Newborn male circumcision remains one of the most common surgical procedures performed in the United States and the World, with substantial evidence supporting several medical benefits.¹˒² The American Academy of Pediatrics’ most recent policy statement concluded that the health benefits of newborn male circumcision outweigh the risks.¹˒² The World Health Organization also recognizes male circumcision as an effective HIV-prevention intervention.³
This clinical overview summarizes the evidence supporting the potential preventive health benefits of circumcision — including reduced urinary tract infections, lower risk of heterosexual HIV acquisition and selected sexually transmitted infections, prevention of certain foreskin-related conditions, and reduced penile cancer risk.¹˒²
From Dr. Tomlinson: The evidence that changed the direction of my career
One of the defining moments in my career came in 2008, when I attended the International AIDS Conference in Mexico City. By then, three large randomized controlled trials in South Africa, Kenya, and Uganda had demonstrated something remarkable: male circumcision reduced a man's risk of acquiring HIV through heterosexual exposure by approximately 50–60%.³˒⁴
I remember listening to the evidence and being struck by the potential impact. HIV was devastating communities around the world, particularly in sub-Saharan Africa, and here was a relatively simple surgical intervention that could substantially reduce the risk of acquiring HIV. The implications for public health were enormous.
As I learned more, I came to appreciate that HIV prevention was only one of the potential health benefits of male circumcision. The evidence also supported reductions in infant urinary tract infections, selected sexually transmitted infections, foreskin-related conditions, and penile cancer.¹˒²
That meeting helped change the direction of my career. I left Mexico City believing that if circumcision could improve the health outcomes of this many people, we had an obligation to find safer, more precise, and more reproducible ways to provide it. Much of my work over the years since has been devoted to that goal: improving the devices, techniques, training, and systems used to deliver newborn male circumcision safely.
Medical consensus on circumcision benefits
The AAP's 2012 policy statement — the most recent formal AAP policy statement addressing newborn male circumcision — concluded that the preventive health benefits of newborn male circumcision outweigh the risks and justify access to the procedure for families who choose it.¹˒²
The AAP identified specific benefits including reductions in urinary tract infections during infancy, heterosexual acquisition of HIV, transmission of other sexually transmitted infections, and penile cancer.¹˒² The AAP emphasized that parents should receive accurate and unbiased information about both benefits and risks when making the decision.¹˒²
The WHO and UNAIDS recommend voluntary medical male circumcision as an additional HIV-prevention strategy.³
These recommendations reflect decades of research demonstrating important preventive health benefits of male circumcision.²˒³
HIV prevention
Circumcision and HIV prevention are among the most rigorously studied. Three large randomized controlled trials conducted in sub-Saharan Africa demonstrated that male circumcision reduced heterosexual HIV acquisition in men by approximately 50–60%.³˒⁴
Longer-term studies and subsequent population-level research have continued to support a protective effect in settings with generalized heterosexual HIV epidemics.³˒⁴
This benefit is particularly relevant in regions with high HIV prevalence. The magnitude of protection was substantial enough that WHO and UNAIDS incorporated voluntary medical male circumcision into combination HIV-prevention strategies.³
Reduction in urinary tract infections
Circumcision and UTI prevention are well documented. Systematic reviews and clinical studies demonstrate that circumcised infants have significantly lower UTI rates during infancy compared with uncircumcised infants.²˒⁵˒⁶,⁷˒⁸˒⁹
UTIs during infancy can result in significant illness, and circumcision can help reduce the risk of these infections and their associated complications.
Protective effects against sexually transmitted infections
Beyond HIV, circumcision has demonstrated protective effects against selected sexually transmitted infections. Randomized controlled trials and systematic reviews indicate that circumcision reduces acquisition of high-risk HPV and HSV-2.¹⁰˒¹¹
Evidence also suggests benefits extending to female sexual partners. Circumcision is associated with reduced high-risk HPV infection in female partners, and observational evidence suggests that this may contribute to a lower risk of cervical dysplasia and cervical cancer, particularly in populations with substantial HPV exposure.¹²˒¹³
Prevention of foreskin-related penile conditions
Circumcision prevents acquired conditions that require the presence of a foreskin, including phimosis and paraphimosis.¹˒² It is also associated with a reduced occurrence of balanitis and balanoposthitis — inflammatory conditions involving the glans and foreskin.²˒¹⁴
Phimosis can occasionally require medical or surgical treatment, while paraphimosis can become an urgent condition when a retracted foreskin cannot be returned to its normal position.²
Circumcision prevents foreskin-specific disorders and reduces the likelihood of several inflammatory conditions involving the foreskin and glans.²˒¹⁴
Reduced incidence of penile cancer
Circumcised males have a lower incidence of invasive penile cancer, particularly when circumcision is performed early in life.¹⁵
Penile cancer is rare. Nevertheless, the association between circumcision and reduced invasive penile cancer risk has been recognized in systematic reviews and medical policy assessments.¹˒²˒¹⁵
Benefits must be considered alongside risks
Newborn circumcision is an elective surgical procedure, and its potential medical benefits should be considered alongside its risks.¹˒²
Potential complications include bleeding, infection, injury, inadequate or excessive skin removal, adhesions, and other healing-related problems.²˒¹⁶ Serious complications are uncommon when circumcision is performed by appropriately trained clinicians using sterile technique, effective analgesia, and appropriate patient selection.¹˒²
Families should receive balanced information about both the potential benefits and risks of circumcision and have an opportunity to consider their own medical, cultural, religious, ethical, and personal preferences when deciding whether circumcision is right for their newborn.¹˒²
Clinical summary
The medical evidence demonstrates several established health benefits of male circumcision. These include reduced urinary tract infection risk during infancy; later reductions in heterosexual HIV acquisition and selected sexually transmitted infections; prevention of foreskin-specific conditions such as phimosis and paraphimosis; and a lower risk of invasive penile cancer.²⁻¹⁵
The magnitude and clinical relevance of these benefits vary according to age, population, underlying medical risk, and future exposure. Some of the strongest evidence for HIV and STI prevention comes from randomized trials of adolescent and adult circumcision in populations with high rates of heterosexual transmission, while the reduction in urinary tract infections is directly relevant during infancy.³⁻¹¹
Newborn circumcision remains an elective procedure. Families should receive accurate information about both its potential benefits and risks so they can make an informed decision for their child.¹˒²
When families choose newborn circumcision, it should be performed by appropriately trained clinicians using careful patient selection, sterile technique, effective analgesia, evidence-based procedural methods, and appropriate aftercare.¹˒²˒¹⁷
References
American Academy of Pediatrics Task Force on Circumcision. Circumcision policy statement. Pediatrics.2012;130(3):585-586. doi:10.1542/peds.2012-1989.
American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012;130(3):e756-e785. doi:10.1542/peds.2012-1990.
World Health Organization. Preventing HIV Through Safe Voluntary Medical Male Circumcision for Adolescent Boys and Men in Generalized HIV Epidemics: Recommendations and Key Considerations. Geneva: World Health Organization; 2020.
Farley TMM, Samuelson J, Grabowski MK, Ameyan W, Gray RH, Baggaley R. Impact of male circumcision on risk of HIV infection in men in a changing epidemic context: systematic review and meta-analysis. J Int AIDS Soc.2020;23(6):e25490. doi:10.1002/jia2.25490.
Renko M, Salo J, Ekstrand M, et al. Meta-analysis of the risk factors for urinary tract infection in children. Pediatr Infect Dis J. 2022;41(10):787-792.
Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J. 2008;27(4):302-308. doi:10.1097/INF.0b013e31815e4122.
Ellison JS, Dy GW, Fu BC, Holt SK, Gore JL, Merguerian PA. Neonatal circumcision and urinary tract infections in infants with hydronephrosis. Pediatrics. 2018;142(1):e20173703. doi:10.1542/peds.2017-3703.
Harper L, Blanc T, Peycelon M, et al. Circumcision and risk of febrile urinary tract infection in boys with posterior urethral valves: result of the CIRCUP randomized trial. Eur Urol. 2022;81(1):64-72. doi:10.1016/j.eururo.2021.08.024.
Chan JYH, et al. The role of circumcision in preventing urinary tract infections in children with antenatal hydronephrosis: systematic review and meta-analysis. J Pediatr Urol. 2023.
Tobian AAR, Serwadda D, Quinn TC, et al. Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. N Engl J Med. 2009;360(13):1298-1309. doi:10.1056/NEJMoa0802556.
Shapiro SB, et al. Association between male circumcision and human papillomavirus infection in males and females: a systematic review, meta-analysis, and meta-regression. Clin Microbiol Infect. 2023.
Wawer MJ, Tobian AAR, Kigozi G, et al. Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: a randomised trial in Rakai, Uganda. Lancet. 2011;377(9761):209-218. doi:10.1016/S0140-6736(10)61967-8.
Castellsagué X, Bosch FX, Muñoz N, et al. Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med. 2002;346(15):1105-1112. doi:10.1056/NEJMoa011688.
Edwards S, et al. 2022 European guideline for the management of balanoposthitis. J Eur Acad Dermatol Venereol.2023;37(6):1104-1117.
Larke NL, Thomas SL, dos Santos Silva I, Weiss HA. Male circumcision and penile cancer: a systematic review and meta-analysis. Cancer Causes Control. 2011;22(8):1097-1110. doi:10.1007/s10552-011-9785-9.
Iacob SI, Feinn RS, Sardi L. Systematic review of complications arising from male circumcision. BJUI Compass.2022;3(2):99-123.
American Academy of Pediatrics Committee on Fetus and Newborn, Section on Anesthesiology and Pain Medicine. Prevention and management of procedural pain in the neonate: an update. Pediatrics.2016;137(2):e20154271. Reaffirmed July 2020 and April 2025. doi:10.1542/peds.2015-4271.