Tobian Aaron A R, Gray Ronald H, Quinn Thomas C
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Arch Pediatr Adolesc Med. 2010 Jan;164(1):78-84. doi: 10.1001/archpediatrics.2009.232.
The American Academy of Pediatrics (AAP) male circumcision policy states that while there are potential medical benefits of newborn male circumcision, the data are insufficient to recommend routine neonatal circumcision. Since 2005, however, 3 randomized trials have evaluated male circumcision for prevention of sexually transmitted infections. The trials found that circumcision decreases human immunodeficiency virus acquisition by 53% to 60%, herpes simplex virus type 2 acquisition by 28% to 34%, and human papillomavirus prevalence by 32% to 35% in men. Among female partners of circumcised men, bacterial vaginosis was reduced by 40%, and Trichomonas vaginalis infection was reduced by 48%. Genital ulcer disease was also reduced among males and their female partners. These findings are also supported by observational studies conducted in the United States. The AAP policy has a major impact on neonatal circumcision in the United States. This review evaluates the recent data that support revision of the AAP policy to fully reflect the evidence of long-term health benefits of male circumcision.
美国儿科学会（AAP）的男性包皮环切术政策指出，虽然新生儿男性包皮环切术有潜在的医学益处，但数据不足以推荐进行常规新生儿包皮环切术。然而，自2005年以来，已有3项随机试验评估了男性包皮环切术对预防性传播感染的作用。试验发现，包皮环切术可使男性感染人类免疫缺陷病毒的几率降低53%至60%，感染2型单纯疱疹病毒的几率降低28%至34%，人乳头瘤病毒感染率降低32%至35%。在接受包皮环切术男性的女性伴侣中，细菌性阴道病减少了40%，阴道毛滴虫感染减少了48%。男性及其女性伴侣的生殖器溃疡疾病也有所减少。在美国进行的观察性研究也支持这些发现。AAP的政策对美国的新生儿包皮环切术有重大影响。本综述评估了近期的数据，这些数据支持修订AAP政策，以充分反映男性包皮环切术对长期健康有益的证据。
