiene)

(let me just say we would choose NOT to circumsize! :mrgreen )

Very well thought out and written. Thank you for sharing.

Most circs are personal preference but not all are. We've had several babies who were circ out of medical necessity. They were foster babies and on medi-cal (medicaid) and it's not a procedure that is routinely covered. In these boys case the doctor and urologist felt that the foreskin was to restricting and recommended having them circ. Medi-cal approved them so it must have valid cause trust me - Medi-cal doesn't pay for anything that they don't have to.

Well said:)

Very well siad. Great research!

Most circs are personal preference but not all are. We've had several babies who were circ out of medical necessity. They were foster babies and on medi-cal (medicaid) and it's not a procedure that is routinely covered. In these boys case the doctor and urologist felt that the foreskin was to restricting and recommended having them circ. Medi-cal approved them so it must have valid cause trust me - Medi-cal doesn't pay for anything that they don't have to.

I did leave out the examples of medical necessity. Since these were so rare, the parents, even if they were against it, chose to do it out of fear for their baby. I did, however, want to stress that just like any other surgical procedure, this optional surgery CAN cause death. I didn't want to confuse necessity with optional. You are 100% correct, whoever. These cases DO happen, and I would safely say that no one has opted to let their child suffer and die over a minor surgery. Thank you for adding!!

I've found a few articles both for and against circumcision (I'll just post the abstracts because there are over 50pgs!):

Published in the Lancet: Circumcision and HIV prevention research: an ethical analysis

Dr Reidar K Lie MDa, , , Ezekiel J Emanuel MDa and Christine Grady PhDa

A large, randomised controlled trial in 3274 men between the ages of 18 and 24 years showed that circumcision resulted in a significant 60% reduction in HIV infection.1 If these results were to be confirmed by two continuing (unpublished) trials, there would be grounds to advocate circumcision as a public health intervention in high prevalence areas.

Several ethical issues arose in relation to this trial, such as the decision not to disclose participants' HIV status to them during the trial, the decision to pay participants, and early termination at the request of the trial's monitoring board.2, 3 and 4 We address the ethical implications for future HIV prevention research, both for biological interventions, such as vaccine and microbicide trials, and for behavioural interventions, such as counselling. First, is there an ethical obligation to provide all male participants in future trials of HIV vaccines and other preventive methods with circumcision (as well as counselling and access to condoms)? Second, should future prevention trials select or stratify participants by circumcision status? Third, should the design of such trials be altered in light of the established effectiveness of circumcision—eg, by requiring circumcision for the control groups?


Published in the Journal of Pediatric Urology: Severe complications of circumcision: An analysis of 48 cases

Kadir Ceylana, , , Köseoğlu Burhanb, Yüksel Yılmaza, Şaban Cana, Alpaslan Kuşa and Güneş Mustafaa

It has been estimated that 25% of the men around the globe are circumcised [1]. Considering this fact, it is clear that circumcision is the most commonly performed surgical operation. Most circumcisions are performed for religious not medical reasons [2]. Complication rates varying from 1% to 15% are reported in circumcision procedures [3]. Most of these complications are minor, such as bleeding, infection and reopening of wounds. Major complications such as glandular necrosis, glans and penis amputations, urethral openings, and preputial fusion defects can also occur.

We report here on cases with complications after circumcision that needed surgical repair and were referred to us. The aim of this study is to emphasize the importance of the problem of such circumcision complications.

Published in the Journal of Pediatrics: Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomized trials and observational studies. Arch Dis Child 2005;90:853-8

Question Does circumcision reduce the risk of urinary tract infection (UTI) in boys?

Data Sources Cochrane controlled trials register, MEDLINE, EMBASE, reference lists of retrieved articles, and contact with known investigators.

Study Identification and Assessment Randomized controlled trials and observational studies that compared the frequency of UTI in circumcised and uncircumcised boys. Two authors independently assessed study quality using guidelines provided by the CONSORT statement for quality of randomized studies and the MOOSE statement for quality of observational studies.

Outcomes Diagnosis with UTI.

Main Results Data on 402,908 children were identified from 12 studies (one randomized controlled trial, four cohort studies, and seven case-control studies). Circumcision was associated with a significantly reduced risk of UTI (OR = 0.13; 95% CI, 0.08 to 0.20; p<0.001) with the same odds ratio (0.13) for all three types of study design.

Conclusions Circumcision reduces the risk of UTI. Given a risk in normal boys of about 1%, the number needed to treat (NNT) to prevent one UTI is 111. In boys with recurrent UTI or high grade vesicoureteric reflux, the risk of UTI recurrence is 10% and 30% and the NNTs are 11 and 4, respectively. Hemorrhage and infection are the most common complications of circumcision, occurring at rate of about 2%. Assuming equal utility of benefits and harms, net clinical benefit is likely only in boys at high risk of UTI.

Commentary The main limitation of this meta-analysis, as acknowledged by the authors, is the variable quality of the included studies. The randomized trial included examined the protective effect of circumcision on boys with recurrent UTI. The risk reduction in this high risk group is likely to be different than in the population as a whole. The retrospective cohort studies, which represent analyses of inpatient billing data, may be biased because: 1) uncircumcised males are more likely to be “worked-up” for a UTI; and 2) uncircumcised males suspected of UTI may be at higher risk of hospitalization (as suggested by two of the included studies). Furthermore, the accuracy of UTI diagnosis in these studies is unknown. The case-control studies also have methodological problems including: use of bag specimens, use of unmatched control groups, and exclusion of eligible children with incomplete circumcision data.

The abovementioned biases could be overcome using a prospective study in which all children suspected of UTI are tested for UTI regardless of circumcision status. Two such large studies with data regarding circumcision are available (one published after the meta-analysis).1 and 2 Inclusion of these two studies in the meta-analysis would not have changed the results (OR= 0.13; CI= 0.07-0.25). A potential, albeit controversial, option for increasing validity is to limit meta-analyses to high quality trials. However, little evidence is available regarding features of observational studies that are most influential in determining accuracy of results. Surprisingly, limiting this meta-analysis to the 3 highest quality prospective studies would have resulted in a very similar risk estimate (OR = 0.12; CI= 0.04-0.37). Because neither stratification of the results by quality nor inclusion of additional data changes the odds ratio, we can more confidently conclude that circumcision reduces the risk of UTI by approximately 10 fold.

Published in the Journal of Men's Health and Gender: Male circumcision: a review of the evidence

Hassan Hirji MPharm MRPharmSa, , , Rodger Charlton MDb and Siddharth Sarmah MBBSc

This literature review details how male circumcision has been a subject of debate for many years with different parties quoting different benefits and risks. The incidences of these risks are seldom quantified. This paper attempts to assess the rationale for circumcision on medical, religious and cultural grounds and examines the relative rate of complications. It also attempts to assess the proposed benefits, one of which relates to infection transmission but these are small on a population scale. The stated risks of surgical complications are small. No studies show impaired sexual functioning following circumcision. All complications are increased and of greater severity with untrained personnel performing circumcision. The available evidence does not justify routine circumcision.

yep it is a personal decision but i disagree that it is only the fathers choice. especially for many of us on this site whos husbands are away for extended periods of time--it is the women that will be taking care of their son and showing him how to take care of it. that seems gross but if your husband is gone for a year in iraq or a year on deployment anywhere saying that it is the father that has to take care of showing the little one how to clean it just seems well seems civilian (if that makes sense). the son doesn't have to know the mother helped make the decision--dh and i discussed this the last time the circumsion debate came up and we will circumcise but not because we are afraid he'll get made fun of in the locker room but that's because dh was circumcised and i'm assuming the men in his family are--i'm okay with the decision. if we have a little boy while dh is in the navy i will be the one to help show my son how to clean his penis with or without foreskin. just as i will be the one to show my little girl how to clean her vagina properly.

I think well written and jeez you actually made me shut my mouth.

*leaves thread*

I'm thoroughly convinced that finding articles like these are your full time job, Zelda. It's always refreshing to see data in a debate instead of finger pointing and name calling. :)

That being said, this is statistical data. Statistical data is often inaccurate (control groups are "best of" and experiment groups are "worst of") and more frequently biased towards a result as a result of funding and principles. This is a personal bias, but it's served me well in the past. Here's my rebuttal:

I've found a few articles both for and against circumcision (I'll just post the abstracts because there are over 50pgs!):

Published in the Lancet: Circumcision and HIV prevention research: an ethical analysis

Dr Reidar K Lie MDa, , , Ezekiel J Emanuel MDa and Christine Grady PhDa

A large, randomised controlled trial in 3274 men between the ages of 18 and 24 years showed that circumcision resulted in a significant 60% reduction in HIV infection.1 If these results were to be confirmed by two continuing (unpublished) trials, there would be grounds to advocate circumcision as a public health intervention in high prevalence areas.

Without knowing more information, specifically, the demographic, lifestyle and awareness education of each member, this study seems a bit flawed. I know you left some material out due to size, but when a report says it can reduce HIV infections by 60% in a certain community, I would absolutely like to see more evidence before I bought off on this. In other words, how the heck did we miss this for the past 20 years?! (I did the math just now. 60% of the world's uncirc'd men is a WHOPPING 1.5 BILLION men. I think that if someone found a way to stop HIV in 1.5 BILLION men, it would be on CNN or something.)

Published in the Journal of Pediatric Urology: Severe complications of circumcision: An analysis of 48 cases

Kadir Ceylana, , , Köseoğlu Burhanb, Yüksel Yılmaza, Şaban Cana, Alpaslan Kuşa and Güneş Mustafaa

It has been estimated that 25% of the men around the globe are circumcised [1]. Considering this fact, it is clear that circumcision is the most commonly performed surgical operation. Most circumcisions are performed for religious not medical reasons [2]. Complication rates varying from 1% to 15% are reported in circumcision procedures [3]. Most of these complications are minor, such as bleeding, infection and reopening of wounds. Major complications such as glandular necrosis, glans and penis amputations, urethral openings, and preputial fusion defects can also occur.

Seeing as how I enjoy math (read: despise math), I decide to calculate these percentages. I took the population of the planet (Over 6 billion), split in half, then multiplied by .02 (there are 102 men per 100 women average). 25% of the male population are circumcised: Mathmatically, on average, there are 847,087,076 circumsized males on the planet as of 0830 on 28AUG06. 1% of that number is 8 million and change. If a surgical procedure killed, maimed or infected 8 million people, it would probably be outlawed.

That means there are 2,541,261,227 UNcircumcised. Not to worry, though. 60% of these men will contract HIV.


Question Does circumcision reduce the risk of urinary tract infection (UTI) in boys?

Data Sources Cochrane controlled trials register, MEDLINE, EMBASE, reference lists of retrieved articles, and contact with known investigators.

Study Identification and Assessment Randomized controlled trials and observational studies that compared the frequency of UTI in circumcised and uncircumcised boys. Two authors independently assessed study quality using guidelines provided by the CONSORT statement for quality of randomized studies and the MOOSE statement for quality of observational studies.

Outcomes Diagnosis with UTI.

Main Results Data on 402,908 children were identified from 12 studies (one randomized controlled trial, four cohort studies, and seven case-control studies). Circumcision was associated with a significantly reduced risk of UTI (OR = 0.13; 95% CI, 0.08 to 0.20; p<0.001) with the same odds ratio (0.13) for all three types of study design.

Conclusions Circumcision reduces the risk of UTI. Given a risk in normal boys of about 1%, the number needed to treat (NNT) to prevent one UTI is 111. In boys with recurrent UTI or high grade vesicoureteric reflux, the risk of UTI recurrence is 10% and 30% and the NNTs are 11 and 4, respectively. Hemorrhage and infection are the most common complications of circumcision, occurring at rate of about 2%. Assuming equal utility of benefits and harms, net clinical benefit is likely only in boys at high risk of UTI.

Commentary The main limitation of this meta-analysis, as acknowledged by the authors, is the variable quality of the included studies. The randomized trial included examined the protective effect of circumcision on boys with recurrent UTI. The risk reduction in this high risk group is likely to be different than in the population as a whole. The retrospective cohort studies, which represent analyses of inpatient billing data, may be biased because: 1) uncircumcised males are more likely to be “worked-up” for a UTI; and 2) uncircumcised males suspected of UTI may be at higher risk of hospitalization (as suggested by two of the included studies). Furthermore, the accuracy of UTI diagnosis in these studies is unknown. The case-control studies also have methodological problems including: use of bag specimens, use of unmatched control groups, and exclusion of eligible children with incomplete circumcision data.

The abovementioned biases could be overcome using a prospective study in which all children suspected of UTI are tested for UTI regardless of circumcision status. Two such large studies with data regarding circumcision are available (one published after the meta-analysis).1 and 2 Inclusion of these two studies in the meta-analysis would not have changed the results (OR= 0.13; CI= 0.07-0.25). A potential, albeit controversial, option for increasing validity is to limit meta-analyses to high quality trials. However, little evidence is available regarding features of observational studies that are most influential in determining accuracy of results. Surprisingly, limiting this meta-analysis to the 3 highest quality prospective studies would have resulted in a very similar risk estimate (OR = 0.12; CI= 0.04-0.37). Because neither stratification of the results by quality nor inclusion of additional data changes the odds ratio, we can more confidently conclude that circumcision reduces the risk of UTI by approximately 10 fold.

A lot of mumbo jumbo there, with some really creative usage of numbers. The overriding issue I see with this entry is the simple fact that they didn't take "random" people - they took people with severe UTI problems already. It doesn't appear they took genetics, water quality and environmental factors
into consideration. The fact that even the report says some of there data isn't correct, but they still go on to report their findings as pro-circumcision. This sounds like a biased judgment.

Published in the Journal of Men's Health and Gender: Male circumcision: a review of the evidence

Hassan Hirji MPharm MRPharmSa, , , Rodger Charlton MDb and Siddharth Sarmah MBBSc

This literature review details how male circumcision has been a subject of debate for many years with different parties quoting different benefits and risks. The incidences of these risks are seldom quantified. This paper attempts to assess the rationale for circumcision on medical, religious and cultural grounds and examines the relative rate of complications. It also attempts to assess the proposed benefits, one of which relates to infection transmission but these are small on a population scale. The stated risks of surgical complications are small. No studies show impaired sexual functioning following circumcision. All complications are increased and of greater severity with untrained personnel performing circumcision. The available evidence does not justify routine circumcision.

The only thing that makes sense to me in this last paragraph is the statement that underqualified medical personnel can cause unnecessary injury. That statement, mixed is some all encompassing catchall statments (risk of surgery is small, impaired sexual functioning afterwards, etc...) fall under the category of "fluff". They're statements added to inflate the value of the paper. I place as much faith in fluff as I do with statistical data.

That ALL being said, the data was a great read! From my point of view, it was just as entertaining as that "Loose Change" video. Remarkable from a standpoint, but baseless past the surface.

I'm thoroughly convinced that finding articles like these are your full time job, Zelda. It's always refreshing to see data in a debate instead of finger pointing and name calling. :)

That being said, this is statistical data. Statistical data is often inaccurate (control groups are "best of" and experiment groups are "worst of") and more frequently biased towards a result as a result of funding and principles. This is a personal bias, but it's served me well in the past. Here's my rebuttal:



Without knowing more information, specifically, the demographic, lifestyle and awareness education of each member, this study seems a bit flawed. I know you left some material out due to size, but when a report says it can reduce HIV infections by 60% in a certain community, I would absolutely like to see more evidence before I bought off on this. In other words, how the heck did we miss this for the past 20 years?! (I did the math just now. 60% of the world's uncirc'd men is a WHOPPING 1.5 BILLION men. I think that if someone found a way to stop HIV in 1.5 BILLION men, it would be on CNN or something.)



Seeing as how I enjoy math (read: despise math), I decide to calculate these percentages. I took the population of the planet (Over 6 billion), split in half, then multiplied by .02 (there are 102 men per 100 women average). 25% of the male population are circumcised: Mathmatically, on average, there are 847,087,076 circumsized males on the planet as of 0830 on 28AUG06. 1% of that number is 8 million and change. If a surgical procedure killed, maimed or infected 8 million people, it would probably be outlawed.

That means there are 2,541,261,227 UNcircumcised. Not to worry, though. 60% of these men will contract HIV.




A lot of mumbo jumbo there, with some really creative usage of numbers. The overriding issue I see with this entry is the simple fact that they didn't take "random" people - they took people with severe UTI problems already. It doesn't appear they took genetics, water quality and environmental factors
into consideration. The fact that even the report says some of there data isn't correct, but they still go on to report their findings as pro-circumcision. This sounds like a biased judgment.



The only thing that makes sense to me in this last paragraph is the statement that underqualified medical personnel can cause unnecessary injury. That statement, mixed is some all encompassing catchall statments (risk of surgery is small, impaired sexual functioning afterwards, etc...) fall under the category of "fluff". They're statements added to inflate the value of the paper. I place as much faith in fluff as I do with statistical data.

That ALL being said, the data was a great read! From my point of view, it was just as entertaining as that "Loose Change" video. Remarkable from a standpoint, but baseless past the surface.


I'm a research associate - it is part of my job!! :P I agree that almost every scientific article can be statistically flawed (some more than others...) I was very interested in the HIV article as it seemed so controversial - I'm just waiting for the other two supporting articles to be published to see what data they have come up with.

(Just for the record, I'm not pro-circumcision)

I'm a research associate - it is part of my job!! :P I agree that almost every scientific article can be statistically flawed (some more than others...) I was very interested in the HIV article as it seemed so controversial - I'm just waiting for the other two supporting articles to be published to see what data they have come up with.

(Just for the record, I'm not pro-circumcision)


I knew it! You have access to stuff I've never even heard of before, and for posting your knowledge, I bow to you! Thanks much!

The 60% thing really hit me too. That seems like such an enormous number! I would really like to see the Peer Review results on that and the other two articles. If those findings are proven accurate, it would revolutionize disease control procedures the world over. Thank you again!

I knew it! You have access to stuff I've never even heard of before, and for posting your knowledge, I bow to you! Thanks much!

The 60% thing really hit me too. That seems like such an enormous number! I would really like to see the Peer Review results on that and the other two articles. If those findings are proven accurate, it would revolutionize disease control procedures the world over. Thank you again!

If you PM me your email I'll send you the full article :)