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	Circumcision has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
Article milestones Date Process Result February 3, 2013 Peer review Reviewed February 12, 2013 Good article nominee Listed
Current status: Good article

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view · edit Frequently asked questions Page name Editors sometimes propose that the page should be renamed to male circumcision, male genital mutilation, or male genital cutting. Consensus has rejected these proposals, because they are used in only a small minority of reliable sources. Most reliable sources refer to circumcision as "circumcision"; thus, in accordance with WP:TITLE, Misplaced Pages does the same.

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Have to repost this because it was archived but not resolved: Poor Source: "Professional Standards and Guidelines – Circumcision (Infant Male)" (PDF). College of Physicians and Surgeons of British Columbia. September 2009. Retrieved 2012-09-11.

The link to this source dosen't go to anything. We should keep this post on the talk page until we have the new link up. This is because if it is archived we will forget about fixing the source.

JohnP (talk) 02:39, 15 January 2015 (UTC)

There is no requirement that every source have a convenience link. There is no basis in Misplaced Pages content policy or guidelines for what you are saying here. Zad68 03:28, 25 January 2015 (UTC)

Should elaborate on Section: Medical indications, Sentence: Circumcision may be medically indicated in children for pathological phimosis, refractory balanoposthitis and chronic, recurrent urinary tract infections (UTIs) in males who are chronically susce

We only have one sentence in this section involving circumcision's medical indications. I've been finding a lot more info on this topic that we could write about. See pmids 16800325, 21298220, 25180668, 24295833. There are two types of phimosis that children can get. One type is physiological phimosis and this dosen't require circumcision. This is the most common type. The other type is caused by premature stretching of the foreskin by parents,Chronic balanoposthitis, and Balanitisxeroticaobliterans as indicated by these sources.

Other stuff we could write about are other medical indications indicated by literature reviews. These are Balanitisxeroticaobliterans and the stretching of the foreskin by parents. I think we should go into more depth here.

JohnP (talk) 03:27, 15 January 2015 (UTC)

You are again bringing up the same topics in a new Talk page discussion that we have already covered. As mentioned before those items should be covered at phimosis, foreskin, BXO, etc. Zad68 03:26, 25 January 2015 (UTC)

Moved here for discussion

It is important to distinguish between the two different types of phimosis. Physiological phimosis is phimosis that is present in all newborn males and naturally goes away on its own. Pathological phimosis is evident in 0.6 to 1.5 percent of males and is caused by scarring of the prepuce. Pathological phimosis can be caused by forced retraction of an infants prepuce by parents, recurrent balanoposthitis, and the skin disease balanitis xerotica obliterans. It is important that parents do not play with or attempt to retract their sons' foreskins because this will cause them to develop phimosis. Pathological phimosis can be a medical indication for circumcision but recent advances in medicine have made the preservation of the foreskin possible. The use of topical corticosteroids has been found to be an effective alternative to circumcision for treating phimosis as well as manual retraction therapy. In addition to this, the surgery Preputioplasty can be used to preserve the foreskin but remove phimosis. A preferred version of this procedure involves making two lateral incisions in the prepuce that allow it to loosen. Circumcision is not needed to treat most cases of pathological phimosis because of these alternative treatments. An exception is for the disease balanitis xerotica obliterans, a genital form of lichen sclerosus, which has been historically known as the only absolute indication for circumcision. However, this has also been changing due to alternative treatment options. Topical steroid application has been found to be effective in early and intermediate stages of the disease when active and irreversible tissue damage has not occurred. Recent trials show good outcomes for boys who undergo Preputioplasty and injections of intralesional triamcinolone for BXO.

2. A primary source. Not needed.
5. 2002 A little old.

It is not clear which ref supports which text above. Doc James (talk · contribs · email) 01:38, 17 January 2015 (UTC)

We should not be providing "how too advice" thus "It is important that parents do not play with or attempt to retract their sons' foreskins because this will cause them to develop phimosis" is not good wording. This than seems to contradict what came before "as well as manual retraction therapy." Doc James (talk · contribs · email) 01:40, 17 January 2015 (UTC)

This bit "It is important to distinguish between the two different types of phimosis. Physiological phimosis is phimosis that is present in all newborn males and naturally goes away on its own. Pathological phimosis is evident in 0.6 to 1.5 percent of males and is caused by scarring of the prepuce. Pathological phimosis can be caused by forced retraction of an infants prepuce by parents, recurrent balanoposthitis, and the skin disease balanitis xerotica obliterans. It is important that parents do not play with or attempt to retract their sons' foreskins because this will cause them to develop phimosis. " was already discussed lower in the article. No need to discuss it twice.Doc James (talk · contribs · email) 01:53, 17 January 2015 (UTC)

Have added a summary of the Cochrane review. And combined the rest of it into the pre existing text Doc James (talk · contribs · email) 01:53, 17 January 2015 (UTC)

1. ^ Moreno G1, Corbalán J, Peñaloza B, Pantoja T. (2014). "Topical corticosteroids for treating phimosis in boys". Cochrane Database Syst Rev. PMID 25180668.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
2. ^ Hayashi Y1, Kojima Y, Mizuno K, Kohri K. (2011). "Prepuce: phimosis, paraphimosis, and circumcision". ScientificWorldJournal. 3 (11): 289–301. PMID 21298220.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
3. ^ Steadman B1, Ellsworth P. (2006). "To circ or not to circ: indications, risks, and alternatives to circumcision in the pediatric population with phimosis". Urol Nurs. 26 (3): 181–94. PMID 16800325.{{cite journal}}: CS1 maint: numeric names: authors list (link)
4. ^ Celis S1, Reed F2, Murphy F3, Adams S3, Gillick J4, Abdelhafeez AH4, Lopez PJ5 (2014). "Balanitis xerotica obliterans in children and adolescents: a literature review and clinical series". J Pediatr Urol. 10 (1): 34–39. PMID 24295833.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
5. ^ Wilkinson DJ1, Lansdale N, Everitt LH, Marven SS, Walker J, Shawis RN, Roberts JP, Mackinnon AE, Godbole PP. (2012). "Foreskin preputioplasty and intralesional triamcinolone: a valid alternative to circumcision for balanitis xerotica obliterans". J Pediatr Surg. 47 (4): 756–9. PMID 22498393.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
6. Crawford DA (2002). "Circumcision: a consideration of some of the controversy". J Child Health Care. 6 (4): 259–70. PMID 12503896.

Ok well the sources that I found all say that circumcision is no longer needed for pathological phimosis and recurrent UTIs. The only thing that they indicate it is really needed for is BXO. This is too important for us to not have at least somewhat included in the indications section.

JohnP (talk) 02:12, 17 January 2015 (UTC)

The sources do not exactly say that. In fact the source you added say that it is useful in some cases. But not most cases of BXO. Doc James (talk · contribs · email) 02:26, 17 January 2015 (UTC)

No but I'm talking about the majority of pathological phimosis. BXO is a pretty rare case. Most pathological phimosis comes from premature stretching of the foreskin by parents and recurrent balanoposthitis as indicated by the sources.

JohnP (talk) 03:31, 17 January 2015 (UTC)

Which ref says "Most pathological phimosis comes from premature stretching of the foreskin by parents and recurrent balanoposthitis" Doc James (talk · contribs · email) 23:02, 17 January 2015 (UTC)

All of the sources here are saying that the main reason for circumcision when the patient has pathological phimosis is for BXO. The amount of babies that have BXO and have pathological phimosis is controversial. Cochrane review states that BXO still represents a highly selected and infrequent group among children with phimosis seen in ambulatory/primary care settings. Prepuce: Phimosis, Paraphimosis, and Circumcision Says 15% of children undergoign circumcision have BXO, To circ or not to circ says causes of phimosis are tramautic tearing of the foreskin, persistent infant adhesions, frenulum breve, phimotic ring, and chronic balanoposthitis. This one dosen't mention BXO.

JohnP (talk) 20:36, 18 January 2015 (UTC)

BXO seems to be the one part of pathological phimosis that requires circumcsion. Rather we should say a medical indication is for pathological phimosis cause by BXO. These sources are all indicating that it is unnecessary for balanoposthitis.

JohnP (talk) 20:38, 18 January 2015 (UTC)

No it is used for a number of causes of phimosis. You still: have not answered what supported "Most pathological phimosis comes from premature stretching of the foreskin by parents and recurrent balanoposthitis" Doc James (talk · contribs · email) 02:24, 20 January 2015 (UTC)

no. This cochrane literature review and the other says its only needed for BXO.

JohnP (talk) 02:26, 21 January 2015 (UTC)

No, I have reviewed this with you before. Your statements are not representing what the sources say. Zad68 03:25, 25 January 2015 (UTC)

Sentence on circumcision controversies

Why'd you delete my sentence. The ethics textbook is a really bad source, it dosen't even go over controversies. Crawford gives a good perspective of controversies in the UK and Pinto gives a good perspective of controversies in the US. Crawford gives a good summary of the controversy over sexual health in the UK and puts emphasis on it, we can't leave this out.

JohnP (talk) 02:14, 17 January 2015 (UTC)

Leaving the sentence as is clearly makes the page North American bias. And the textbook is a poor source.

JohnP (talk) 02:15, 17 January 2015 (UTC)

Crawford is a little old. Why remove this which provides a good summary? Doc James (talk · contribs · email) 02:27, 17 January 2015 (UTC)

The textbook does not talk about questions that are being asked about circumcision. Only covers legal and ethical problems that doctors can encounter when asked to circumcise.

JohnP (talk) 03:28, 17 January 2015 (UTC)

Yes and the sentence it supports is about "Ethical and legal questions" Doc James (talk · contribs · email) 23:08, 17 January 2015 (UTC)

No its about questions that have been raised overall. Not ethical and legal questions that doctors naturally have to work through when they're asked to circumcise. This is not a statement about the law, its about what the literature overall is saying.

JohnP (talk) 02:12, 18 January 2015 (UTC)

Once again please do not keep repeatedly bringing up the same topic in multiple Talk page sections. Zad68 03:17, 25 January 2015 (UTC)

AIDS part in summary isn't really clear.

The part in summary dosen't match up with what we have written in article. There's level 1 evidence as of now so we might as well point it out. But also should point out that the inclusion in the health policies of other developed countries is undetermined.

JohnP (talk) 03:33, 17 January 2015 (UTC)

We are writing for a general audience. The term "level 1" evidence is not appropriate, at least not in the lead. Doc James (talk · contribs · email) 23:09, 17 January 2015 (UTC)

Should not use the word routine when talking about the developed world. Noone is even thinking about routine in the developed world. Should seperate out part on homosexuals from MSM. Make MSM part more clear

JohnP (talk) 02:20, 18 January 2015 (UTC)

Yes agree. We can summarize this further as "Its use to prevent HIV in the developed world is unclear"

Effects in MSM apply globally. Thus this should come after the global discussion. We can summarize as " For men who have sex with men the evidence of an HIV benefit is less clear" Which ref says "slight benefit"? And these details are best dealt with in the body of the article. Doc James (talk · contribs · email) 02:28, 18 January 2015 (UTC)

Rearranging text

The secual effects are adverse effects. Thus resorted content to were it was before. Doc James (talk · contribs · email) 02:25, 20 January 2015 (UTC)

No sexual effects are the first thing circumcision effects. And we really don't know what they are as indicated by the sources.

JohnP (talk) 02:25, 21 January 2015 (UTC)

It was better discussed under adverse effects. Disagree with your moving it. Doc James (talk · contribs · email) 03:59, 21 January 2015 (UTC)

Per Jewish tradition a purpose of circumcision is to diminish sexual pleasure. Should a reduction in pleasure go into a positive or into a a negative effects section ?--— ⦿⨦⨀Tumadoireacht /_Stalk 14:24, 21 January 2015 (UTC)

Tumadoireacht are you suggesting that the reasoning given for a religious tradition should be treated by this Misplaced Pages article as a medical effect and given equal footing with the up-to-date medical review articles? A simple Yes or No answer would be sufficient, please. Zad68 03:03, 25 January 2015 (UTC)

Do you. in your turn consider Zad that the loss of penile sensation caused by cutting off up to 80% of the skin of the penis and making it up to 25% shorter something that only medical researchers have any right to be heard on within this article Please feel free to answer as fully as possible. A simple yes or no answer would not be sufficient.--— ⦿⨦⨀Tumadoireacht /_Stalk 10:58, 27 January 2015 (UTC)

No way. Circumcision first and foremost directly effects sexual health. And we don't even know what that effect is. An effect that we need to list is its sexual effect. DocJames your statement suffers from cultural bias.

JohnP (talk) 21:47, 21 January 2015 (UTC)

No the majority of the high quality literature dose not comment on sexual health. Doc James (talk · contribs · email) 02:54, 22 January 2015 (UTC)

I just did a review of a big chunk of the literature that we have. I actually found that the majority of the articles that I read did give some reference to circumcision's effect on sexual health. Many authors would briefly describe how it improves or harms sexual health in the summaries of their articles. So it looks like the majority of our literature is giving some reference to it.

JohnP (talk) 16:08, 24 January 2015 (UTC)

Where is the list of the articles "we have" that you looked at? Doc James (talk · contribs · email) 02:12, 25 January 2015 (UTC)

Last I checked the Misplaced Pages article summarized six high-quality up to date meta-analyses and review articles, the Misplaced Pages article summarizes their conclusions accurately, you agreed that this was the case earlier, what is the problem now? Zad68 03:05, 25 January 2015 (UTC)

you can't discredit Bossio because she's a masters student

You can't discredit Bossio just because she's a masters student. WikiProject Medicine Guidelines say that literature reviews are the highest quality medical sources so this still must be included in page. Also, even though here conclusion relates to North America please see her results. She clearly states that there are gaps in the overall literature relating to sexual health. Here conclusion was written in that way to Emphasize the fact that the gaps in the literature regarding sexual health are so severe that people in North America need to look at their policies regarding circumcision.

JohnP (talk) 21:51, 21 January 2015 (UTC)

Bossio is a master's student in psychology, she has no medical qualifications whatsoever. She also has almost no publishing footprint. It's a very weak source. In addition her conclusions are very clearly localized to North America, the abstract alone mentions this a half-dozen times. Frankly it's really quite unreasonable of you, on the one hand for some things, to insist on tiny wording changes to nudge the content closer to the source (here I'm thinking of your request to add "insertive anal sex" to the recommendations for MSM) but in this case feel it unnecessary at all to mention how specific Bossio's comments are to North America alone. Zad68 03:14, 25 January 2015 (UTC)

The WHO report on Safety and Acceptibility of Circumcision in Africa is a Bad Source for Describing the Foreskin

We cannot use this source to describe the foreskin. It wasn't even made to describe the foreskin. The WHO is clearly biased here, as it is promoting circumcision to prevent an Epidemic that is going on in Africa. We need a better source that does not have bias and actually focuses on the prepuce. The functions of the prepuce have been known for thousands of years, this can't be too hard to find. The WHO is clearly incredibly bias, it only uses 3 sources on the prepuce all of which are quite bad. It doesn't even summarize its sources right. 2 of them say that the foreskin has a role, and the other doesn't focus much on the topic.

JohnP (talk) 21:55, 21 January 2015 (UTC)

"WHO is clearly biased" Actually WHO is a very high quality source per WP:MEDRS which cares greatly about global health. Doc James (talk · contribs · email) 02:57, 22 January 2015 (UTC)

Let me correct you. They're good for talking about HIV and the global epidemic, and they're good at encouraging the use of circumcision in Africa, but they are not good for describing the foreskin. The purpose of their article is so far from that, I don't know why you insist on using it for this purpose.

JohnP (talk) 05:15, 22 January 2015 (UTC)

You mention that the WHO is biased three times. Doc James (talk · contribs · email) 05:20, 22 January 2015 (UTC)

Yes they are biased when it comes to talking about the prepuce. Let me give you an example to illustrate this: Lets say there is an area of the world, like Africa, where people are dying of HIV all over the place. Then there is a procedure like circumcision that turns out to prevent HIV. The procedure is known to be highly controversial, and many people in Africa probably won't initially want to have it done. The WHO may know that the prepuce has some functions, but their primary goal here is to save Massive amounts of people from dying over in Africa. They don't want HIV to spread uncontrollably into other areas of the world like Europe and Asia. This is because if HIV gets uncontrollable then everyone could start dying.

The WHO's goal here was to downplay the sexual effects so that they could convince Africans to do it. They probably knew that it does have some sexual effects, just the HIV benefit here is much more important so they tried to cover it up. This is what makes their source bias.

Now going away from this, the mere presence of an epidemic makes this source bias according to our guidelines for medical literature. Medical literature is supposed to be objective. Here, with an epidemic present, this source is clearly using circumcision to treat an illness that is present in one part of the globe. Using it to treat an illness makes its results unobjective.

This is the English Misplaced Pages page. We don't broadcast to most people in Africa anyway. If this was Africa's page I would be Ok with using this source because the African guys should get circumcised if they don't all want to die. However, here in developed countries where there's little HIV, I think that we should actually use a source that tries to describe the foreskin.

JohnP (talk) 05:49, 22 January 2015 (UTC)

John - I admire your energy in trying to improv this article. Many of the points you make are correct and, if this article were permitted to be objective, would be acted upon. However your last entry has several glaring errors, some original research and some assumptions about Misplaced Pages and Africa which are plain wrong. The WHO enthusiasm for Circumcision may have many sources apart from the purpose of curbing an epidemic. Some of the consciousness of the medical industry is tainted by its previous recent devotion to Circumcision (" the cure in search of an illness") as a cure for a myriad of real, rare, and imaginary conditions. Perhaps when this article does come to be overhauled from its present unbalanced pro-circumcision state it will be by considering the sociological and psychological aspects of the genital cutter mindset more and the medical aspects less. The utter absence of any mention of forced and tribal circumcisions in Africa and elsewhere within the article is a good illustration of how badly this article has deteriorated. --— ⦿⨦⨀Tumadoireacht /_Stalk 18:00, 22 January 2015 (UTC)

Tumadoireacht once again please be reminded not to use the article Talk page to air your personal opinions. If you return to the same disruptive editing behavior, I'll ask again for an administrator to review your behavior. Zad68 02:57, 25 January 2015 (UTC)

Zad - once again you attempt to characterize useful debate as personal opinion. Why is it that you cannot countenance these aspects of circumcision being considered for mention within either the article or now even considered on the Talkpage ?. Please be reminded that debate to improve the article is the purpose of this page. Please desist from your attempts to intimidate other editors and to stifle debate.Please desist from your threatening and disruptive behaviour. --— ⦿⨦⨀Tumadoireacht /

Stalk 11:47, 26 January 2015 (UTC)

The previous content was better

It was simpler for example "The foreskin extends out from the base of the glans and covers the glans when the penis is flaccid."

This is more complicated "The foreskin(prepuce) is a specialized, junctional mucocutaneous tissue. "

Doc James (talk · contribs · email) 02:47, 24 January 2015 (UTC)

I could fix that really easily. I didn't have the time this week to look over that article that much. There are sections that are much simpler, and we could state them in a way that would be beneficial to the reader.

JohnP (talk) 16:12, 24 January 2015 (UTC)

John please stop making multiple Talk page sections to cover the same topic. Your view appears to be that basically you feel the WHO is publishing lies. You may feel that way, however the WHO is regarded within the medical community and by Misplaced Pages as a reliable source, you don't appear to have a valid argument here. Zad68 03:00, 25 January 2015 (UTC)

I don't think section 1.1 should be called routine or elective.

I don't think that the literature is indicating that most people are thinking about routine or elective circumcision. The Bolnick textbook seems to be saying that countries are arguing over its medical value. It also says that no country recommends it non-therapeutically and no one wants to ban it either.

Well, overall the source doesn't give any indication that people are thinking about it routinely. This should be taken out of this title.

JohnP (talk) 00:14, 23 January 2015 (UTC)

Do not see what is wrong with it. Doc James (talk · contribs · email) 02:50, 24 January 2015 (UTC)

I mean noone is even arguing over it being routine or elective. Keeping it as routine or elective shouldn't be done because we're describing a discussion in the medical field that isn't even existant. We're basically lying to Misplaced Pages readers.

JohnP (talk) 16:10, 24 January 2015 (UTC)

Sorry you have lost me. Lots of sources use those terms. Doc James (talk · contribs · email) 21:25, 24 January 2015 (UTC)

I'm talking about the Bolnick book. They clearly state that noone wants to do it routinely and noone wants to ban it. Also, they say that medical organizations are arguing over whether its pros outweigh its cons or its cons outweigh its pros basically.

JohnP (talk) 01:04, 25 January 2015 (UTC)

Okay so what is the issue? Doc James (talk · contribs · email) 02:11, 25 January 2015 (UTC)

I do not see an issue, routine and elective are the terms the sources use, are you suggesting the article be edited to not use the terms the authoritative sources use? Zad68 02:55, 25 January 2015 (UTC)

Study links autism with circumcision

Well, might go into the article somewhere. // Liftarn (talk)

A report of primary research on "sciencenordic.com" does not clear the bar of WP:MEDRS. Alexbrn 12:11, 24 January 2015 (UTC)

But perhaps Journal of the Royal Society of Medicine may // Liftarn (talk) 22:39, 25 January 2015 (UTC)

Please take care to discriminate between primary and secondary sources. Zad68 03:33, 26 January 2015 (UTC)

Primary and secondary // Liftarn (talk)

Pain and autism risk, include?

• Circumcision tied to autism risk: study January 21, 2015

See causes of autism too? 108.73.112.31 (talk) 07:17, 25 January 2015 (UTC) 108.73.112.31 (talk) 07:17, 25 January 2015 (UTC)

• • No. The study itself does not meet MEDRS as it is a primary study, not a review of literature. Everymorning talk 15:12, 25 January 2015 (UTC)

Trimmed poor quality sources

Have trimmed "" We need to use sources that meet WP:MEDRS Doc James (talk · contribs · email) 23:20, 25 January 2015 (UTC)

References

1. ScienceNordic: Male circumcision leads to a bad sex life
2. Videnskab dk: Omskæring af mænd giver dårligt sexliv
3. International Journal of Epidemiology: Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark

Agreed, a clear violation of WP:MEDREV. Zad68 03:32, 26 January 2015 (UTC)

"Trimmed" is a pretty funny verb given the subject matter and echoing the euphemisms in the Circumcision article? Perhaps the editor meant "I have cut out" these sources. Like a foreskin. Will we ever get to a stage of examining the notion that "medical" articles may not be the only place to seek confirmation that cutting off up to 15 square inches of the skin at the head of the penis and sewing back together the remainder may have some diminishing effect on sensation ? Here is a circumcision information website which addresses, with medical references, 19 of the many issues which at present are hardly considered at all within the article.

http://intaction.org/10-myths-about-circumcision/

The rebuttal of the heavily promoted HIV prevention possibility of Circumcision is particularly useful. It is odd that given the current obsession with "medical" content for this article that neither the frenulum nor the ridged band of highly innervated tissue located just inside the tip of the foreskin, nor the synechia tissue which joins the foreskin to the penis head in infancy get any mention at all. The lifelong PTSD which a cut male can experience (Boyle 2002, Hammond 1999, Goldman 1999) gets no mention yet either within the article. --— ⦿⨦⨀Tumadoireacht /_Stalk 12:46, 26 January 2015 (UTC)

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