Why is AAP so critical

European pediatricians criticize AAP statement on circumcision

18.03.2013

German paediatricians, together with European pediatricians, criticize the statement of the American Academy of Pediatrics (AAP) on the circumcision of young boys, on which the Bundestag has largely based its legislation.

Leading doctors and university professors from many countries criticize the American Academy of Pediatrics (AAP) position on the medically non-indicated circumcision of young boys in a joint article. In this article, published March 18, 2013 in the magazine Pediatrics is published, the European pediatricians find that circumcision has no convincing health benefits. However, they can have long-term disadvantages, particularly in the urological, psychological and sexual areas. Circumcision is also a violation of the United Nations Charter of the Rights of the Child. It contradicts the basic medical principle: nil nocere, not to harm the patient. Doctors and medical organizations should therefore discourage parents from having their healthy boys circumcised.

Appears in the scientific newspaper on March 18th Pediatrics an article opposing the AAP's position on circumcision of August 2012. This article was written by 38 doctors and university teachers from 16 European countries and Canada. These include presidents and officials of national medical associations, pediatric and adolescent medical and pediatric surgical societies. They criticize the AAP for claiming circumcision has significant health benefits. The cited health benefits are questionable and, moreover, have no practical significance in the western world. According to the AAP, circumcision protects against urinary tract infections in childhood, reduces the risk of HIV / AIDS and other sexually transmitted diseases, and reduces the incidence of penile cancer. However, urinary tract infections only occur in one in 100 boys in the first year of life and are usually easy to treat with antibiotics. With a complication rate of 2%, circumcision would prevent urinary tract infection for the price of two complications. Complications could include rebleeding, infection or, in the worst case, serious problems or even fatal outcome.

Data from the western world do not support the belief that boy circumcision could curb the spread of HIV / AIDS or other sexually transmitted diseases. These diseases are much more common in the US, where around 75-80% of all men are circumcised, than in Europe, with a circumcision rate of 5-10%. Circumcision is clearly not an effective general preventive measure against HIV / AIDS or other sexually transmitted diseases.

Penile cancer is a rare disease. It affects about 1 in 100,000 older men. Penile cancer is equally common in the US and Europe. This proves that circumcision cannot be an effective preventive measure against it. In addition, even according to the AAP data, 300,000 circumcisions would be necessary to avoid a case of penile cancer.

The group of authors also point out that the foreskin is not just a meaningless piece of skin. It is a strongly innervated organ that protects the glans and plays an important role in the mechanical function of the penis in sexuality.
As co-authors of the article from the pediatric and pediatric surgical associations in Germany, we state: “Doctors in the western world outside the US cannot support the new position of the American Academy of Pediatrics on the circumcision of boys. There are no convincing health arguments for medically unindicated circumcision in the western world. The circumcision of young boys without medical indication is contrary to medical principles. Circumcision should not be done until the young are old enough to make their own decisions.

The professional association of paediatricians also explicitly takes a position on the AAP statement. BVKJ President Dr. Wolfram Hartmann: "Finally, the renowned specialist journal" Pediatrics "has published the statement from well-known representatives of European pediatric and pediatric surgical societies, which has been available since October 2012, and which deals very critically with the publication of the American Pediatricians (AAP) in the same journal and makes essential claims about the benefits of preventive circumcision of newborns and children. This is an important basis for decision-making for the legislation of the Bundestag and the approval of the Bundesrat. We already referred to this statement at the hearing before the Legal Committee of the German Bundestag, but man didn't want to hear this and ignored it. "

Article from 18.3.2013 on "Pediatrics"Available:
www.pediatrics.org/cgi/doi/10.1542/peds.2012-2896