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Male CircumcisionTASK FORCE ON CIRCUMCISIONPediatrics 2012;130;e756; originally published online August 27, 2012;DOI: 10.1542/peds.2012-1990The online version of this article, along with updated information and services, islocated on the World Wide Web at:http://pediatrics.aappublications.org/content/130/3/e756.full.htmlPEDIATRICS is the official journal of the American Academy of Pediatrics. A monthlypublication, it has been published continuously since 1948. PEDIATRICS is owned,published, and trademarked by the American Academy of Pediatrics, 141 Northwest PointBoulevard, Elk Grove Village, Illinois, 60007. Copyright © 2012 by the American Academyof Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.Downloaded from pediatrics.aappublications.org by guest on June 19, 2013
TECHNICAL REPORTMale CircumcisionabstractMale circumcision consists of the surgical removal of some, or all, of theforeskin (or prepuce) from the penis. It is one of the most common proceduresin the world. In the United States, the procedure is commonly performedduring the newborn period. In 2007, the American Academy ofPediatrics (AAP) convened a multidisciplinary workgroup of AAP membersand other stakeholders to evaluate the evidence regarding male circumcisionand update the AAP’s 1999 recommendations in this area. The TaskForce included AAP representatives from specialty areas as well as membersof the AAP Board of Directors and liaisons representing the AmericanAcademy of Family Physicians, the American College of Obstetricians andGynecologists, and the Centers for Disease Control and Prevention. TheTask Force members identified selected topics relevant to male circumcisionand conducted a critical review of peer-reviewed literature by usingthe American Heart Association’s template for evidence evaluation.Evaluation of current evidence indicates that the health benefits of newbornmale circumcision outweigh the risks; furthermore, the benefits ofnewborn male circumcision justify access to this procedure for familieswho choose it. Specific benefits from male circumcision were identified forthe prevention of urinary tract infections, acquisition of HIV, transmissionof some sexually transmitted infections, and penile cancer. Male circumcisiondoes not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction. It is imperative that those providing circumcisionare adequately trained and that both sterile techniques andeffective pain management are used. Significant acute complicationsare rare. In general, untrained providers who perform circumcisions havemore complications than well-trained providers who perform the procedure,regardless of whether the former are physicians, nurses, or traditionalreligious providers.Parents are entitled to factually correct, nonbiased information about circumcisionand should receive this information from clinicians before conceptionor early in pregnancy, which is when parents typically makecircumcision decisions. Parents should determine what is in the best interestof their child. Physicians who counsel families about this decisionshould provide assistance by explaining the potential benefits and risksand ensuring that parents understand that circumcision is an electiveprocedure. The Task Force strongly recommends the creation, revision,and enhancement of educational materials to assist parents of maleinfants with the care of circumcised and uncircumcised penises. The TaskForce also strongly recommends the development of educational materialsfor providers to enhance practitioners’ competency in discussingcircumcision’s benefits and risks with parents.The Task Force made the following recommendations:TASK FORCE ON CIRCUMCISIONKEY WORDcircumcisionABBREVIATIONSAAFP—American Academy of Family PhysiciansAAP—American Academy of PediatricsACOG—American College of Obstetricians and GynecologistsBV—bacterial vaginosisCB—caudal blockCDC—Centers for Disease Control and PreventionCDM—Charge Data MasterCI—confidence intervalDPNB—dorsal penile nerve blockHPV—human papillomavirusHSV—herpes simplex virusIELT—Intravaginal Ejaculatory Latency TimesMSM—men who have sex with menNHDS—National Hospital Discharge SurveyNIS—National Inpatient SampleOR—odds ratioRCT—randomized controlled trialSTI—sexually transmitted infectionUTI—urinary tract infectionThis document is copyrighted and is property of the AmericanAcademy of Pediatrics and its Board of Directors. All authorshave filed conflict of interest statements with the AmericanAcademy of Pediatrics. Any conflicts have been resolved througha process approved by the Board of Directors. The AmericanAcademy of Pediatrics has neither solicited nor accepted anycommercial involvement in the development of the content ofthis publication.The guidance in this report does not indicate an exclusivecourse of treatment or serve as a standard of medical care.Variations, taking into account individual circumstances, may beappropriate.All technical reports from the American Academy of Pediatricsautomatically expire 5 years after publication unless reaffirmed,revised, or retired at or before that time.www.pediatrics.org/cgi/doi/10.1542/peds.2012-1990doi:10.1542/peds.2012-1990PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).Copyright © 2012 by the American Academy of Pediatricse756FROM THE AMERICAN ACADEMY OF PEDIATRICSDownloaded from pediatrics.aappublications.org by guest on June 19, 2013
Page 1 and 2: OMSKÆRINGAF DRENGENotat2013
Page 3 and 4: Indhold1 Sundhedsstyrelsens sammenf
Page 5 and 6: 1 Sundhedsstyrelsens sammenfatningO
Page 7 and 8: døgn under indlæggelse på sygehu
Page 9 and 10: arnet ligger på en pude på et bor
Page 11 and 12: se områder i Afrika. WHO understre
Page 13 and 14: 3 Omskæring i DanmarkFor en del å
Page 15 and 16: Hvis en person, der hverken er læg
Page 17 and 18: 4 Omskæring i andre landEfter Sund
Page 19 and 20: sundhedsmæssige fordele ikke er tu
Page 21: 6 Bilagsfortegnelse:Bilag 1:Sundhed
Page 24 and 25: WHITEPAPER- OM RITUEL OMSKÆRELSE A
Page 26 and 27: OM RITUEL JØDISK OMSKÆRELSE AF DR
Page 29 and 30: White Paper om religiøs omskærels
Page 31 and 32: har været oppe med jævne mellemru
Page 33 and 34: To tredjedel færre infektioner på
Page 35 and 36: Der er en betydelig risiko for, at
Page 37 and 38: 2.3 Beskrivelse af afrapporteringen
Page 39 and 40: 3.5 Betydningen for den jødiske fa
Page 41 and 42: af medicinske årsager, hvoraf alvo
Page 43 and 44: lodtrækning fik foretaget omskære
Page 45 and 46: Endvidere skal lægen i fornødent
Page 47 and 48: Stritøreoperationer udføres både
Page 49: Den foreliggende medicinske forskni
Page 53 and 54: principle on which each of thesedev
Page 55 and 56: FIGURE 2Prevalence of male circumci
Page 57 and 58: TABLE 2 Results from Medline, Cochr
Page 59 and 60: Male Circumcision and Diseases,Morb
Page 61 and 62: een diagnosed with genital herpes a
Page 63 and 64: Results data indicate that the inci
Page 65 and 66: participants’ ages and any coexis
Page 67 and 68: without general anesthesia in boys
Page 69 and 70: was reported in 2.2% of cases andin
Page 71 and 72: nurse practitioners) should workcol
Page 73 and 74: circumcision practices in theUnited
Page 75 and 76: at: www.cdc.gov/hiv/resources/facts
Page 77 and 78: childhood: a meta-analysis. Pediatr
Page 79 and 80: multicenter survey. Isr Med Assoc J
Page 81 and 82: Male CircumcisionTASK FORCE ON CIRC
Page 83 and 84: The online version of this article,
Page 85 and 86: COMMENTARYIn this commentary, a dif
Page 87 and 88: COMMENTARYThe cardinal medical ques
Page 89 and 90: Cultural Bias in the AAP's 2012 Tec
Page 91 and 92: Weiss et al. BMC Urology 2010, 10:2
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Weiss et al. BMC Urology 2010, 10:2
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