Elektif erkek sünneti; Medikolegal tartışmalar ve güncel literatür

Year 2018, Volume: 13 Issue: 2, 77 - 86, 01.06.2018

Zeki Bayraktar

Abstract

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.

Keywords

Erkek sünneti , enfeksiyon , kanser , cinsel fonksiyon , ruh sağlığı , komplikasyon

Elective male circumcision; Medicolegal discussions and current literature

Abstract

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. 

Keywords

Male circumcision , infection , cancer , sexual function , mental health , complication

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