Cons:
-The most important consideration is the ethical consideration. The bodily integrity of a child should always be respected. Always. And it is the professional duty of a physician to respect the life and wellness of the child *regardless* of parental desires.
No sane plastic surgeon would ever perform a rhinoplasty on an eight year old.
Why do I bring this up? Because the most common reason for circumcising boys is "because his dad is circumcised" or "because it looks better" or "because its cleaner". None of these are true.
-Yes, boys are less likely to develop at UTI. But what people citing these statistics fail to do is recognize the more important statistical number: the Number Needed to Treat (or NNT). The NNT is the number of procedures or interventions required before you get ONE positive outcome.
A lot of screening tools have actually really low NNTs. Self breast exams, for instance, has an NNT something like 1 in 2,000. So for every 2,000 women we teach to perform self breast exams, ONE will detect cancer. However, we still encourage it because it's free, easy, and unlikely to cause harm.
The NNT for circumcisions to prevent UTIs is about 130. That's 130 healthy foreskins removed to prevent ONE UTI. And of those UTIs probably only about 10% will require serious intervention.
"But that's pretty low" some of my colleagues might state. To which I would reply: given the incidence of acute appendicitis in the general population, the NNT for prophylactic appendectomies is *higher* than circumcisions. Acute appendicitis is also more dangerous. So why aren't we removing healthy appendices in order to prevent this disease?
-There are evolving data to suggest circumcision adversely affects sexual function and pleasure. However, these data, really are poor. And, unfortunately, when it comes to social data, most women prefer cut when given the option to the detriment of healthy penises everywhere. But culture can always change.
It's an unnecessary procedure unless there is some other co-morbidity (such as vesicoureteral reflux) is present. And it's taught like dogma by the old guard still. But younger doctors are analyzing the data. They are recognizing that science should supplant "experience". Things are changing.
