Study examines risks of circumcision

January 09, 2000

Parents of newborn boys have better knowledge about the possible risks of circumcision from a new study by doctors at the University of Washington.

This report, the broadest of its kind, examined all hospital records in the state of Washington for a study period of more than nine years. The study finds there was a complication in one out of every 476 circumcisions.

"Circumcision is a relatively safe procedure. However, for some parents, the risks we report may outweigh the benefits," says Dr. Dimitri Christakis, an assistant professor of pediatrics at the UW School of Medicine and associate director of the UW's Child Health Institute in Seattle.
Christakis got the idea for the study from the parents of his patients. He's a pediatrician at UW Medical Center-Roosevelt's Pediatric Care Center in Seattle. Christakis says that many parents already know what they want for their baby boys. But other parents would ask him about the risks and benefits of circumcision.

Benefits of circumcision have been extensively studied, Christakis said. But the risks have been examined with more limited studies.

"Parents ask about this all the time. I was dissatisfied with the evidence available that delineates the risks," Christakis says.

What UW doctors did was pore over Washington state hospital records from 1987 to 1996. Of the 354,297 boys born during the study period, 130,475 had circumcisions in the hospital. The study found that 287 of them had complications related to the procedure. The most common were intraoperative bleeding (230 cases) and damage to the penis that required treatment (52 cases). Those complications required longer hospital stays.

The UW study is a "trade-off analysis." The trade-off analysis determined that for every case of a boy who has a complication from circumcision, six boys can be expected to have avoided urinary tract infections. For every two cases of circumcision complications, one case of penile cancer is prevented.

The study offers a conservative estimate of the actual risks, Christakis says, because it only measured complications during a baby's first hospital stay. For example, doctors know that some children with circumcisions suffer infections. But those usually occur after the birth hospitalization, and were not reflected in the database used in the study.

The trade-off analysis does not attempt to tell parents whether they should have their child circumcised or not. That's because different parents view risks and benefits differently.

For example, some parents may not want to do something that might cause their baby both pain and a complication, even if there is a fractional chance that the circumcision may prevent another problem.

Almost all of the problems arising from either circumcision or its lack ­ urinary tract infections, excessive bleeding and penile wounds -- are easily treated. Penile cancer usually occurs only in the very elderly and can also be prevented with good hygiene.

"We're talking about trade-offs for very rare risks and very rare benefits," Christakis says. "Now, I can tell parents that one in 500 circumcised children may suffer a complication, and one in 100 children may derive a benefit. But people will weigh that differently. However, the vast majority of children will gain no medical benefit nor suffer any complication as a result of circumcision."

Other authors of the study include Dr. Frederick A. Connell from the Department of Health Services in the UW School of Public Health; Dr. Danielle M. Zerr of the School of Medicine's Division of Infectious Disease; Eric Harvey of the Department of Pharmacy; and Dr. Chris Feudtner and Dr. Jeffrey Wright, both of the Department of Pediatrics.
Copies of the study are available from the American Academy of Pediatrics' Office of Public Relations. Call Sheryl Cash at 847-981-7131 or Gina Steiner at 847-981-7872.

University of Washington

Related Circumcision Articles from Brightsurf:

Male circumcision campaigns in Africa to fight HIV are a form of cultural imperialism
World Health Organization-recommended campaigns to circumcise millions of African boys and men to reduce HIV transmission are based more on systemic racism and 'neocolonialism' than sound scientific research, according to a critical appraisal published in Developing World Bioethics.

New HIV program increased viral suppression, decreased new infections in Botswana
In a randomized trial in Botswana, an HIV prevention intervention that included increased testing and counseling, assistance with accessing care, and expanded ART coverage increased population viral suppression to among the highest levels reported globally.

Voluntary medical male circumcision may cost-effectively prevent HIV in Zimbabwe
Voluntary medical male circumcision could impact Zimbabwe's HIV epidemic in the coming years, and this investment may save costs in the longer term.

Peer influence, better HIV counseling could encourage boys in Africa to be circumcised
With research showing that male circumcision reduces the odds of getting HIV through heterosexual sex by 60 percent, more boys and young men -- primarily those between the ages of 10 and 19 -- are having the procedure done, largely in eastern and southern African nations where circumcision is rarely performed at birth.

Male circumcision and antiviral drugs appear to sharply reduce HIV infection rate
A steep drop in the local incidence of new HIV infections accompanied the rollout of a US-funded anti-HIV program in a large East-African population, according to a study led by researchers at Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Medicine.

Combination HIV prevention reduces new infections by 42 percent in Ugandan district
A study published today in the New England Journal of Medicine provides real-world evidence that implementing a combination of proven HIV prevention measures across communities can substantially reduce new HIV infections in a population.

The Lancet: Religious leaders could help improve uptake of male circumcision in HIV-prevention effort
Educating religious leaders about how circumcision helps to prevent HIV infection increased the number of men being circumcised in Tanzania, according to a study published in The Lancet.

West African HIV-2 prevalence associated with lower historical male circumcision rates
In West African cities, male circumcision rates in 1950 were negatively correlated with HIV-2 prevalence from 1985, according to a study published Dec.

Infant circumcision can be safely performed in rural Africa
A new study indicates that early infant circumcision, which helps to prevent HIV transmission later in life, can be safely performed in rural Uganda.

Male circumcision, HIV treatment can significantly reduce new infections in African men
Increasing the number of men who undergo circumcision and increasing the rates at which women with HIV are given antiretroviral therapy were associated with significant declines in the number of new male HIV infections in rural Ugandan communities, new Johns Hopkins Bloomberg School of Health research suggests.

Read More: Circumcision News and Circumcision Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to