Revista de Pesquisa de Pediatria Clínica

Should a Pediatrician Recommend Circumcision?

Mustafa Akman

Circumcision is a social reality that should be assessed in terms of social, cultural, psychological, medical, and many other aspects. This phenomenon should be on the agenda of the physician, without ignoring other aspects, primarily with its medical aspect; the physician should determine the steps, which would be followed, based on the guidelines of competent institutions, apply them to patients with personal experience and competencies, or guide the patient to have circumcision. If she/he is a pediatrician, that is, if she/he is not a physician who performs circumcision, she/he should know the details of the procedure at least as much as the practitioner and inform the family on the details of the procedure before referring to circumcision.

Many question marks need to be answered for physicians who perform the circumcision procedure as well. The objective of our review is to shed light on these question marks and to form a common language between the recommender and the practitioner of circumcision.

Since the subject is a child, many times a neonate and always a urological intervention, research and assessments of institutions such as American Academy of Pediatrics and European Association of Urology and Pediatric Urology should be followed, and new developments and recommendations should be taken into consideration. Conscientious, legal, and moral responsibility necessitates this. Neonatal circumcision is not recommended routinely in these guidelines, which have changed over the years; yet it cannot be rejected totally due to its contributions to perineal hygiene. It is recommended in numerous studies thanks to its benefit is more than its harms. Interestingly, in countries where circumcision is not practiced routinely, it is observed that it is recommended in cases where the regional colonization burden needs to be lessened rapidly.

Circumcision, which has been performed for centuries, is a surgical procedure, yet has some geographical differences. Some beliefs and myths influence physicians on the issue of circumcision, as it could be in all cases beyond centuries. Of these, the belief that "newborn does not suffer" might lead physicians to make mistakes in practice.  This indicates that physicians need to reconsider even the subjects they know best. Put differently, physicians should keep their medical knowledge and experience up to date. Circumcision is also included in this scope.