Male circumcision: assessment of health benefits and risks
Male circumcision: assessment of health benefits and risks
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DOI：
10.1136/sti.74.5.368
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发表时间：
1998-10-01
影响因子：
3.6
通讯作者：
Ronald, AR
中科院分区：
文献类型：
--
作者：
Moses, S;Bailey, RC;Ronald, AR
目标：全球大约 25% 的男性因宗教、文化、医疗或父母选择的原因而接受割礼。然而，围绕该手术及其对健康的益处和风险存在争议。我们回顾了当前与男性包皮环切相关的健康益处和风险的知识。方法：我们尽可能使用之前对男性包皮环切与特定结果之间关系进行的审查作为“基准”，并通过搜索 Medline 数据库获取最新信息来更新它们。结果：有大量证据表明包皮环切可以保护男性免受艾滋病毒感染、阴茎癌、尿路感染和溃疡性性传播疾病。我们几乎找不到任何科学证据表明对性、心理或情绪健康有不利影响。与包皮环切术相关的手术风险，特别是出血、阴茎损伤和局部感染，以及新生儿包皮环切术带来的疼痛后果，都是需要适当应对的担忧。结论：根据这些信息，对男性包皮环切术作为预防性健康措施的效用和成本效益的进一步分析应成为研究和政策的重点。在特定社会中，是否建议男性包皮环切术的决定应基于对与包皮的存在相关的疾病的风险和发生以及手术并发症的风险的评估。为了让个人及其家人做出明智的决定，应向他们提供有关已知益处和风险的最佳可用证据。
Objectives: Globally approximately 25% of men are circumcised for religious, cultural, medical, or parental choice reasons. However, controversy surrounds the procedure, and its benefits and risks to health. We review current knowledge of the health benefits and risks associated with male circumcision.Methods: We have used, where available, previously conducted reviews of the relation between male circumcision and specific outcomes as "benchmarks", and updated them by searching the Medline database for more recent information.Results: There is substantial evidence that circumcision protects males from HIV infection, penile carcinoma, urinary tract infections, and ulcerative sexually transmitted diseases. We could find little scientific evidence of adverse effects on sexual, psychological, or emotional health. Surgical risks associated with circumcision, particularly bleeding, penile injury, and local infection, as well as the consequences of the pain experienced with neonatal circumcision, are valid concerns that require appropriate responses.Conclusion: Further analyses of the utility and cost effectiveness of male circumcision as a preventive health measure should, in the light of this information, be research and policy priorities. A decision as to whether to recommend male circumcision in a given society should be based upon an assessment of the risk for and occurrence of the diseases which are associated with the presence of the foreskin, versus the risk of the complications of the procedure. In order for individuals and their families to make an informed decision, they should be provided with the best available evidence regarding the known benefits and risks.