Pune Institute Of Nephro Urology(PINU), Pune

Male circumcision is a surgical procedure when the skin (foreskin or prepuce) covering the tip of the penis is removed. The origin of the procedure is unknown, although it has been practised for several centuries.

Various medical trials have shown that male circumcision reduces heterosexual acquisition of HIV, herpes simplex virus 2, human papillomavirus (HPV), and genital ulcers in men. In addition, it reduces HPV, genital ulcer disease, bacterial vaginosis, and trichomoniasis in female partners. In fact, some studies have shown a reduction in the risk of HIV acquisition by 50-60%.

Circumcision is a cost-effective procedure in developing countries where HIV is endemic. Also, women with circumcised partners are at a lower risk of sexually transmitted infections (STIs) ranging from HPV to Trichomonas vaginalis.



How does circumcision protect against diseases?


There have been various theories have been put forward for the protection caused by male circumcision. Some of the possibilities include the thickness of the foreskin and specific bacterial environment. Finally, there is also evidence to suggest that penile cancer is less common in men who had circumcision and a reduced risk of cervical cancer in women. Some doctors and scientists even go to the extent of calling male circumcision a surgical ‘vaccine’ against a variety of infections. Male circumcision is also beneficial because it protects their partners too. Overall, the benefits outweigh the risks of an operation.


The disadvantages of male circumcision


There are no major disadvantages to male circumcision. The main effect of circumcision is reducing the sensitivity of the glans penis (tip of the penis). This may actually prolong sexual activity by delaying the male orgasm. It may also cause ulceration of the opening of the urethra (urethral meatus – the opening of the urinary passage in the penis) although this is rare and gets less with time. There is nothing to fear about male circumcision. In experienced hands, it is a safe procedure and can be performed at any age.


With regard to prostate cancer, the above-mentioned research suggests that men particularly black men who had circumcision after the age of 35 had a reduced risk of prostate cancer. Other studies have indicated that circumcision before first sexual intercourse is associated with a reduction in the relative risk of Prostate Cancer. These findings are consistent with research supporting the infectious/inflammation pathway in the development of prostate cancer.

The advice, therefore, is that if there is a medical indication for circumcision, do not hesitate to get an opinion and circumcision done. If the skin is healthy and presents no problem there is no need to have a circumcision but look after the foreskin well.