Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
widely performed for religious or cultural reasons, while in others it is
performed principally on medical grounds. In order to make an
informed decision, every potential client or parent is entitled to full
information about the benefits and risks of the procedure.
The decision of an adult or young man to be circumcised, and
the decision of a parent to have his or her son circumcised,
should be based on culture, religion, personal preference, and
evidence-based information provided by a health care worker.
Benefits
If circumcision is being done for reasons other than the treatment of a
specific medical problem, the health benefits are primarily preventive,
and may only be realized long after the procedure. Circumcision may
reduce the risk of acquiring some infections and related complications,
but does not guarantee complete protection. Some of these conditions
are common, while others are less so, and the degree of risk of the
individual is likely to depend on his behaviour and where he lives.
Although the strength of the evidence varies by disease, the benefits
of circumcision include the following:
• It is easier to keep the penis clean.
• There is a reduced risk of urinary tract infections in childhood. 1
• Circumcision prevents inflammation of the glans (balanitis) and the
foreskin (posthitis).
• Circumcision prevents the potential development of scar tissue on
the foreskin, which may lead to phimosis (inability to retract the
foreskin) and paraphimosis (swelling of the retracted foreskin
resulting in inability to return the foreskin to its normal position).
• There is a reduced risk of some sexually transmitted infections
(STIs), especially ulcerative diseases, such as chancroid and
syphilis. 2, 3
• There is a reduced risk of becoming infected with human
4, 5, 6, 7, 8
immunodeficiency virus (HIV).
9, 10
• There is a reduced risk of penile cancer.
• There is a reduced risk of cancer of the cervix in female sex
partners. 11
Risks
As for any surgical procedure, there are risks associated with
circumcision. While the benefits of circumcision may be wide-ranging
and long-term, any problems generally occur during or soon after the
procedure. They include:
• pain;
• bleeding;
• haematoma (formation of a blood clot under the skin);
• infection at the site of the circumcision;
• increased sensitivity of the glans penis for the first few months
after the procedure;
• irritation of the glans;
• meatitis (inflammation of the opening of the urethra);
• injury to the penis;
Male circumcision and HIV infection Chapter 1-2