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Neonatal Circumcision: A Review of the Worlds Oldest and Most Controversial Operation

Alanis, Mark C. MD*; Lucidi, Richard S. MD†

Obstetrical & Gynecological Survey: May 2004 - Volume 59 - Issue 5 - pp 379-395
CME Program: Category 1 CME Review Articles 13, 14 and 15: CME Review Article 15

Untimely old, circumcision has elicited more controversy and war of words than any surgical procedure in history. Although previous claims of benefits like curing masturbation, gout, epilepsy, and even insanity were no doubt absurd, important research has shed light on real medical benefits of circumcision. In particular, the procedure has consistently shown to result in the decreased risk of debilitating and costly diseases such as HIV, cervical cancer, and infantile urinary tract infection. Because of advances in the understanding of the anatomy of the foreskin and pain conditioning in infants, prevailing attitudes have changed about anesthesia and analgesia during the procedure. This article objectively summarizes the bulk of significant medical literature over the last century to provide an accurate statement about what we know and what we do not know about neonatal circumcision, including its history, epidemiology, medical benefits, complications, contraindications, techniques, management for pain, and current controversies.

Target Audience: Obstetricians & Gynecologists, Family Physicians.

Learning Objectives: After completion of this article, the reader should be able to describe the evolution of circumcision, to list the potential benefits of circumcision, to outline the various neonatal circumcision techniques, and to summarize the data on the use of analgesia for circumcision.

*Resident, Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina; and †Assistant Instructor and Fellow, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, The University of Texas Health Sciences Center at San Antonio, San Antonio, Texas

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credit hours can be earned in 2004. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

Reprint requests to: Mark C. Alanis, MD, Carolinas Medical Center, Department of Ob-Gyn, 1000 Blythe Blvd., Charlotte, NC 28203. E-mail: Mark.alanis@carolinashealthcare.org

The authors have disclosed no significant financial or other relationship with any commercial entity.

© 2004 Lippincott Williams & Wilkins, Inc.