Comparing countries for which both predicted and reported MC rates are available showed that reported MC prevalence generally exceeded religion-based predictions for these particular countries Additional file 2. This may suggest that actual MC prevalence is greater than the value we estimated based on religion or culture in some countries lacking MC survey data.
However, large surveys base MC prevalence on self-reports and even with the use of drawings or photographs to assist men in accurate self-reporting, some men who are not circumcised report that they are, while some who are circumcised report that they are not [ 94 , , ].
For The total number of men in these countries 2. The proportion of males in surveyed countries who were circumcised was Considering that there were 73 countries with survey data As accurately as might reasonably be expected, the present study has determined estimates for the prevalence of MC in every country in the world.
Altogether, our findings suggest that MC prevalence globally is approximately Given the known benefits and low risks of MC [ 4 ] and recent affirmative recommendations in the interests of public health and disease prevention by the American Academy of Pediatrics, the CDC, the WHO and UNAIDS, as well as the large-scale roll out of VMMC by multilateral donors and agencies, the present findings on current prevalence of MC across geographies and cultures may help guide policy development and resource allocation in all countries.
Additional file 1: 46K, xlsx This spreadsheet provides data from published surveys on MC prevalence in all countries for which such studies have been conducted. XLSX 45 kb. This spreadsheet shows data for number of males using CIA data and estimates of number of circumcised males in all countries and territories in the world, as well as basis for the estimate and MC percentage for each. XLSX 32 kb. This spreadsheet shows data for number of males using UN data for all but 45 countries and territories in the world and estimates of number of circumcised males in all but these 45, as well as basis for the estimate and MC percentage for each.
XLSX 29 kb. Competing interests. BM set up the study design and was responsible for the conceptualization of the study. BM led the drafting. JB compiled Fig. BM wrote the initial draft. All authors contributed to the interpretation and final manuscript drafting and approved the final version of the manuscript.
Brian J Morris, Email: ua. Richard G Wamai, Email: ude. Esther B Henebeng, Email: ude. Aaron AR Tobian, Email: ude. Jeffrey D Klausner, Email: ude. Joya Banerjee, Email: gro. Catherine A Hankins, Email: gro. National Center for Biotechnology Information , U. Journal List Popul Health Metr v. Popul Health Metr. Published online Mar 1. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Feb 27; Accepted Feb This article has been corrected.
See Popul Health Metr. This article has been cited by other articles in PMC. Results The estimated percentage of circumcised males in each country and territory varies considerably. Conclusions The present study provides the most accurate estimate to date of MC prevalence in each country and territory in the world.
Electronic supplementary material The online version of this article doi Keywords: Male circumcision, Global prevalence, Country-specific prevalence, Population health. Background The circumcision of males is one of the most common surgical procedures in the world.
Methods Literature searches The method we used to determine MC prevalence in each country is shown in Fig. Open in a separate window. Table 1 Percentage of circumcised males in each of the countries and territories in the world a.
Countries lacking data For many countries, no data were available for MC prevalence. Estimation of global prevalence In order to estimate the global prevalence of circumcision, we started with known figures for number of males in each country using two different authorities due to limitations in various databanks.
Results Data obtained from surveys Additional file 1 lists alphabetically those countries for which surveys of MC prevalence were available [ 26 , 27 , 29 , 33 — ] and provides reported country estimates, together with size of the survey, age range of males, national or regional survey scope, urban or rural and other demographic information, and the relevant citation.
Estimates for all countries The estimated percentage of circumcised males for each country or territory appears in Additional file 2 , column 4. Estimation of global prevalence We then summed the total number for each country, starting first with figures obtained using the CIA database to calculate total males. Discussion The true global MC prevalence is not known precisely and can only be estimated.
Conclusions As accurately as might reasonably be expected, the present study has determined estimates for the prevalence of MC in every country in the world.
Additional files Additional file 1: 46K, xlsx This spreadsheet provides data from published surveys on MC prevalence in all countries for which such studies have been conducted. XLSX 45 kb Additional file 2: 33K, xlsx This spreadsheet shows data for number of males using CIA data and estimates of number of circumcised males in all countries and territories in the world, as well as basis for the estimate and MC percentage for each.
XLSX 32 kb Additional file 3: 29K, xlsx This spreadsheet shows data for number of males using UN data for all but 45 countries and territories in the world and estimates of number of circumcised males in all but these 45, as well as basis for the estimate and MC percentage for each. Footnotes Competing interests The authors declare they have no competing interests.
References 1. Cox G, Morris BJ. Why circumcision: From pre-history to the twenty-first century. Surgical Guide to Circumcision. London: Springer; Morris BJ, Cox G. Current medical evidence supports male circumcision. Circumcision and lifetime risk of urinary tract infections: A systematic review and meta-analysis.
J Urol. Circumcision rates in the United States: Rising or falling? What effect might the new affirmative pediatric policy statement have? Mayo Clin Proc. Morris BJ, Castellsague X. The role of circumcision in preventing STIs. Berlin and Heidelberg: Springer; Male circumcision for prevention of heterosexual acquisition of HIV in men.
Accessed 15 Sep Accessed 16 Sep Accessed 2 Oct Rates of adverse events associated with male circumcision in US medical settings, to JAMA Pediatr. BMC Pediatr. Hospital stays for children, Accessed 3 Mar Male circumcision: global trends and determinants of prevalence, safety and acceptability. Geneva: World Health Organization. Last accessed 17 Aug Waskett JH. Global circumcision rates. Circumcision Independent reference and Commentary Service.
Accessed 18 Feb Male circumcision, religion, and infectious diseases: an ecologic analysis of developing countries. BMC Infect Dis. Muslim Population by Country. Accessed 12 Jun Desilver D. Pew Research Center. World's Muslim population more widespread than you might think. Jewish Virtual Library. Vital statistics: Jewish population of the world - present.
Accessed 19 Oct World Health Organization. Traditional male circumcision and young people: A public health perspective in the context of HIV prevention.
Accessed 6 Oct Attitudes of Pacific parents to circumcision of boys. Pac Health Dialog. Hawaii: The University of Hawaii Press; Silverman EK. Anthropology and circumcision. Annu Rev Anthropol. If balanoposthitis is caused by a fungal or bacterial infection, an antifungal cream or a course of antibiotics may be needed.
In adults, phimosis can occasionally be associated with sexually transmitted infections STIs. Topical steroids a cream, gel or ointment that contains corticosteroids are sometimes prescribed to treat a tight foreskin.
They can help soften the skin of the foreskin, making it easier to retract. Phimosis can cause pain, skin splitting, or a lack of sensation during sex. Using a condom and lubricants while having sex may make your penis more comfortable. Surgery may be needed if a child or adult has severe or persistent balanitis or balanoposthitis that causes their foreskin to be painfully tight. Circumcision surgically removing part or all of the foreskin may be considered if other treatments have failed, but it carries risks such as bleeding and infection.
This means it's usually only recommended as a last resort, although it can sometimes be the best and only treatment option. Alternatively, surgery to release the adhesions areas where the foreskin is stuck to the glans may be possible. This will preserve the foreskin but may not always prevent the problem recurring. This can sometimes cause pain when the penis is erect and, in rare cases, passing urine may be difficult.
Balanitis is where the foreskin and head of the penis become inflamed and infected. Paraphimosis is where the foreskin can't be returned to its original position after being pulled back, causing the head of the penis to become swollen and painful. Immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis. This condition causes phimosis and, in some cases, also affects the head of the penis, which can become scarred and inflamed.
Cancer of the penis is a very rare type of cancer, where a red patch, wart-like growth or ulcer appears on the end of the penis or under the foreskin. In most cases, circumcision will only be recommended when other, less invasive and less risky treatments have been tried and haven't worked. Mild cases of phimosis can be treated with topical steroids to help soften the skin and make it easier for the foreskin to retract.
In paraphimosis, a healthcare professional may rub a local anaesthetic gel onto the glans to help reduce pain and inflammation. They may then apply pressure to the head of the penis while pushing the foreskin forward. In severe cases of paraphimosis, local anaesthetic gel can be applied to the penis and a small slit is made in the foreskin to help relieve the pressure. Balanitis and balanitis xerotica obliterans can sometimes be successfully treated using corticosteroid ointment, gel or cream , antibiotic creams or antifungal creams.
If you're considering circumcision for a medical reason, it's worth discussing alternative treatment options with your GP or specialist.
There's evidence from several trials carried out in Africa that circumcised men have a lower risk of acquiring HIV from infected women. But it's unclear whether male circumcision can help prevent other sexually transmitted infections STIs. There have been several studies into male circumcision and the risk of other STIs, but the evidence to date has been inconclusive and conflicting.
Circumcision is usually carried out on a day patient basis. This means you'll be admitted to hospital on the same day you have surgery and won't have to stay overnight. Also, circumcision does not shorten the penis.
If you have scarring from a previous circumcision, we can also repair it successfully. However, as with any surgery, you can experience some unwanted side effects and risks after your circumcision.
These may include:. This procedure is a variation of a circumcision that doctors try first on patients with a tight frenulum the tissue between the head of the penis and the underside of the penis. This can cause pain or bending during an erection.
If this is the case, your doctor may perform a frenuloplasty to change length of the frenulum of the penis and ease the restriction. The procedure can be done under a local anesthetic or general anesthetic, whichever you prefer.
Your doctor will start by dividing the skin with a horizontal incision near the top of the frenulum. The cut will be re-stitched lengthwise to elongate the frenulum and alleviate the pain. We will use dissolvable stitches to close up the incision, which usually disappear within two to three weeks. Each patient may experience different things after their surgery.
The important thing to remember is that the side effects below are either temporary or uncommon:. If you would like to consult with one of our men's health specialists, contact us at to make an appointment.
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