Snip or don’t snip?

In 2012, the American Academy of Pediatrics declared that the benefits of circumcising boys outweighed the risks of the procedure. They cited health benefits that, while not great enough to warrant a recommendation for all males to undergo the procedure, were significant enough that it should be available to all, and that it should be covered by insurance. Not long after, the CDC concurred.

Let’s look at the evidence. For years, pediatricians have cited studies that show that being uncircumcised is a risk factor for developing a urinary tract infection. They point to research that shows that circumcised penises have lower levels of yeast and bacteria. Even more compelling, cohort studies showed that there was a tenfold increase in the rate of urinary tract infection in boys who were uncircumcised versus those who were.

The actual rates of urinary tract infection were 1.1 percent versus 0.1 percent, for an absolute rate difference of 1 percent. This means that 100 boys would need to be circumcised to prevent one urinary tract infection. Other studies say the number might be higher.

It’s really hard to argue that this decrease is worth a permanent, surgical procedure. It’s especially hard to argue given that we don’t really have data from randomized controlled trials. It’s possible that there’s something else different between boys who were circumcised and those who were not, especially since the vast majority (more than 80 percent) of boys in these studies were circumcised. Regardless, this amount of benefit seems to pass the threshold for coverage by insurance (which is low), so the procedure is available.