Cathcart P, Nuttall M, van der Meulen J, Emberton M, Kenny S E
Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.
Br J Surg. 2006 Jul;93(7):885-90. doi: 10.1002/bjs.5369.
It has been suggested that too many English boys undergo circumcision. This report describes how circumcision rates have changed in England between 1997 and 2003, including data on complication rates and on how age, medical indication and surgical specialty affect postoperative haemorrhage rates.
Data were extracted from the Hospital Episode Statistics database of admissions to National Health Service hospitals in England. Patients were included in the study if an Office of Population Censuses and Surveys version 4 code for circumcision was present in any of the operative procedure fields of the database; 75 868 boys below 15 years of age were included in the study.
Circumcision rates declined by about 20 per cent, from 2.6 per 1000 boys per year in 1997 to 2.1 in 2003. Between 2000 and 2003, circumcision rates remained static at 2.1 per 1000 boys per year. Circumcision rates fell by 31.2 per cent for boys aged 0-4 years, 9.3 per cent for boys aged 5-9 years and increased by 7.7 per cent in boys aged 10-14 years; 90.2 per cent of circumcisions were done for phimosis and 1.2 per cent of boys experienced a complication.
Circumcision rates in England continued to fall up until 2000, particularly in those aged under 5 years, in whom pathological phimosis is rare. The circumcision rate remains five times higher than the reported incidence of Phimosis.
有人认为，英国有太多男孩接受了包皮环切术。本报告描述了1997年至2003年间英国包皮环切术的发生率如何变化，包括并发症发生率的数据，以及年龄、医学指征和手术专科如何影响术后出血率。
数据取自英格兰国民健康服务体系医院入院情况的医院事件统计数据库。如果数据库的任何手术操作字段中存在人口普查与调查办公室第4版包皮环切术代码，则将患者纳入研究；75868名15岁以下男孩被纳入研究。
包皮环切术发生率下降了约20%，从1997年的每年每1000名男孩2.6例降至2003年的2.1例。在2000年至2003年间，包皮环切术发生率保持稳定，为每年每1000名男孩2.1例。0至4岁男孩的包皮环切术发生率下降了31.2%，5至9岁男孩下降了9.3%，10至14岁男孩上升了7.7%；90.2%的包皮环切术是因包茎进行的，1.2%的男孩出现了并发症。
直到2000年，英国的包皮环切术发生率持续下降，尤其是在5岁以下儿童中，病理性包茎在这些儿童中很少见。包皮环切术发生率仍比报道的包茎发病率高五倍。
