Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
Chapter 1
Benefits and risks of male circumcision
Summary
• Circumcision is the surgical removal of the foreskin, the fold of skin
that covers the head of the penis (glans).
• The benefits of male circumcision include a reduced risk of urinary
tract infections in childhood, a reduced risk of ulcerative sexually
transmitted diseases in adulthood, protection against penile
cancer, a reduced risk of cervical cancer in female sex partners,
and prevention of balanitis (inflammation of the glans), posthitis
(inflammation of the foreskin), phimosis (inability to retract the
foreskin) and paraphimosis (inability to return the retracted
foreskin to its original location).
• Complication rates following male circumcision are very low when
it is performed by well equipped and trained health care providers.
• Numerous regional and global studies since the 1980s have noted
a lower risk of HIV infection in circumcised men, as well as lower
HIV prevalence in populations where male circumcision is
common.
• Randomized controlled trials in Kenya, South Africa and Uganda
have demonstrated that male circumcision reduces the individual
man’s risk of acquiring HIV infection by 60%.
INTRODUCTION
BENEFITS AND RISKS
What is male circumcision
Circumcision is the surgical removal of the foreskin, the fold of skin
that covers the head of the penis. It is widely practised for religious
and traditional reasons, often within the first two weeks after birth, or
at the beginning of adolescence as a rite of passage into adulthood. It
may also be performed for medical reasons to treat problems involving
the foreskin.
How circumcision is performed
During a circumcision, the foreskin is freed from the head of the penis
(glans) and removed. When done in a newborn baby, the procedure is
simpler and quicker than in adolescents and adults. Superficial wound
healing after circumcision in adults generally takes 5–7 days.
However, about 4–6 weeks are needed for the wound to heal fully. In
babies and young boys, the healing time is considerably shorter.
Whether or not circumcision is necessary has been a subject of
heated debate in many countries. In some settings, circumcision is
Male circumcision and HIV infection Chapter 1-1