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Executive News Svc.

APn  03/06 1955  Circumcision

Copyright, 1989. The Associated Press. All rights reserved.

By PAULINE JELINEK Associated Press Writer
   CHICAGO (AP) -- Newborn boys may benefit from circumcision, the American
Academy of Pediatrics said Monday in a modification of its previous stand, but
the organization stopped short of endorsing the procedure.
   The academy, which has a membership of 37,000 pediatricians, said it was
changing the position it adopted in 1971, when it found "no absolute medical
necessity" to circumcise newborns.
   The group now believes circumcision, the removal of a band of skin encircling
the tip of the penis, may help prevent some urinary tract infections, said Dr.
Donald Schiff, the academy's president.
   "The previous statement was pretty dogmatic and no longer holds," he said.
   Circumcision is the nation's most commonly performed surgical procedure, but
appears to be on the decline.
   About 75 percent of infant boys in the United States are circumcised now,
compared with 85 to 90 percent 10 or 15 years ago, Schiff said.
   The academy, which is based in suburban Elk Grove Village, said the decision
on whether a child should be circumcised is best made by parents in consultation
with their doctors.
   "Before, we told parents there may be social and religious reasons to do it
but that there were no specific medical benefits," Schiff said. "Now we can tell
them there may be some potential value."
   The group was influenced partly by 1985 studies at Army hospitals that found
an elevenfold increase in urinary tract infections in uncircumcised boys
compared with circumcised infants, Schiff said. The study involved 200,000
infants.
   "When physicians talk to parents, they should say we still don't know for
sure, but there is data that suggests not having a circumcision is linked with a
greater liklihood of urinary tract infection," Schiff said.
   However, the Army research is not convincing enough to merit an all-out
endorsement of circumcision, Schiff said. He said the studies may have been
flawed.
   "If those studies are corrorborated ... we could take an even stronger
position," Schiff said, adding that further research is under way.
   In its statement on circumcision, the academy said infants undergoing
circumcision without anesthesia appear to experience pain.
   But, it said, "reported experience with local anesthesia in newborn
circumcision is limited, and the procedure (anesthesia) is not without risk."
   More studies are needed before routine local anesthesia can be endorsed, the
group said.
   Circumcision is a controversial issue worldwide. The first International
Symposium on Circumcision was held last week in Anaheim, Calif., sponsored by
the National Organization of Circumcision Information Resource Centers and the
Institute for the Advancement of Human Behavior.
   The symposium concluded that the medical need for circumcision is very rare
and that ordinarily it should not be done, said Billy Boyd, a participant and
co-founder of The Victims Speak, a group working against circumcision.
   "Parents do not have the right to consent to unnecessary medical procedures
on their children," and physicians have an obligation to refuse to remove normal
body parts, the symposium said in a policy statement presented to the California
Medical Association.



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