A leading researcher is calling for public hospitals to provide all baby boys with the option of circumcision, saying the benefits far outweigh the risks.

The protection boys get from circumcision against severe infection is akin to what they get from vaccination, a leading Australian researcher claims.

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A systematic review of male infant circumcision, published in the World Journal of Clinical Pediatrics, has found the benefits of the procedure exceed the associated risks by 200 to one.

The study by researchers at the University of Sydney, the University of New South Wales and several teaching hospitals reports that uncircumcised males face an 80 per cent risk of developing a foreskin-related condition requiring medical attention.

By comparison, the risk of an "associated adverse event" from the circumcision procedure is about one in 250, or less than one per cent.
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"Over their lifetime more than one in two uncircumcised males will suffer an adverse medical condition caused by their foreskin," said the study's lead author, Dr Brian Morris, professor emeritus at the University of Sydney.

No evidence of adverse effect on penile function, sexual sensitivity or pleasure was found, Dr Morris said.

The researchers' risk-benefit estimates are based on an analysis of research data compiled from 140 "high-quality" research studies relevant to Australia.

The studies had determined the level of protection male circumcision affords against conditions such as urinary infections, inflammatory conditions, sexually transmitted infections and genital cancers, as well as the level of risk posed by the circumcision procedure in infancy.

Circumcision is the surgical removal of the foreskin of the penis and is generally undertaken for religious and cultural reasons.

However there is much debate regarding both the potential health benefits and the ethical and human rights issues relating to infant male circumcision.

Cosmetic circumcision is banned at Australian public hospitals, although the surgery can be carried out privately.

Dr Morris said circumcision was a desirable public health intervention and public hospital policy in all states of permitting male circumcision only for medical reasons was "penny wise, pound foolish".

"The enormous benefit but low risk makes early infant circumcision akin to childhood vaccination," he said.

The current position on male infant circumcision of Australian physicians is that the procedure is "generally safe" but there are risks of minor complications and some "rare but serious" complications.

According to The Royal Australasian College of Physicians the most important conditions to benefit from circumcision is recurrent urinary tract infections in children, and HIV plus some other sexually transmitted infections in adults with a high prevalence of these conditions.

The college's position statement on the highly emotive issue also lists "cancer of the penis in men with a history of phimosis" and "cancer of the cervix" in some women as conditions that my benefit from circumcision.

A comment from the Paediatrics & Child Health Division at the college in response to the latest study has been sought.

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