ABSTRACT
Circumcision remains one of the oldest and most commonly practised surgical procedures worldwide. The benefits and ethics of non-therapeutic male circumcision continue to be debated widely and passionately, a situation that is unlikely to change any time soon. The historical origins of circumcision are unclear, but the practice is found throughout the world – in Native Americans, Australian Aboriginals, African and Middle Eastern tribesmen, and in the earliest Egyptian mummies. During development, there is no plane of separation between the epithelial layers of the glans and the prepuce: at birth the prepuce is almost always non-retractile. The prepuce is therefore a specialised erogenous tissue, and surgical removal of the normal prepuce results in the loss of most of the fine touch receptors of the penis. The pathology for which circumcision is the appropriate treatment is different in infants and adults. The increasing demand for cosmetic genital surgery in both men and women poses particular medico-legal pitfalls for physicians.
