Elektif erkek sünneti; Medikolegal tartışmalar ve güncel literatür

Elektif erkek sünneti(EES) hakkında bazı medikolegal tartışmalar vardır. Amerikan Pediatri Akademisi’nin (AAP) 2012 yılındaki raporuna göre, yeni doğan erkek sünnetinin tıbbî faydaları risklerinden fazladır. AAP’nin bu raporu, EMC hakkındaki tartışmalara yeni bir boyut kazandırmıştır. Bu rapor, sünnetin etik ve yasal bir müdahale olmadığını söyleyen çevreler tarafından eleştirilmiştir. Ancak, mevcut literatür AAP’nin bu raporunu doğrulamaktadır. ES, üriner enfeksiyonlar, fimozis, balanit, kandidiyaz, yüksek riskli HPV enfeksiyonu, HIV, genital ülser, sifiliz, trikomonas vaginalis, mikoplazma genitalium, herpes simpleks virüs tip 2, şankroid, penil kanser, prostat kanseri ve serviks kanseri riskini anlamlı derecede azaltıyor iken, seksüel fonksiyonlar üzerinde de olumsuz bir etki yapmamaktadır. EMC için önerilen yaş 0-1 yıldır. Çünkü infantil MC’de komplikasyonlar daha az, iyileşme daha hızlı ve maliyet daha avantajlıdır. Bu dönemdeki sünnetin ruh sağlığı açısından da bir riski bulunmamaktadır. İnfantil MC’nin komplikasyonları % 0,2-0,3 civarındadır ve bunların çoğu da genellikle minimal müdahalelerle önlenebilmektedir. Eğer 0-1 yaş arasında sünnet yapılmamış ise kastrasyon fobisi nedeniyle 3-6 yaş arasında sünnetten kaçınılmalı ve çocuğun 7-10 yaşına ulaşması beklenmelidir.

Elective male circumcision; Medicolegal discussions and current literature

There are some medicolegal discussion about elective male circumcision(EMC). According to the report of the American Academy of Pediatrics (AAP) in 2012, the health benefits of newborn MC outweigh the risks. This report of the AAP has given a new dimension to the discussion about MC. This report has been criticized by circles who say circumcision is not an ethical and legal intervention. However, the current literature confirms this report of the AAP. While MC significantly reduces the risks of urinary tract infections, phimosis, balanitis, candidiasis, high-risk HPV infection, HIV, genital ulcer disease, syphilis, trichomonas vaginalis, mycoplasma genitalium, herpes simplex virus type 2, shancroid, penile cancer, prostate cancer and cervical cancer, it does not negatively affect on sexual functions. MC also affects mental health positively in populations where circumcision is prevalent because of traditions and beliefs. The recommended age for MC is 0-1 years. Because, the complications are less, the healing is faster, and the cost is more advantageous in infantile MC. There is also no risk of circumcision in this period in terms of mental health. MC complications in infancy are around 0,2-0,3% and most of them are usually prevented with minimal intervention. If MC is not performed between 0-1 age it should be avoided between 3-6 years of age due to castration phobia and the boy should be expected to reach the age of 7-10 years.

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Kaynak Göster

Yeni Üroloji Dergisi
  • ISSN: 1305-2489
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2005

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