Disadvantages of Male Circumcision
Male circumcision carries several disadvantages including risk of surgical complications, pain, potential psychological effects, and ethical concerns related to performing an elective procedure on infants who cannot consent. 1
Surgical Complications
Circumcision, while generally considered safe, can lead to various complications:
Local Complications
- Infections: Staphylococcal and streptococcal infections, cellulitis, impetigo, pyoderma, necrotizing fasciitis 2
- Bleeding: Hemorrhage occurs in approximately 0.19% of cases, with some requiring suturing or even blood transfusion 3
- Surgical trauma: Occurs in about 25 per 100,000 circumcisions 3
- Wound complications: Poor cosmetic results may occur in some cases 4
Severe Complications (Rare)
- Glanular necrosis and scrotal abscess 2
- Systemic infections: Bacteremia, wound sepsis, and meningitis 2
- Fournier gangrene (extremely rare but serious) 2
Pain and Discomfort
- Procedural pain: Even with analgesia, the procedure causes pain, particularly in neonates 5
- Post-procedural discomfort: Healing process can be uncomfortable 5
- Potential for inadequate pain management: If proper analgesia protocols aren't followed 5
Sexual Function Concerns
- Potential changes in sensation: Some men report changes in penile sensitivity following adult circumcision 4
- Frictional irritation: Can occur in men with genital piercings following circumcision 6
Specific Concerns for Uncircumcised Males with Other Conditions
- Paraphimosis risk: In uncircumcised men with genital piercings, there's risk of inability to replace a retracted foreskin 6
- Complications with lichen sclerosus: Men with this condition may experience disease progression despite circumcision 6
Ethical and Psychological Considerations
- Lack of consent: Infants cannot provide informed consent for an elective procedure 5
- Cultural and personal identity issues: Some men may feel their bodily autonomy was violated 5
- Potential psychological impact: Though evidence is limited, some men report distress about having been circumcised without their consent 5
Procedural Requirements
- Need for trained providers: Complications are significantly higher when performed by untrained providers 2, 5
- Sterile technique requirements: Proper surgical environment and sterilization are necessary to prevent infections 2
- Follow-up care: Parents need proper education on care of the circumcised penis 5
Comparison with Benefits
While circumcision does provide benefits including reduced risk of HIV transmission (53-60% reduction), decreased HPV and HSV-2 transmission, lower UTI risk, and protection against penile cancer 1, these benefits must be weighed against the potential disadvantages outlined above.
The American Academy of Pediatrics states that while health benefits outweigh risks, the benefits alone may not justify the procedure for all families, who should consider their own religious, cultural, and personal preferences 5.