CIRCUMCISION – MEDICAL BENEFITS

Prof. Ibrahim B. Syed

President

Islamic Research Foundation International, Inc.

Louisville, Kentucky

E-Mail: President@irfi.org

Website: WWW.IRFI.ORG

Circumcision was practised by some pre-Islamic Arabs and was a common practice in Africa from very early times. With the Africans it marked the passage from childhood into adulthood. It was and still is practised just before marriage. Circumcision is not mentioned in Quran but is regarded as a tradition of the Prophet and has become obligatory. The prophet Muhammad himself is quoted as saying "It is an ordinance in men and honourable in women" indicating that the practice is very strongly urged, if not required outright. Many Islamic theologians have insisted that Muhammad and indeed all prophets were born circumcised. It is practised on all male children born to Muslim parents as well as males of any age who join the religion. Most literature regarding circumcision is found in ‘hadith’. These are narratives, sayings and deeds of Prophet and his associates recorded by the Muslim scholars and biographers.

The most common hadith attributed to the Prophet himself, mentions circumcision in a list of practices known as "fitrah", meaning natural way or instinct.

Muslims trace the genesis of the practice to  Prophet Ibrahim (Abraham) in a manner similar to Judaism. In Islam, Prophet Ibrahim is the spiritual ancestor and the physical forefather of the Arabs, through his son Ismail. Along with Ismail, Prophet Ibrahim built the Ka'bah, the holiest shrine of Islam, and established many of the rituals practiced there.

MALE CIRCUMCISION CUTS AIDS RISK

Male circumcision reduces the risk that men will contract HIV through intercourse with infected women by about 70 percent, according to a study reported in The Wall Street Journal (July 5, 2005). This study was conducted on over 3,000 HIV-negative men, newspaper says.

After discovering the dramatic results, French and South African researchers halted the study about nine months in order to offer the uncircumcised men the opportunity to undergo the procedure, the newspaper reported.

The results of the study have not been published in a medical journal, although Bertran Auvert, the French researcher who headed the team is expected to present them at an International AIDS Society conference in Brazil later this month.

The study was conducted on more than 3,000 HIV-negative South African men, ages 18 to 24. Half of the men were randomly selected to be circumcised while the other half remained uncircumcised.

After following the men for a year, the researchers found that for every 10 uncircumcised men in the study who became infected with HIV, the virus that causes AIDS, only an estimated three circumcised men contracted the virus, the newspaper reported.

The study is considered significant because scientists have yet to discover an effective vaccine against the HIV virus or develop a reliable way to prevent infection other than through abstinence or safe-sex practices.

Previous studies have linked circumcision with increased HIV infection.

Uncircumcised men are at a much greater risk of becoming infected with HIV from heterosexual sex than circumcised men, say researchers.

They found a man who is circumcised is up to eight times less likely than one who is not to acquire HIV from "straight" sex.

A team from Australia have analyzed data from more than 40 studies.

They found evidence that the HIV virus targets specific cells from the inner surface of the foreskin.

These cells possess HIV receptors, making this area particularly susceptible to infection.

The researchers suggest that male circumcision provides significant protection against HIV infection by removing most of the receptors.

Circumcision also reduces the likelihood of contracting other sexually transmitted diseases, such as gonorrhea and syphilis, which make a person more vulnerable to HIV infection.

The most dramatic evidence of this protective effect comes from a new study of couples in Uganda, where each woman was HIV positive and her male partner was not.

Over a period of 30 months, no new infections occurred among 50 circumcised men, whereas 40 of 137 uncircumcised men became infected - even though all couples were given advice about preventing infection and free condoms were available to them.

Cultural problems

In many countries circumcision is frowned upon for cultural or religious reasons.

However, the scientists, led by Professor Roger Short, from the University of Melbourne Royal Women's Hospital, wrote in the British Medical Journal: "In light of the evidence presented here, circumcising males seems highly desirable, especially in countries with a high prevalence of HIV infection."

Alternatively, say the authors, the development of 'chemical condoms' - products which can block HIV receptors in the penis and the vagina - might provide a more acceptable form of HIV prevention in the future.

A spokesman for the National Aids Trust said the findings were not so relevant in the West, where the vast majority of HIV transmission was between gay men.

In Africa, heterosexual infection was far more prevalent, and world-wide about 70% of HIV positive men acquired the virus through vaginal sex.

Safe sex education

He said: "We know from the US example, where the majority of men already are circumcised, that circumcision does not protect against infection from anal intercourse."

"We really have to look at safe sex education and condom use as the way forward here."

"While it seems from this research that circumcised men may be less likely to become infected with HIV through vaginal intercourse, using condoms still remains the best protection against HIV and other sexually transmitted infections."

Protection from urinary tract infection (UTI)

Since 1980, at least ten research studies have been published linking urinary tract infections to a lack of circumcision. These studies found a minimum twelve-fold increased risk for urinary tract infections among uncircumcised males one to sixteen years of age, as well as among adult males. There is no data that contradicts these findings.

In 1997 a team of pediatric surgeons concluded that “streptococci, strict anaerobes, and genital mycoplasmas were found almost exclusively in uncircumcised males of more than fifteen years of age.” They further stated, “Our results also support the role of the prepuce [uncircumcised foreskin] as a reservoir for sexually transmitted organisms.”

Guarding against cervical cancer

In an important study done on the cause of cervical cancer, it was discovered that there was a 2,000% greater incidence of cervical cancer among  women whose husbands were uncircumcised. A New England Journal of Medicine  (NEJM) article, published in April 2002, affirms the relationship between cervical cancer and men who are not circumcised. The results come at a time when public opinion is turning away from circumcision, which many doctors have increasingly come to view as painful and unnecessary.

According to the  NEJM  Journal, “uncircumcised men are more likely to harbor human papilloma virus (HPV).” HPV, a sexually transmitted virus, is believed to cause nearly all cervical cancer. The article also states that if all men were circumcised, it could “reduce the incidence of cervical cancer world-wide by as much as 43%.”

Avoidance of penile cancer

After reviewing the data from 50,000  cancer cases in the past half-century, it was  concluded that “circumcision categorically prevents penile cancer.”  Out of 50,000 cancer cases, only ten had occurred in circumcised men. These men had all been circumcised later in life. Thus, none of the men diagnosed with penile cancer had been circumcised during infancy.

Reduction of harmful bacteria

Circumcision unquestionably facilitates better hygiene and the avoidance of conditions that result from uncleanliness. However, the most compelling reasons for circumcision among pediatric surgeons and urologists are balanitis (inflammation of the glans) and phimosis (stricture of the foreskin, resulting from recurrent infections). These painful conditions almost always occur in uncircumcised males. In babies, balanitis is caused by soiled diapers, as well as by playing or sitting in dirty areas.