Circumcision and STDs: Difference between revisions

Evidence-based medicine does not support the opinion of the early circumcision-promoters.

The circumcision promoters claimed that the sub-preputial space was a filth and disease bearing repository of illness that was best eliminated by circumcision. However, Parkash ''et al''. (1982) showed that the sub-preputial moisture contained lytic material with antiseptic qualities that protected the area from disease.<ref>{{REFjournal

Smith ''et al''. (1987) found evidence that the foreskin protected against acquisition of non-gonococcal urethritis, possibly "by effecting the physiologic milieu of the glans penis, by association with post-coital hygiene behavior, or by local immune defense mechanisms acting against the agent."<ref name="smith1987">{{REFjournal

Cook ''et al''. (1993) reported their findings that circumcised men are more likely to have genital warts than intact men. The authors speculated, "the presence of the foreskin may confer nonspecific protection of the proximal penis from acquisition of HPV infection."<ref name="cook1993A>{{REFjournal

In this clinic-based prospectively collected survey we found no association between male circumcision status and STDs that are common in our population. Perhaps importantly, our study group was relatively racially homogeneous, lack of circumcision was not a marker of lower socioeconomic status (using the index of education level; Table 2), and we controlled for a major parameter of sexual behaviour (lifetime number of sexual partners).<ref name="donovan1994">{{REFjournal

With respect to STDs, we found no evidence of a prophylactic role for circumcision and a slight tendency in the opposite direction. Indeed, the absence of a foreskin was significantly associated with contraction of bacterial STDs among men who have had many partners in their lifetimes. These results suggest a reexamination of the prevailing wisdom regarding the prophylactic effect of circumcision. While circumcision may have an impact that was not picked up by the NHSLS data, it seems unlikely to justify the claims made by those who base their support for widespread circumcision on it.<ref name="laumann1997">{{REFjournal

What began as speculation has resulted a century later in 60-75% of American boys being circumcised with no clearly confirmed medical benefit. In the interim, no solid epidemiological evidence has been found to support the theory that circumcision prevents STDs or to justify a policy of involuntary mass circumcision as a public health measure. While the number of confounding factors and the inability to perform a random, double-blind, propective trial make assessing the role of circumcision in STD acquisition difficult, there is no clear evidence that circumcision prevents STDs. The only consistent trend is that uncircumcised males may be more susceptible to GUD, while circumcised men are more prone to urethritis. Currently, in developed nations, urethritis is more common than GUD [34]. In summary, the medical literature does not support the theory that circumcision prevents STDs.<ref name="vanhowe1999">{{REFjournal

Dave ''et al''. (2003) studied data from the 2000 British National Survey of Sexual Attitudes and Lifestyles (Natsal 2000). They "found no significant associations between circumcision and being diagnosed with any one of the seven specific STIs."<ref name="dave2003">{{REFjournal

greater risk for GUD while at lower risk for GDS, NSU, genital warts, and the overall risk of any STIs. It is also clear that any positive impact of circumcision on STIs is not seen in general populations. Consequently, the prevention of STIs cannot be rationally interpreted as a benefit of circumcision, and a policy of circumcision for the general population to prevent STIs is not supported by the evidence currently available in the medical literature.<ref name="vanhowe2013">{{REFjournal

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