In human anatomy, the penis ( /ˈpiːnɪs/ ; pl.: penises or penes; from the Latin pēnis, initially "tail" [1] ) is an external sex organ (intromittent organ) through which males urinate and ejaculate. Together with the testes and surrounding structures, the penis functions as part of the male reproductive system.
The main parts of the penis are the root, body, the epithelium of the penis including the shaft skin, and the foreskin covering the glans. The body of the penis is made up of three columns of tissue: two corpora cavernosa on the dorsal side and corpus spongiosum between them on the ventral side. The urethra passes through the prostate gland, where it is joined by the ejaculatory ducts, and then through the penis. The urethra goes across the corpus spongiosum and ends at the tip of the glans as the opening, the urinary meatus.
An erection is the stiffening expansion and orthogonal reorientation of the penis, which occurs during sexual arousal. Erections can occur in non-sexual situations; spontaneous non-sexual erections frequently occur during adolescence and sleep. In its flaccid state, the penis is smaller, gives to pressure, and the glans is covered by the foreskin. In its fully erect state, the shaft becomes rigid and the glans becomes engorged but not rigid. An erect penis may be straight or curved and may point at an upward angle, a downward angle, or straight ahead. As of 2015 [update] , the average erect human penis is 13.12 cm (5.17 in) long and has a circumference of 11.66 cm (4.59 in). [2] [3] Neither age nor size of the flaccid penis accurately predicts erectile length. There are several common body modifications to the penis, including circumcision and piercings.
The penis is homologous to the clitoris in females. [4]
Three main parts of the human penis include:
The human penis is made up of three columns of erectile tissue: two corpora cavernosa lie next to each other (separated by a fibrous septum) on the dorsal side and one corpus spongiosum lies between them on the ventral side. [7] These columns are surrounded by a fibrous layer of connective tissue called the tunica albuginea. The corpora cavernosa are innervated by lesser and greater cavernous nerves and form most of the penis containing blood vessels that fill with blood to help make an erection. [8] The crura are the proximal parts of the corpora cavernosa. The corpus spongiosum is an erectile tissue surrounding the urethra. The proximal parts of the corpus spongiosum form the bulb and the distal ends form the glans penis. [5]
The enlarged and bulbous-shaped end of the corpus spongiosum forms the glans penis with two specific types of sinusoids, which supports the foreskin, a loose fold of skin that in adults can retract to expose the glans. [9] The area on the underside of the glans, where the foreskin is attached, is called the frenulum. The rounded base of the glans is called the corona. The inner surface of the foreskin and corona is rich in sebaceous glands that secrete smegma. The structure of the penis is supported by the pelvic floor muscles.
The urethra, which is the last part of the urinary tract, traverses the corpus spongiosum (spongy urethra) and opens through the urinary meatus on the tip of the glans.
The penile raphe is the visible ridge between the lateral halves of the penis, found on the ventral or underside of the penis, running from the meatus and continuing as the perineal raphe across the scrotum and the perineum (area between scrotum and anus). [10]
The human penis differs from those of most other mammals, as it has no baculum (or erectile bone) and instead relies entirely on engorgement with blood to reach its erect state. A distal ligament buttresses the glans penis and plays an integral role to the penile fibroskeleton, and the structure is called "os analog", a term coined by Geng Long Hsu in the Encyclopedia of Reproduction. [11] It is a remnant of the baculum that has likely evolved due to change in mating practice. [12]
The human penis cannot be withdrawn into the groin, and it is larger than average in the animal kingdom in proportion to body mass. The human penis is reciprocating from a cotton soft to a bony rigidity resulting from penile arterial flow varied between 2–3 to 60–80 mL/Min implies the most ideal milieu to apply Pascal's law in the entire human body; the overall structure is unique. [11]
Penile measurements vary, with studies that rely on self-measurement reporting a significantly higher average size than those which rely on measurements taken by health professional. A 2015 systematic review of 15,521 men in which the subjects were measured by health professionals showed that the average length of an erect human penis is 13.12 cm (5.17 inches) long, while the average circumference of an erect human penis is 11.66 cm (4.59 inches). [2] [3]
Among all primates, the human penis is the largest in girth, but is comparable to the chimpanzee penis and the penises of certain other primates in length. [13] Penis size is affected by genetics, but also by environmental factors such as fertility medications [14] [ unreliable medical source? ] and chemical/pollution exposure. [15] [ unreliable medical source? ] [16] [ unreliable medical source? ]
When the fetus is exposed to testosterone, the genital tubercle elongates (primordial phallus) and develops into the glans and shaft of the penis and the urogenital folds fuse to become the penile raphe. [19] [20] [21] The urethra within the penis (except within the glans) is developed from the urogenital sinus. [22]
On entering puberty, the penis, scrotum and testicles will enlarge toward maturity. During the process, pubic hair grows above and around the penis. A large-scale study assessing penis size in thousands of 17- to 19-year-old males found no difference in average penis size between 17-year-olds and 19-year-olds. From this, it can be concluded that penile growth is typically complete not later than age 17, and possibly earlier. [23] [ unreliable medical source? ]
Males expel urine from the bladder through the urethra, which passes through the prostate where it is joined by the ejaculatory ducts, and then onward through the penis. At the root of the penis (the proximal end of the corpus spongiosum) lies the external sphincter muscle. This is a small sphincter of striated muscle tissue and is in healthy males, under voluntary control. Relaxing the urethral sphincter allows the urine in the upper urethra to enter the penis properly and thus empty the urinary bladder.
Physiologically, urination involves coordination between the central, autonomic, and somatic nervous systems. In infants, some elderly individuals, and those with neurological injury, urination may occur as an involuntary reflex. Brain centers that regulate urination include the pontine micturition center, periaqueductal gray, and the cerebral cortex. [24] [ unreliable medical source? ] During erection, these centers block the relaxation of the sphincter muscles, so as to act as a physiological separation of the excretory and reproductive function of the penis, and preventing urine from entering the upper portion of the urethra during ejaculation. [25] [ unreliable medical source? ]
The distal section of the urethra allows a human male to direct the stream of urine by holding the penis. This flexibility allows the male to choose the posture in which to urinate. In cultures where more than a minimum of clothing is worn, the penis allows the male to urinate while standing without removing much of the clothing. It is customary for some boys and men to urinate in seated or crouched positions. The preferred position may be influenced by cultural or religious beliefs. [26] Research on the medical superiority of either position exists, but the data are heterogenic. A meta-analysis [27] summarizing the evidence found no superior position for young, healthy males. For elderly males with LUTS, however, the sitting position when compared to the standing position is differentiated by the following:
This urodynamic profile is related to a lower risk of urologic complications, such as cystitis and bladder stones.
The penis incites sexual arousal when sexually stimulated, such as from mental stimuli (sexual fantasy), partnered activity, or masturbation, which can lead to orgasm.
The glans and the frenulum are erogenous zones of the penis. [28] The glans has a lot of nerve endings, which makes it the most sensitive. [29] [ unreliable medical source? ] The most effective way to stimulate the penis is through oral stimulation (fellatio), manual stimulation (a handjob or manual masturbation), or during sexual penetration. Frot is mutual penile stimulation between men.
An erection is the stiffening and rising of the penis, which occurs during sexual arousal, though it can also happen in non-sexual situations. Spontaneous erections frequently occur during adolescence due to friction with clothing, a full bladder or large intestine, hormone fluctuations, nervousness, and undressing in a nonsexual situation. It is also normal for erections to occur during sleep and upon waking. (See nocturnal penile tumescence.) The primary physiological mechanism that brings about erection is the autonomic dilation of arteries supplying blood to the penis, which allows more blood to fill the three spongy erectile tissue chambers in the penis, the corpora cavernosa and corpus spongiosum, causing it to lengthen and stiffen. After vasocongestion, the now-engorged erectile tissue presses against and constricts the veins that carry blood away from the penis. More blood enters than leaves the penis until an equilibrium is reached where an equal volume of blood flows into the dilated arteries and out of the constricted veins; a constant erectile size is achieved at this equilibrium.
Erection facilitates sexual intercourse though it is not essential for various other sexual activities.
Although many erect penises point upwards, it is common and normal for erect penis to curve in any direction. Many penises are curved in right, left, upwards or downwards direction depending upon the tension of the suspensory ligament that holds it in position.
The following table shows how common various erection angles are for a standing male, out of a sample of 81 males aged 21 through 67. In the table, zero degrees is pointing straight up against the abdomen, 90 degrees is horizontal and pointing straight forward, while 180 degrees would be pointing straight down to the feet. An upward pointing angle is most common. [30] [ unreliable medical source? ]
Angle (°) from vertically upwards | Percent of males |
---|---|
0–30 | 4.9 |
30–60 | 29.6 |
60–85 | 30.9 |
85–95 | 9.9 |
95–120 | 19.8 |
120–180 | 4.9 |
Ejaculation is the ejection of semen from the penis. It is usually accompanied by orgasm. A series of muscular contractions delivers semen, containing male gametes known as sperm cells or spermatozoa, from the penis. Ejaculation usually happens as the result of sexual stimulation, but it can be due to prostatic disease in rare cases. Ejaculation may occur spontaneously during sleep (known as a nocturnal emission). Anejaculation is the condition of being unable to ejaculate.
Sperm are produced in the testicles and stored in the attached epididymides. During ejaculation, sperm are propelled up the vasa deferentia, two ducts that pass over and behind the bladder. Fluids are added by the seminal vesicles and the vasa deferentia turn into the ejaculatory ducts, which join the urethra inside the prostate. The prostate, as well as the bulbourethral glands, add further secretions (including pre-ejaculate), and the semen is expelled through the penis.
Ejaculation has two phases: emission and ejaculation proper. The emission phase of the ejaculatory reflex is under control of the sympathetic nervous system, while the ejaculatory phase is under control of a spinal reflex at the level of the spinal nerves S2–4 via the pudendal nerve. A refractory period succeeds the ejaculation, and sexual stimulation precedes it. [31]
The ischiocavernosus muscle helps to stabilize the penis during erection by compressing the crus and slowing the return of blood through the veins. The bulbospongiosus muscle also contributes to erection along with the expulsion of urine and semen.
The human penis has been argued to have several evolutionary adaptations that maximise reproductive success and minimise sperm competition. Sperm competition is where the sperm of two males simultaneously occupy the reproductive tract of a female and they compete to fertilise the egg. [32] If sperm competition results in the rival male's sperm fertilising the egg, cuckoldry could occur. This is the process whereby males unwittingly invest their resources into offspring of another male and, evolutionarily speaking, should be avoided. [33]
The most researched human penis adaptations are penis size and semen displacement. [34]
Evolution has caused sexually selected adaptations to occur in penis size in order to maximise reproductive success and minimise sperm competition. [35] [ unreliable medical source? ] [36] [ unreliable medical source? ]
Sperm competition has caused the human penis to evolve in length and size for sperm retention and displacement. [36] To achieve this, the penis must be of sufficient length to reach any rival sperm and to maximally fill the vagina. [36] In order to ensure that the female retains the male's sperm, the adaptations in length of the human penis have occurred so that the ejaculate is placed close to the female cervix. [37] [ unreliable medical source? ] This is achieved when complete penetration occurs and the penis pushes against the cervix. [38] [ unreliable medical source? ] These adaptations have occurred in order to release and retain sperm to the highest point of the vaginal tract. As a result, this adaptation also leaves the sperm less vulnerable to sperm displacement and semen loss. Another reason for this adaptation is that, due to the nature of the human posture, gravity creates vulnerability for semen loss. Therefore, a long penis, which places the ejaculate deep in the vaginal tract, could reduce the loss of semen. [39] [ unreliable medical source? ]
Another evolutionary theory of penis size is female mate choice and its associations with social judgements in modern-day society. [36] [40] [ unreliable medical source? ] A study which illustrates female mate choice as an influence on penis size presented females with life-size, rotatable, computer generated males. These varied in height, body shape and flaccid penis size, with these aspects being examples of masculinity. [36] [ unreliable medical source? ] Female ratings of attractiveness for each male revealed that larger penises were associated with higher attractiveness ratings. [36] [ unreliable medical source? ] These relations between penis size and attractiveness have therefore led to frequently emphasized associations between masculinity and penis size in popular media. [40] [ unreliable medical source? ] This has led to a social bias existing around penis size with larger penises being preferred and having higher social status. This is reflected in the association between believed sexual prowess and penis size and the social judgement of penis size in relation to 'manhood'. [40] [ unreliable medical source? ]
The shape of the human penis is thought to have evolved as a result of sperm competition. [41] Semen displacement is an adaptation of the shape of the penis to draw foreign semen away from the cervix. This means that in the event of a rival male's sperm occupying the reproductive tract of a female, the human penis is able to displace the rival sperm, replacing it with his own. [42]
Semen displacement has two main benefits for a male. Firstly, by displacing a rival male's sperm, the risk of the rival sperm fertilising the egg is reduced. [43] Secondly, the male replaces the rival's sperm with his own, thereby increasing the probability of his fertilising the egg and successfully reproducing with the female. However, males have to ensure they do not displace their own sperm. It is thought that the relatively quick loss of erection after ejaculation, penile hypersensitivity following ejaculation, and the shallower, slower thrusting of the male after ejaculation prevent this from occurring. [42]
The coronal ridge is the part of the human penis thought to have evolved to allow for semen displacement. Research has studied how much semen is displaced by differently shaped artificial genitals. [43] This research showed that, when combined with thrusting, the coronal ridge of the penis is able to remove the seminal fluid of a rival male from within the female reproductive tract. It does this by forcing the semen under the frenulum of the coronal ridge, causing it to collect behind the coronal ridge shaft. [43] When model penises without a coronal ridge were used, less than half the artificial sperm was displaced, compared to penises with a coronal ridge. [43]
The presence of a coronal ridge alone, however, is not sufficient for effective semen displacement. It must be combined with adequate thrusting to be successful. It has been shown that the deeper the thrusting, the larger the semen displacement. No semen displacement occurs with shallow thrusting. [43] Some have therefore termed thrusting as a semen displacement behaviour. [44]
The behaviours associated with semen displacement, namely thrusting (number of thrusts and depth of thrusts), and duration of sexual intercourse, [44] have been shown to vary according to whether a male perceives the risk of partner infidelity to be high or not. Males and females report greater semen displacement behaviours following allegations of infidelity. In particular, following allegations of infidelity, males and females report deeper and quicker thrusting during sexual intercourse. [43]
In many cultures, referring to the penis is considered taboo or vulgar, and a variety of slang words and euphemisms are used to talk about it. In English, these include member, dick , cock, prick , johnson, dork, peter, pecker, manhood, stick, rod, third/middle leg, dong, willy, schlong, and todger. [49] Many of these are used as insults—though sometimes playfully—meaning an unpleasant or unworthy person. [50] [51] Among these, historically, the most commonly used euphemism for penis in English literature and society was member. [52]
The penis is sometimes pierced or decorated by other body art. Other than circumcision, genital alterations are almost universally elective and usually for the purpose of aesthetics or increased sensitivity. Piercings of the penis include the Prince Albert, apadravya, ampallang, dydoe, deep shaft and frenum piercings. Foreskin restoration or stretching is a further form of body modification, as well as implants under the shaft of the penis. Another type of alteration to the penis is genital tattooing.
Trans women who undergo sex reassignment surgery have their penis surgically modified into a vagina or clitoris via vaginoplasty or clitoroplasty respectively. [53] Trans men who undergo such surgery have a phalloplasty or metoidioplasty.
Other practices that alter the penis are also performed, although they are rare in Western societies without a diagnosed medical condition. Apart from penectomy, perhaps the most radical of these is subincision, in which the urethra is split along the underside of the penis. Subincision originated among Australian Aborigines, although it is now done by some in the U.S. and Europe.
The most common form of body modification related to the penis is circumcision: removal of part or all of the foreskin. It is most commonly performed as an elective procedure for prophylactic, cultural, or religious reasons. [54] For infant circumcision, modern devices such as the Gomco clamp, Plastibell, and Mogen clamp are available. [55] The ethics of circumcision in children is a source of controversy. [56] [57] Among the world's major medical organizations, there is a consensus that circumcision reduces heterosexual HIV infection rates in high-risk populations during penile-vaginal sex. [58] [59] [60] [61] There are differing perspectives on the prophylactic efficacy and cost effectiveness of circumcision in developed nations. [54] Circumcision plays a significant role in many of the world's cultures. [62] When performed for religious reasons, it is most common among both Jews and Muslims, among whom it is near-universal. [63]
There are efforts by scientists to partially or fully regenerate the structures of the human penis. [64] [65] [66] Patients who can benefit most from this field are those who have congenital defects, cancer, and injuries that have excised parts of their genitalia. [67] [68] [69] Some organizations which perform research into, or conduct regeneration procedures, include the Wake Forest Institute for Regenerative Medicine and the United States Department of Defense. [68] [69] The first successful penis allotransplant surgery was done in September 2005 in a military hospital in Guangzhou, China. [70] A man at 44 sustained an injury after an accident and his penis was severed; urination became difficult as his urethra was partly blocked. A recently brain-dead man, aged 23, was selected for the transplant. Despite atrophy of blood vessels and nerves, the arteries, veins, nerves and the corpora spongiosa were successfully matched. But, on 19 September (after two weeks), the surgery was reversed because of a severe psychological problem (rejection) by the recipient and his wife. [71]
In 2009, researchers Chen, Eberli, Yoo and Atala have produced bioengineered penises and implanted them on rabbits. [72] They were able to obtain erection and copulate, with 10 of 12 rabbits achieving ejaculation. This study shows that in the future it could be possible to produce artificial penises for replacement surgeries or phalloplasties. In 2015, the world's first successful penis transplant took place in Cape Town, South Africa in a nine-hour operation performed by surgeons from Stellenbosch University and Tygerberg Hospital. The 21-year-old recipient, who had been sexually active, had lost his penis in a botched circumcision at 18. [73]
In male human anatomy, the glans penis or penile glans, commonly referred to as the glans, is the bulbous structure at the distal end of the human penis that is the human male's most sensitive erogenous zone and primary anatomical source of sexual pleasure. The glans penis is present in the male reproductive organs of humans and most other mammals where it may appear smooth, spiny, elongated or divided. It is externally lined with mucosal tissue, which creates a smooth texture and glossy appearance. In humans, the glans is located over the distal ends of the corpora cavernosa and is a continuation of the corpus spongiosum of the penis. At the summit appears the urinary meatus and at the base forms the corona glandis. An elastic band of tissue, known as the frenulum, runs on its ventral surface. In men who are not circumcised, it is completely or partially covered by a fold of skin called the foreskin. In adults, the foreskin can generally be retracted over and past the glans manually or sometimes automatically during an erection.
Foreskin restoration is the process of expanding the skin on the penis to reconstruct an organ similar to the foreskin, which has been removed by circumcision or injury. Foreskin restoration is primarily accomplished by stretching the residual skin of the penis, but surgical methods also exist. Restoration creates a facsimile of the foreskin, but specialized tissues removed during circumcision cannot be reclaimed. Actual regeneration of the foreskin is experimental at this time. Some forms of restoration involve only partial regeneration in instances of a high-cut wherein the circumcisee feels that the circumciser removed too much skin and that there is not enough skin for erections to be comfortable.
Penis enlargement, or male enhancement, is any technique aimed to increase the size of a human penis. Some methods aim to increase total length, others the shaft's girth, and yet others the glans and foreskin size. Techniques include surgery, supplements, ointments, patches, and physical methods like pumping, jelqing, and traction.
Phimosis is a condition in which the foreskin of the penis cannot stretch to allow it to be pulled back past the glans. A balloon-like swelling under the foreskin may occur with urination. In teenagers and adults, it may result in pain during an erection, but is otherwise not painful. Those affected are at greater risk of inflammation of the glans, known as balanitis, and other complications.
Erectile tissue is tissue in the body with numerous vascular spaces, or cavernous tissue, that may become engorged with blood. However, tissue that is devoid of or otherwise lacking erectile tissue may also be described as engorging with blood, often with regard to sexual arousal.
Penile cancer, or penile carcinoma, is a cancer that develops in the skin or tissues of the penis. Symptoms may include abnormal growth, an ulcer or sore on the skin of the penis, and bleeding or foul smelling discharge.
Hypospadias is a common malformation in fetal development of the penis in which the urethra does not open from its usual location on the head of the penis. It is the second-most common birth defect of the male reproductive system, affecting about one of every 250 males at birth, although when including milder cases, is found in up to 4% of newborn males. Roughly 90% of cases are the less serious distal hypospadias, in which the urethral opening is on or near the head of the penis (glans). The remainder have proximal hypospadias, in which the meatus is all the way back on the shaft of the penis, near or within the scrotum. Shiny tissue or anything that typically forms the urethra instead extends from the meatus to the tip of the glans; this tissue is called the urethral plate.
The ejaculatory ducts are paired structures in the male reproductive system. Each ejaculatory duct is formed by the union of the vas deferens with the duct of the seminal vesicle. They pass through the prostate, and open into the urethra above the seminal colliculus. During ejaculation, semen passes through the prostate gland, enters the urethra and exits the body via the urinary meatus.
Frenulum breve, or short frenulum, is a condition in which the frenulum of the penis, which is an elastic band of tissue under the glans penis that connects to the foreskin and helps contract it over the glans, is too short and thus restricts the movement of the foreskin. The frenulum should normally be sufficiently long and supple to allow for the full retraction of the foreskin so that it lies smoothly back on the shaft of the erect penis.
A corpus cavernosum penis (singular) is one of a pair of sponge-like regions of erectile tissue, which contain most of the blood in the penis of several animals during an erection.
The frenulum of the penis, often known simply as the frenulum or frenum, is a thin elastic strip of tissue on the underside of the glans and the neck of the human penis. In men who are not circumcised, it also connects the foreskin to the glans and the ventral mucosa. In adults, the frenulum is typically supple enough to allow manual movement of the foreskin over the glans and help retract the foreskin during erection. In flaccid state, it tightens to narrow the foreskin opening.
In human male anatomy, the radix or root of the penis is the internal and most proximal portion of the human penis that lies in the perineum. Unlike the pendulous body of the penis, which is suspended from the pubic symphysis, the root is attached to the pubic arch of the pelvis and is not visible externally. It is triradiate in form, consisting of three masses of erectile tissue; the two diverging crura, one on either side, and the median bulb of the penis or urethral bulb. Approximately one third to one half of the penis is embedded in the pelvis and can be felt through the scrotum and in the perineum.
An erection is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, and endocrine factors, and is often associated with sexual arousal, sexual attraction or libido, although erections can also be spontaneous. The shape, angle, and direction of an erection vary considerably between humans.
Ejaculation is the discharge of semen from the penis through the urethra. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. After forming an erection, many men emit pre-ejaculatory fluid during stimulation prior to ejaculating. Ejaculation involves involuntary contractions of the pelvic floor and is normally linked with orgasm. It is a normal part of male human sexual development.
Diphallia, penile duplication (PD), diphallic terata, or diphallasparatus is an extremely rare developmental abnormality in which a male is born with two penises. The first reported case was by Johannes Jacob Wecker in 1609. Its occurrence is 1 in 5.5 million boys in the United States.
Clitoral erection is a physiological phenomenon where the clitoris becomes enlarged and firm.
In male human anatomy, the foreskin, also known as the prepuce, is the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis that covers the glans and the urinary meatus. The foreskin is attached to the glans by an elastic band of tissue, known as the frenulum. The outer skin of the foreskin meets with the inner preputial mucosa at the area of the mucocutaneous junction. The foreskin is mobile, fairly stretchable and sustains the glans in a moist environment. Except for humans, a similar structure known as a penile sheath appears in the male sexual organs of all primates and the vast majority of mammals.
A penile injury is a medical emergency that afflicts the penis. Common injuries include fracture, avulsion injury, strangulation, entrapment, and amputation.
Penile ultrasonography is medical ultrasonography of the penis. Ultrasound is an excellent method for the study of the penis, such as indicated in trauma, priapism, erectile dysfunction or suspected Peyronie's disease.
Glans insufficiency syndrome, also known as soft glans, cold glans, or glans insufficiency, is a medical condition that affects male individuals. This condition is characterized by the persistent inability of the glans penis to achieve and maintain an erect or turgid state during sexual arousal, remaining soft and cold. This condition can have an impact on a person's sexual function, including decreased sensitivity, difficulty in maintaining an erection, and overall quality of life.
...the most pleasurable of all body parts when stimulated sexually: the glans (or tip) of the penis.
The Paediatrics and Child Health Division, The Royal Australasian College of Physicians (RACP) has prepared this statement on routine circumcision of infants and boys to assist parents who are considering having this procedure undertaken on their male children and for doctors who are asked to advise on or undertake it. After extensive review of the literature the RACP reaffirms that there is no medical indication for routine neonatal circumcision. Circumcision of males has been undertaken for religious and cultural reasons for many thousands of years. It remains an important ritual in some religious and cultural groups.…In recent years there has been evidence of possible health benefits from routine male circumcision. The most important conditions where some benefit may result from circumcision are urinary tract infections, HIV and later cancer of the penis.…The complication rate of neonatal circumcision is reported to be around 1% and includes tenderness, bleeding and unhappy results to the appearance of the penis. Serious complications such as bleeding, septicaemia and may occasionally cause death (1 in 550,000). The possibility that routine circumcision may contravene human rights has been raised because circumcision is performed on a minor and is without proven medical benefit. Whether these legal concerns are valid will be known only if the matter is determined in a court of law. If the operation is to be performed, the medical attendant should ensure this is done by a competent operator, using appropriate anaesthesia and in a safe child-friendly environment. In all cases where parents request a circumcision for their child the medical attendant is obliged to provide accurate information on the risks and benefits of the procedure. Up-to-date, unbiased written material summarizing the evidence should be widely available to parents. Review of the literature in relation to risks and benefits shows there is no evidence of benefit outweighing harm for circumcision as a routine procedure in the neonate.
It is now generally accepted in public health spheres that medical male circumcision is efficacious in the prevention of HIV infection.
This led to a [medical] consensus that male circumcision should be a priority for HIV prevention in countries and regions with heterosexual epidemics and high HIV and low male circumcision prevalence.
Male circumcision is standard practice, by tradition, among the Druze