Simpson Michael
LewisGale Medical Center Family Medicine Residency Program, 1900 Electric Rd Salem, VA 24153.
FP Essent. 2020 Jan;488:11-15.
Circumcision is the surgical removal of some or all of the foreskin (ie, prepuce) of the penis. Among high-resource countries, the United States is the only country in which the majority of newborns are circumcised for nonreligious reasons. The rate of circumcision in the United States has been decreasing. Circumcised males have a lower risk of urinary tract infections, penile cancer, and several sexually transmitted infections. The benefit of circumcision is greater for males with certain urologic conditions, such as isolated hydronephrosis, vesicoureteral reflux, and ureteropelvic junction obstruction. Complications develop in approximately 1 of every 200 procedures. The American Academy of Pediatrics and the American Academy of Family Physicians recommend continued access to circumcision on an elective basis and conclude that the benefits outweigh the risks. However, they do not endorse routine neonatal circumcision. Local anesthesia should be used to decrease pain during the procedure. Three devices commonly are used. Each has risks and benefits, and no one device has been proven to be superior to another.
包皮环切术是指手术切除阴茎的部分或全部包皮（即阴茎头包皮）。在资源丰富的国家中，美国是唯一一个大多数新生儿因非宗教原因接受包皮环切术的国家。美国的包皮环切率一直在下降。接受包皮环切术的男性患尿路感染、阴茎癌和几种性传播感染的风险较低。对于患有某些泌尿系统疾病（如孤立性肾积水、膀胱输尿管反流和输尿管肾盂连接部梗阻）的男性，包皮环切术的益处更大。每200例手术中约有1例会出现并发症。美国儿科学会和美国美国家庭医师学会建议继续在选择性基础上提供包皮环切术，并得出结论认为其益处大于风险。然而，他们不支持常规新生儿包皮环切术。手术过程中应使用局部麻醉以减轻疼痛。通常使用三种器械。每种器械都有风险和益处，而且没有一种器械被证明优于另一种。
