Circumcision | |
---|---|
ICD-10-PCS | Z41.2 |
ICD-9-CM | V50.2 |
MeSH | D002944 |
OPS-301 code | 5–640.2 |
MedlinePlus | 002998 |
eMedicine | 1015820 |
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.[1] Circumcision is generally electively performed, most commonly done as a form of preventive healthcare, as a religious obligation, or as a cultural practice.[2] It is also an option for cases of phimosis, other pathologies that do not resolve with other treatments, and chronic urinary tract infections (UTIs).[3][4] The procedure is contraindicated in cases of certain genital structure abnormalities or poor general health.[4][5]
The procedure is associated with reduced rates of sexually transmitted infections[6] and urinary tract infections.[1][7][8] This includes reducing the incidence of cancer-causing forms of human papillomavirus (HPV) and significantly reducing HIV transmission among heterosexual men in high-risk populations;[9] its prophylactic efficacy against HIV transmission in the developed world or among men who have sex with men is debated.[10][11][12] Neonatal circumcision decreases the risk of penile cancer.[13] Complication rates increase significantly with age.[14] Bleeding, infection, and 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.[15] 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 the risks, while other medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk.[16][17][18][19]
Circumcision is one of the world's most common and oldest medical procedures.[2] Prophylactic usage originated in England during the 1850s and subsequently widely spread, becoming predominately established as a way to prevent sexually transmitted infections.[20][21] Beyond use as 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.[22][23] It is widespread in Australia, Canada, the United States, South Korea, most of Africa, and parts of Asia.[2] It is relatively rare for non-religious reasons in parts of Southern Africa, Latin America, Europe, and parts of Asia.[2] The origin of circumcision is not known with certainty, but the oldest documentation comes from ancient Egypt.[2][24][25]
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