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Circumcision

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83-418: Circumcision is a procedure that removes the foreskin from the human penis . In the most common form of the operation, the foreskin is extended with forceps , then a circumcision device may be placed, after which the foreskin is excised . Topical or locally injected anesthesia is generally used to reduce pain and physiologic stress . Circumcision is generally electively performed , most commonly done as

166-473: A dorsal slit ), which remains until blood flow has stopped. Finally, the foreskin is amputated . For older babies and adults, circumcision is often performed surgically without specialized instruments, and alternatives such as Unicirc or the Shang ring are available. The circumcision procedure causes pain, and for neonates this pain may interfere with mother-infant interaction or cause other behavioral changes, so

249-514: A 2014 review, the effect of circumcision on sexual partners' experiences is unclear as this has not been well studied. According to a policy statement from the Canadian Paediatric Society that was reaffirmed in 2021, "medical studies do not support circumcision as having an impact on sexual function or satisfaction for partners of circumcised individuals". There are popular misconceptions that circumcision benefits or adversely impacts

332-425: A Plastibell device is used, the most common complication is the retention of the device occurring in around 3.5% of procedures. Other possible complications include buried penis , chordee , phimosis, skin bridges , urethral fistulas, and meatal stenosis . These complications may be partly avoided with proper technique, and are often treatable without requiring surgical revision. The most common long-term complication

415-464: A combination of these, or one of the newer terms indicating a similar sexual, romantic, and cultural identity like bi-curious . In their assessment of the knowledge about the sexual networks and behaviors of MSM in Asia, Dowsett, Grierson and McNally concluded that the category of MSM does not correspond to a single social identity in any of the countries they studied. There were no similar traits in all of

498-450: A condom is considered to be high-risk for STI transmission. A person who inserts their penis into an infected partner is at risk because sexually transmitted infections (STIs) can enter through the urethra or through small cuts, abrasions, or open sores on the penis. Also, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky. Acquired immune deficiency syndrome (AIDS)

581-552: A contributing cause of the Bar Kokhba revolt . According to Silverman (2006), these restrictions were part of a "broad campaign" by the Romans to "civilize" the Jewish people, viewing the practice as repulsive and analogous to castration . His successor, Antoninus Pius , altered the edict to permit Brit Milah . During this period in history, Jewish circumcision called for the removal of only

664-404: A cultural identity. Homosexuality refers to sexual/romantic attraction between members of the same sex and may or may not include romantic relationships. Gay is a social identity and is generally the preferred social term, whereas homosexual is used in formal contexts, though the terms are not entirely interchangeable. Men who are non-heterosexual or questioning may identify with all, none,

747-500: A form of preventive healthcare , as a religious obligation , or as a cultural practice . It is also an option for cases of phimosis , other pathologies that do not resolve with other treatments, and chronic urinary tract infections (UTIs). The procedure is contraindicated in cases of certain genital structure abnormalities or poor general health. The procedure is associated with reduced rates of sexually transmitted infections and urinary tract infections . This includes reducing

830-439: A group. It does not describe any specific kind of sexual activity, and which activities are covered by the term depends on context. The alternative term " males who have sex with males " is sometimes considered more accurate in cases where those described may not be legal adults . The term men who have sex with men had been in use in public health discussions, especially in the context of HIV/AIDS , since 1990 or earlier, but

913-459: A man who self-identifies as straight may nonetheless be sexually active with other men; similarly, a man who self-identifies as gay or bisexual is not necessarily sexually active with other men. Second, the concept's usage is tied to criticism of sexual identity terms prevalent in social construction literature, which typically rejected the use of identity-based concepts across cultural and historical contexts. The Huffington Post postulates that

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996-642: A mark of distinction for the elite: the Egyptian Book of the Dead describes the sun god Ra as having circumcised himself. Circumcision is prominent in the Hebrew Bible . In addition to proposing that circumcision was adopted by the Israelites purely as a religious mandate, scholars have suggested that Judaism's patriarchs and their followers adopted circumcision to make penile hygiene easier in hot, sandy climates; as

1079-407: A part of the prepuce, and Hellenized Jews often attempted to look uncircumcised by stretching the extant parts of their foreskins. This was considered by the Jewish leaders to be a serious problem, and during the second century CE they changed the requirements of Jewish circumcision to call for the complete removal of the foreskin, emphasizing the Jewish view of circumcision as intended to be not just

1162-549: A particularly low prevalence of circumcised males. This region has a disproportionately high HIV infection rate, with a significant number of those infections stemming from heterosexual transmission. As a result, the promotion of prophylactic circumcision has been a priority intervention in that region since the WHO's 2007 recommendations. The International Antiviral Society–USA also suggests circumcision be discussed with men who have insertive anal sex with men , especially in regions where HIV

1245-646: A placebo, but the American Academy of Pediatrics (AAP) states that such methods are insufficient alone and should be used to supplement more effective techniques. A quicker procedure reduces duration of pain; use of the Mogen clamp was found to result in a shorter procedure time and less pain-induced stress than the use of the Gomco clamp or the Plastibell. The available evidence does not indicate that post-procedure pain management

1328-696: A prophylactic or treatment option in healthcare, circumcision plays a major role in many of the world's cultures and religions, most prominently Judaism and Islam . Circumcision is among the most important commandments in Judaism . It is widespread in Australia, Canada, the United States, South Korea, most of Africa, and parts of Asia. It is relatively rare for non-religious reasons in parts of Southern Africa, Latin America, Europe, and parts of Asia. The origin of circumcision

1411-434: A reduced risk of cervical cancer (which is caused by a type of HPV) in female partners of men. There is some evidence that circumcision is associated with reduced risk of prostate cancer . A 2017 systematic review found consistent evidence that male circumcision prior to heterosexual contact was associated with a decreased risk of cervical cancer, cervical dysplasia , HSV-2, chlamydia, and syphilis among women. The evidence

1494-592: A rite of passage into adulthood; or as a form of blood sacrifice. Historical campaigns of ethnic, cultural, and religious persecution frequently included bans on circumcision as a means of forceful assimilation, conversion, and ethnocide . Alexander the Great conquered the Middle East in the fourth century BCE, and in the following centuries ancient Greek cultures and values came to the Middle East. The Greeks abhorred circumcision, making life for circumcised Jews living among

1577-425: A spiritual concept, arguing literal circumcision to be unnecessary for Gentile converts to Christianity. The teaching that circumcision was unnecessary for membership in a divine covenant was instrumental to the separation of Christianity from Judaism. While the circumcision of Jesus is celebrated as a feast day in the liturgical calendar of many Christian denominations . Although it is not explicitly mentioned in

1660-419: A strong protective effect against penile cancer in later life. Penile cancer is a rare disease in the developed world but much more prevalent in the developing world . The penile tissue removed during circumcision is a potential origin for penile cancer. Risk-benefit considerations around the use of circumcision as a cancer-preventive measure are a source of debate. Penile cancer development can be detected in

1743-413: A third of the world's population , more than 2 billion people, have been infected with hepatitis B virus (HBV). Hepatitis B is a disease caused by HBV which infects the liver and causes an inflammation called hepatitis. Syphilis (caused by infection with Treponema pallidum ) is passed from person to person through direct contact with a syphilis sore; these occur mainly on the external genitals, or in

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1826-507: Is a common virus that most sexually active people in the U.S. will have at some time in their lives. It is passed on through genital contact and is also found on areas that condoms do not cover. Most men who get HPV of any type never develop any symptoms or health problems. Some types of HPV can cause genital warts, penile cancer, or anal cancer. MSM and men with compromised immune systems are more likely than other men to develop anal cancer. The incidence of anal cancer among HIV‐positive MSM

1909-619: Is a course of action intended to achieve a result in the delivery of healthcare . A medical procedure with the intention of determining, measuring, or diagnosing a patient condition or parameter is also called a medical test . Other common kinds of procedures are therapeutic (i.e., intended to treat, cure, or restore function or structure), such as surgical and physical rehabilitation procedures. Men who have sex with men Men who have sex with men ( MSM ) are men who engage in sexual activity with other men, regardless of their sexual orientation or sexual identity . The term

1992-413: Is a disease of the human immune system caused by the human immunodeficiency virus (HIV). HIV can infect anybody, regardless of sex, ethnicity, or sexual orientation . Worldwide, an estimated 5–10% of HIV infections are the result of men having sex with men. However, in many developed countries , more HIV infections are transmitted by men having sex with men than by any other transmission route. In

2075-461: Is a risk that the circumcision scar may be tender. There is no good evidence that circumcision affects cognitive abilities. Circumcision is the oldest known surgical procedure. Depictions of circumcised penises are found in Paleolithic art , predating the earliest signs of trepanation . The history of the migration and evolution of circumcision is known mainly from the cultures of two regions. In

2158-400: Is also used to treat various pathologies. These include pathological phimosis , refractory balanoposthitis and chronic or recurrent urinary tract infections (UTIs). Circumcision is contraindicated in certain cases. These include infants with certain genital structure abnormalities, such as a misplaced urethral opening (as in hypospadias and epispadias ), curvature of the head of

2241-457: Is common. There is evidence that circumcision is associated with a reduced risk of HIV infection for such men, particularly in low-income countries. The finding that circumcision significantly reduces female-to-male HIV transmission has prompted medical organizations serving communities affected by endemic HIV/AIDS to promote circumcision as an additional method of controlling the spread of HIV. Major medical organizations hold varying positions on

2324-506: Is difficult to determine due to scant data on complications and inconsistencies in their classification. Complication rates are greater when the procedure is performed by an inexperienced operator, in unsterile conditions, or when the child is at an older age. Significant acute complications happen rarely, occurring in about 1 in 500 newborn procedures in the United States. Severe to catastrophic complications, including death, are so rare that they are reported only as individual case reports. Where

2407-562: Is difficult. Worldwide, at least 3% of men have had sex at least once with a man. In the U.S., among men aged 15 to 44, an estimated 6% have engaged in oral or anal sex with another man at some point in their lives, and about 2.9% have had at least one male sexual partner in the previous 12 months. Historically, anal sex has been popularly associated with male homosexuality and MSM. However, many MSM do not engage in anal sex, and may engage in oral sex , frotting or mutual masturbation instead. Among men who have anal sex with other men,

2490-495: Is known about that history. It has been speculated that circumcision originated as a substitute for castration of defeated enemies or as a religious sacrifice . In many traditions, it acts as a rite of passage marking a boy's entrance into adulthood . At Oued Djerat , in Algeria , engraved rock art with masked bowmen, which feature male circumcision and may be a scene involving ritual, have been dated to earlier than 6000 BP amid

2573-568: Is meatal stenosis, this is almost exclusively seen in circumcised children, it is thought to be caused by ammonia producing bacteria coming into contact with the meatus in circumcised infants. It can be treated by meatotomy . Effective pain management should be used during the procedure. Inadequate pain relief may carry the risks of heightened pain response for newborns. Newborns that experience pain due to being circumcised have different responses to vaccines given afterwards, with higher pain scores observed. For adult men who have been circumcised, there

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2656-412: Is needed. For adults, topical anesthesia , ring block, dorsal penile nerve block (DPNB) and general anesthesia are all options, and the procedure requires four to six weeks of abstinence from masturbation or intercourse to allow the wound to heal. Male circumcision reduces the risk of human immunodeficiency virus (HIV) transmission from HIV positive women to men in high risk populations. In 2020,

2739-487: Is nine times higher than among HIV‐negative MSM, even in antiretroviral therapy. HIV-negative MSM has a higher incidence than the general population. Men with HIV are also more likely to get severe cases of genital warts that are hard to treat. Though not commonly classified as an STI, giardiasis can be transmitted between gay men, and it can be responsible for severe weight loss and death for individuals who have compromised immune systems, especially HIV. According to

2822-451: Is not known with certainty, but the oldest documentation comes from ancient Egypt . Around half of all circumcisions worldwide are performed for reasons of prophylactic healthcare. There is a consensus among the world's major medical organizations and in the academic literature that circumcision is an efficacious intervention for HIV prevention in high-risk populations if carried out by medical professionals under safe conditions. In 2007,

2905-403: Is the inability to retract the foreskin over the glans penis. At birth, the foreskin cannot be retracted due to adhesions between the foreskin and glans, and this is considered normal (physiological phimosis). Over time the foreskin naturally separates from the glans, and a majority of boys are able to retract the foreskin by age three. Less than one percent are still having problems at age 18. If

2988-513: Is the use of medication to prevent HIV transmission in people who have not yet been exposed to the virus. When used as directed, PrEP has been shown to be highly effective, reducing the risk of contracting HIV up to 99%. As of 2018 , numerous countries have approved the use of PrEP for HIV/AIDS prevention, including the United States , South Korea , France , Norway , Australia , Israel , Canada , Kenya , South Africa , Peru , Thailand ,

3071-926: The Bubaline Period ; more specifically, while possibly dating much earlier than 10,000 BP, rock art walls from the Bubaline Period have been dated between 9200 BP and 5500 BP. The cultural practice of circumcision may have spread from the Central Sahara , toward the south in Sub-Saharan Africa and toward the east in the region of the Nile . Based on engraved evidence found on walls and evidence from mummies , circumcision has been dated to at least as early as 6000 BCE in ancient Egypt . Some ancient Egyptian mummies , which have been dated as early as 4000 BCE, show evidence of circumcision. Evidence suggests that circumcision

3154-507: The European Union and Taiwan . New Zealand was one of the first countries in the world to publicly fund PrEP for the prevention of HIV in March 2018. Men who have sex with men are at a higher risk of acquiring hepatitis B and hepatitis A through unprotected sexual contact. The U.S. CDC and ACIP recommend hepatitis A and hepatitis B vaccination for men who have sex with men. About

3237-522: The Quran (early seventh century CE), circumcision is considered essential to Islam, and it is nearly universally performed among Muslims. The practice of circumcision spread across the Middle East, North Africa, and Southern Europe with Islam. Genghis Khan and the following Yuan Emperors in China forbade Islamic practices such as halal butchering and circumcision. Medical procedure A medical procedure

3320-474: The World Health Organization (WHO) reiterated that male circumcision is an efficacious intervention for HIV prevention if carried out by medical professionals under safe conditions. Human papillomavirus (HPV) is the most commonly transmitted sexually transmitted infection , affecting both men and women. While most infections are asymptomatic and are cleared by the immune system , some types of

3403-409: The prophylactic efficacy of the elective circumcision of minors in the context of developed countries . Literature on the matter is polarized, with the cost-benefit analysis being highly dependent on the kinds and frequencies of health problems in the population under discussion and how circumcision affects them. The World Health Organization (WHO), UNAIDS , and American medical organizations take

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3486-507: The 1980s and early 1990s, as well as " condom fatigue " among those who have grown tired of and disillusioned with the unrelenting safer sex message. The increase may also be because of new treatments. In developing countries, HIV infection rates have been characterized as skyrocketing among MSM. Studies have found that less than 5% of MSM in Africa, Asia, and Latin America have access to HIV-related health care. Pre-exposure prophylaxis (PrEP)

3569-764: The 2013 NATSAL (a representative population study in the UK), MSM typically had 17 lifetime sexual partners (median), which included all forms of sexual contact including oral and anal sex. An epidemiological article in The BMJ reported that national probability surveys like the NATSAL have been found to better reflect the population of MSM but are limited by their smaller samples of MSM. Convenience sample surveys recruit larger samples of MSM but tend to over-represent MSM identifying as gay and reporting more sexual risk behaviors. Among men who have anal sex with other men, anal sex without use of

3652-499: The DPNB. They are more effective than EMLA (eutectic mixture of local anesthetics) cream, which is more effective than a placebo . Topical creams have been found to irritate the skin of low birth weight infants, so penile nerve block techniques are recommended in this group. For infants, non-pharmacological methods such as the use of a comfortable, padded chair and a sucrose or non-sucrose pacifier are more effective at reducing pain than

3735-492: The Egyptians for hygienic reasons, but also was part of their obsession with purity and was associated with spiritual and intellectual development. No well-accepted theory explains the significance of circumcision to the Egyptians, but it appears to have been endowed with great honor and importance as a rite of passage , performed in a public ceremony emphasizing the continuation of family generations and fertility. It may have been

3818-705: The Greeks and later the Romans very difficult. Restrictions on the Jewish practice by European governments have occurred several times in world history, including the Seleucid Empire under Antiochus IV and the Roman Empire under Hadrian , where it was used as a means of forceful assimilation and conversion . Antiochus IV's restriction on Jewish circumcision was a major factor in the Maccabean Revolt . Hadrian 's prohibition has also been considered by some to have been

3901-467: The MSM population studied, other than them being males and engaging in sex with other men. In some countries, homosexual relationships may be illegal or taboo, making MSM difficult to reach. The term's precise use and definition has varied with regard to transgender and intersex people, who do not fall neatly into binary sex categories. Determining the number of men who have ever had sex with another man

3984-845: The U.S. Centers for Disease Control , the majority of gay and bisexual men have and maintain good mental health, though research has shown that they are at greater risk for mental health problems. Stigma and homophobia can have negative consequences on health. Compared to other men, gay and bisexual men have a higher chance of having depression and anxiety disorders . Mpox has been shown to disproportionately affect men who have sex with men. Many countries impose restrictions on donating blood for men who have or have had sex with men, as well as their female sexual partners. Similar restrictions in many countries also prohibit donation of tissues such as corneas by men who have sex with men, often with far longer deferral periods than for MSM blood donors. Most national standards require direct questioning regarding

4067-490: The U.S. population they accounted for 53% of the overall diagnoses and 71% among men. According to a 2010 federal study, one in five men who have sex with men are HIV positive and nearly half do not realize it. According to a CDC study, HIV prevalence in the MSM population of the U.S. varies widely by ethnicity. "As many as 46% of black MSM have HIV" while "the HIV rate is estimated at 21% for white MSM and 17% for Hispanic MSM." In

4150-468: The USA. These follow the same basic procedure. First, the amount of foreskin to be removed is estimated. The practitioner opens the foreskin via the preputial orifice to reveal the glans underneath and ensures it is normal before bluntly separating the inner lining of the foreskin ( preputial epithelium ) from its attachment to the glans. The practitioner then places the circumcision device (this sometimes requires

4233-409: The United States from 2001 to 2005, the highest transmission risk behaviors were sex between men (40–49% of new cases) and high risk heterosexual sex (32–35% of new cases). HIV infection is increasing at a rate of 12% annually among 13–24-year-old American men who have sex with men. Experts attribute this to " AIDS fatigue " among younger people who have no memory of the worst phase of the epidemic in

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4316-411: The United States, "men who have had sex with men since 1977 have an HIV prevalence (the total number of cases of a disease that are present in a population at a specific point in time) 60 times higher than the general population". In 2007, the largest estimated proportion of HIV/AIDS diagnoses among adults and adolescents in the U.S. were men who have sex with men (MSM). While this category is only 2% of

4399-485: The WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that they recommended adolescent and adult circumcision as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV, as long as the program includes " informed consent , confidentiality , and absence of coercion " — known as voluntary medical male circumcision, or VMMC. In 2010, this

4482-669: The carcinoma in situ (CIS) cancerous precursor stage and at the more advanced invasive squamous cell carcinoma stage. There is an association between adult circumcision and an increased risk of invasive penile cancer; this is believed to be from men being circumcised as a treatment for penile cancer or a condition that is a precursor to cancer rather than a consequence of circumcision itself. Penile cancer has been observed to be nearly eliminated in populations of males circumcised neonatally. Important risk factors for penile cancer include phimosis and HPV infection, both of which are mitigated by circumcision. The mitigating effect circumcision has on

4565-415: The coining of the initialism by Glick et al. in 1994 "signaled the crystallization of a new concept." This behavioral concept comes from two distinct academic perspectives. First, it was pursued by epidemiologists seeking behavioral categories that would offer better analytical concepts for the study of disease-risk than identity-based categories (such as " gay ", " bisexual ", or "straight"), because

4648-402: The development of phimosis. Phimosis is also a complication that can result from circumcision. An inflammation of the glans penis and foreskin is called balanoposthitis, and the condition affecting the glans alone is called balanitis . Most cases of these conditions occur in uncircumcised males, affecting 4–11% of that group. The moist, warm space underneath the foreskin is thought to facilitate

4731-578: The fulfillment of a Biblical commandment but also an essential and permanent mark of membership in a people. A narrative in the Christian Gospel of Luke makes a brief mention of the circumcision of Jesus , but physical circumcision is not part of the received teachings of Jesus. Circumcision has played an important role in Christian history and theology . Paul the Apostle reinterpreted circumcision as

4814-442: The growth of pathogens, particularly when hygiene is poor. Yeasts, especially Candida albicans , are the most common penile infection and are rarely identified in samples taken from circumcised males. Both conditions are usually treated with topical antibiotics (metronidazole cream) and antifungals (clotrimazole cream) or low-potency steroid creams. Circumcision is a treatment option for refractory or recurrent balanoposthitis, but in

4897-449: The inability to do so becomes problematic (pathological phimosis) circumcision is a treatment option. This pathological phimosis may be due to scarring from the skin disease balanitis xerotica obliterans (BXO), repeated episodes of balanoposthitis or forced retraction of the foreskin. Steroid creams are also a reasonable option and may prevent the need for surgery including in those with mild BXO. The procedure may also be used to prevent

4980-431: The incidence of cancer-causing forms of human papillomavirus (HPV) and significantly reducing HIV transmission among heterosexual men in high-risk populations; its prophylactic efficacy against HIV transmission in the developed world or among men who have sex with men is debated. Neonatal circumcision decreases the risk of penile cancer . Complication rates increase significantly with age. Bleeding, infection, and

5063-504: The incidence of UTIs in boys under two years of age, and there is fair evidence that the reduction in incidence is by a factor of 3–10 times (100 circumcisions prevents one UTI). Circumcision is most likely to benefit boys who have a high risk of UTIs due to anatomical defects, and may be used to treat recurrent UTIs. There is a plausible biological explanation for the reduction in UTI risk after circumcision. The orifice through which urine passes at

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5146-456: The insertive partner may be referred to as the top , the one being penetrated may be referred to as the bottom , and those who enjoy either role may be referred to as versatile —with those who do not prefer/practice anal sex being referred to as side . A 2007 study reported that two large population surveys found "the majority of gay men had similar numbers of unprotected sexual partners annually as straight men and women." According to

5229-734: The lands south and east of the Mediterranean, starting with Central Sahara, Sudan and Ethiopia, the procedure was practiced by the ancient Egyptians and the Semites , and then by the Jews and Muslims. In Oceania, circumcision is practiced by the Australian Aboriginals and Polynesians . There is also evidence that circumcision was practiced among the Aztec and Mayan civilizations in the Americas, but little

5312-405: The likelihood of multiple infections. As of 2012, there was no strong evidence that it reduces the rate of new HPV infection, but the procedure is associated with increased clearance of the virus by the body, which can account for the finding of reduced prevalence. Although genital warts are caused by a type of HPV, there is no statistically significant relationship between being circumcised and

5395-554: The neonatal period when it is less expensive and has a lower risk of complications. The American Academy of Pediatrics and Centers for Disease Control and Prevention stated that the potential benefits of circumcision outweigh the risks. The World Health Organization in 2010 stated: There are significant benefits in performing male circumcision in early infancy, and programmes that promote early infant male circumcision are likely to have lower morbidity rates and lower costs than programmes targeting adolescent boys and men. Circumcision

5478-423: The penis ( chordee ), or ambiguous genitalia , because the foreskin may be needed for reconstructive surgery. Circumcision is contraindicated in premature infants and those who are not clinically stable and in good health. If an individual is known to have or has a family history of serious bleeding disorders such as hemophilia , it is recommended that the blood be checked for normal coagulation properties before

5561-403: The position that it carries prophylactic health benefits which outweigh the risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk. Advocates of circumcision consider it to have a net health benefit, and therefore feel that increasing the circumcision rate is "imperative". They recommend performing it during

5644-673: The presence of genital warts. Studies evaluating the effect of circumcision on the rates of other sexually transmitted infections have, generally, found it to be protective. A 2006 meta-analysis found that circumcision was associated with lower rates of syphilis , chancroid , and possibly genital herpes . A 2010 review found that circumcision reduced the incidence of HSV -2 (herpes simplex virus, type 2) infections by 28%. The researchers found mixed results for protection against trichomonas vaginalis and chlamydia trachomatis , and no evidence of protection against gonorrhea or syphilis. It may also possibly protect against syphilis in MSM. Phimosis

5727-505: The procedure is attempted. The foreskin is the double-layered fold of tissue at the distal end of the human penis that covers the glans and the urinary meatus . For adult medical circumcision, superficial wound healing takes up to a week, and complete healing 4 to 6 months. For infants, healing is usually complete within one week. For infant circumcision, devices such as the Gomco clamp , Plastibell and Mogen clamp are commonly used in

5810-455: The removal of either too much or too little foreskin are the most common acute complications, while meatal stenosis is the most common long-term. There are various cultural, social , and ethical views on circumcision. Major medical organizations hold variant views on the strength of circumcision's prophylactic efficacy in developed countries. Some medical organizations take the position that it carries prophylactic health benefits which outweigh

5893-404: The risk factor introduced by the possibility of phimosis is secondary, in that the removal of the foreskin eliminates the possibility of phimosis. This can be inferred from study results that show uncircumcised men with no history of phimosis are equally likely to have penile cancer as circumcised men. Circumcision is also associated with a reduced prevalence of cancer-causing types of HPV in men and

5976-476: The risks, while other medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk. Circumcision is one of the world's most common and oldest medical procedures. Prophylactic usage originated in England during the 1850s and subsequently widely spread, becoming predominately established as a way to prevent sexually transmitted infections. Beyond use as

6059-550: The sexual pleasure of the circumcised person. Neonatal circumcision is generally a safe, low-risk procedure when done by an experienced practitioner. The most common acute complications are bleeding, infection and the removal of either too much or too little foreskin. These complications occur in approximately 0.13% of procedures, with bleeding being the most common acute complication in the United States. Minor complications are reported to occur in three percent of procedures. Severe complications are rare. A specific complication rate

6142-422: The term MSM was created by Cleo Manago , who is also credited for coining the term " same gender loving " (SGL). MSM are not limited to small, self-identified, and visible sub-populations. MSM and gay refer to different things: behaviors and social identities. MSM refers to sexual activities between men, regardless of how they identify, whereas gay can include those activities but is more broadly seen as

6225-428: The tip of the penis (the urinary meatus ) hosts more urinary system disease-causing bacteria in uncircumcised boys than in circumcised boys, especially in those under six months of age. As these bacteria are a risk factor for UTIs, circumcision may reduce the risk of UTIs through a decrease in the bacterial population. Not being circumcised is the primary risk factor for penile cancer . Pre-adolescent circumcision has

6308-402: The twenty-first century the availability of the other treatments has made it less necessary. A UTI affects parts of the urinary system including the urethra , bladder , and kidneys . There is about a one percent risk of UTIs in boys under two years of age, and the majority of incidents occur in the first year of life. There is good but not ideal evidence that circumcision of babies reduces

6391-402: The use of analgesia is advocated. Ordinary procedural pain may be managed in pharmacological and non-pharmacological ways. Pharmacological methods, such as localized or regional pain-blocking injections and topical analgesic creams, are safe and effective. The ring block and dorsal penile nerve block (DPNB) are the most effective at reducing pain, and the ring block may be more effective than

6474-476: The vagina, anus, or rectum. Sores also can occur on the lips and in the mouth. Transmission of the organism occurs during vaginal, anal, or oral sex. In 2006, 64% of the reported cases in the United States were among men who have sex with men. This is consistent with a rise in the incidence of syphilis among MSM in other developed nations, attributed by Australian and UK authors to increased rates of unprotected sex among MSM. Genital human papillomavirus (HPV)

6557-489: The virus cause genital warts , and other types, if untreated, cause various forms of cancer, including cervical cancer and penile cancer . Genital warts and cervical cancer are the two most common problems resulting from HPV. Circumcision is associated with a reduced prevalence of oncogenic types of HPV infection, meaning that a randomly selected circumcised man is less likely to be found infected with cancer-causing types of HPV than an uncircumcised man. It also decreases

6640-408: Was created by epidemiologists in the 1990s, to better study and communicate the spread of sexually transmitted infections such as HIV/AIDS between all sexually active males, not strictly those identifying as gay , bisexual , pansexual or various other sexualities, but also for example male prostitutes . The term is often used in medical literature and social research to describe such men as

6723-532: Was expanded to routine neonatal circumcision, as long as those undergoing the procedure received assent from their parents. In 2020, the World Health Organization again concluded that male circumcision is an efficacious intervention for HIV prevention and that the promotion of male circumcision is an essential strategy, in addition to other preventive measures, for the prevention of heterosexually acquired HIV infection in men. Eastern and southern Africa had

6806-466: Was less consistent in regards to the potential association of circumcision with women's risk of HPV and HIV. The accumulated data show circumcision does not have an adverse physiological effect on sexual pleasure, function, desire, or fertility. There is some evidence that circumcision has no effect on pain with intercourse , premature ejaculation , intravaginal ejaculation latency time , erectile dysfunction or difficulties with orgasm . According to

6889-553: Was practiced in the Middle East by the fourth millennium BCE, when the Sumerians and the Semites moved into the area that is modern-day Iraq from the North and West. The earliest historical record of circumcision comes from Egypt, in the form of an image of the circumcision of an adult carved into the tomb of Ankh-Mahor at Saqqara , dating to about 2400–2300 BCE. Circumcision was possibly done by

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