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1st September 2026. Analgesia for infnt circumcision.

It is now pretty generally agreed that circumcising newborn boys without anaesthetic is not a good idea. (It used to be believed that neonates were insensitive to pain.) But what is the best sort of anaesthesia to use? It is accepted that it should be local, and now a major review has looked at the various options. The review is led by Gabriel Lemos González, from Rio de Janiero, but includes both North Anericam and South Americam authors. Their conclusion is tha dorsal penile nerve block is the best technique.

You can read the abstract at PubMed or the full paper, which is open access, at Journal of Perinatology. Thanks to two regulars, BM and JH, for the link.

12th August 2026. A major trial of the Alisklamp Nero device.

The original Turkish Alisklamp was a disposable plastic clamp and leave device, intended as an improvement on the Plastibell. However many adverse reports on such devices (see this column) led the company to introduce a device, the Alisklamp Nero, which is made of metal and removed after the operation. (We initially thougt it was reusable, like the Gomco, but not so, it is still disposable). The device is described in our Instruments and Techniques page.

Now we have a major study of the safety and efficacy of this device. 6,000 circumcisions carried out by one surgeon betweem 2020 and 2025 (that's more than 3 a day!) showed a minor complication rate (mostly the cut coming apart or bleeding) of 2.16% and only 0.16% needing further surgery. Pretty impressive figures.

The paper, by Mecit Çelik and Necip Fazıl Aras is in Pediatric Surgery International. Read the abstract (free) at PubMed of the full paper (requires payment or login) at Pediatric Surgery International. Thanks to Prof. BM for the link.

5th August 2026. Neonatal Medical Male Circumcision and Child Autism Diagnosis

We all know how alt-facts spread these days and one such was that circumcision predisposes boys to autism. This claim comes from the Danish anti-circumcision campaigner Morten Fritsch who, to put it mildly, is not a reliable source. A possibly more plausible claim, not from Fritsch, was that early exposure to acetaminophen (paracetamol) could cause autism, and boys circumcised neonatally would be more likely to be given it.

This was a huge prospective study carried out over 22 years and at multiple institutions. It involved 2,271 boys, 1,840 circumcised and 890 not. Of the circumcised boys 11% had beem given acetaminophen. The paper has 30 authors and an even longer list of collaborators. Results? 6% of circumcised boys were sunsequently diagnse with autism, compared to 9% of uncircumcised boys. After adjusting for confounders this was not regarded as significant but it certainly lays Fritsch's claim to rest.

Read the abstract at PubMed or the full paper by McGrath et al (open access) at JAMA Pediatrics. Thanks to BM for the link (Academia also sent it but Brian was first).

30th July 2026. Male genital lichen sclerosus after circumcision in infancy

Infant circumcision is supposed to protect from BXO / lichen sclerosus. But what if you put on so much weight that your skin starts to cover your glans again? Sadly, it can still occur. A 27-year old overweight Iraqi man presented with such symptoms. Read the short note (with illustrations) in Skin Health and Disease.

Moral? #1 - a tight circumcision is a good idea. #2 - don't get fat - that's not theonly comlication you are likely to face.

29th July 2026. Diode laser circumcision

OK, I had always thought that diode lasers were more or less toys - laser pointers, DVD players, etc. - but it seem that they are now powerful enough to perform circumcisions. A recent paper from Mexico looks at their safety record- and it's pretty good. "A retrospective cohort of 51 patients ≤ 17 years who underwent diode laser circumcision diagnosed with phimosis (n = 29), balanitis (n = 13), balanitis xerotica obliterans (n = 5), and paraphimosis (n = 4). General anesthesia was used in patients under 10 years, and local block with sedation in older patients." Absolutely no complications. OK, a small sample but pretty encouraging.

Read the abstract (in English) at PubMed or the full pasper (in Spanish) at Boletín Médico del Hospital Infantil de México. Thankd to Prof. BM for the link'

20th July 2026. Denying AIDS: Conspiracy Theories and Pseudoscience in a Post-COVID World

This is a book by Seth Kalichman, a professor at the University of Connecticut, and a much enlarged second edition has now been published. The chapter list is long, but Brian Morris, who brought it to our attention, writes: "psychologist Seth Kalichman dismantles the anti-circumcision rhetoric used by AIDS denialisms. The book critically evaluates the claims of circumcision opponents—such as Benjamin Natelson or figures associated with SCIRP (Scientific Research Publishing)—exposing them as pseudoscientific, flawed, and based on cherry-picked data."

Seth writes: "Get your copy of Denying AIDS now and buckle up, it's a wild ride". Read full details, and order paperback or e-book copies, at the Springer site, publishers of the book. Seth adds "use code SPRAUT for a 20% discount at checkout."

8th July 2026. 0% foreskin 100% Anerican.

Comedy time Yes, this is a real T-shirt, available from Amazon. One has to wonder whether it is for or against circumcision! I rather suspect that this posting will lead to many more laughs than purchases. Just a bit too late for the 4th July. Thanks to SP for the link.

17th June 2026. Young Arab boys statistics.

"Penile anthropometry is essential for diagnosing genital anomalies. However, as these biometric values vary ethnically, population-specific standards are necessary." So starts a paper by Habib Ullah Joya and colleagues: "Penile anthropometry of healthy boys in Qatar" in Journal of Pediatric Urology. So they measured stretched penis length (SPL), diameter of glans and shaft diameter in boys being circumcised at differemt ages. They compared thr results with those from other continents.

Comparison af stretched pemile lengths of young boys in different countries

Brazilian boys seem to be very well endowed, Qatari and Egyptian boys (both predominantly Arab) are simiilar, whhile Asian boys are generally smaller. The authors say that this also applies to European boys but really Bulgaria is not typical of Europe. One point they don't fully address is that in some countries the pre-pubertal growth spurt seem to start more dramatically than in others. Does this reflact a difference in age at puberty? Maybe that will be the next paper.

The abstract is available at PubMed. The full paper is behind a paywall. Thanks to Professor Brian for the link;

12th June 2026. Update on the Belgian situation,

On 11th May we ran a story about the harassment and possible prosecution of two modelim in Antwerp. Last week the court announced that they will decide whether or not to prosecute on June 18th, so watch this page in a week's time. Meamwhile, the Jewish community in Belgium is seeking to establish a body to oversee Jewish ritual circumcision in the country. Philippe Markiewicz, president of the Central Israelite Consistory, proposed that this could consist of pediatricians and urologists. Whether this would solve the problem, which seems to be racially motivated, is a moot point bu it would surely help.

Thanks to LMS for the story, which you can find at BRF, Belgian National radio (but it is in German).

27th May 2026. Traditional Chinese medicine proves useful in adult circumcision.

According to Jiangping Xie and colleagues in Guanzhou, China, it is customary to use a gauze dressing with povidone iodine (Betadine) after adult circumcision. (Let it be said that after your Editor's adult circumcision there was no dressing, and why antiseptics should be needed after an aseptic operation is a questionable point). Xie and colleagues compared it with a dressing using the traditional Chinese medicine tung leaf burn oil which, as its name implies, is normally used to treat burns. It reduced post-op pain, but was particularly effective in reducing oedema (swelling) which is common after adult circumcision. One gripe - they mention (in the full paper) that other treatments including silver-based dressings and hyaluronic acid preparations, may achieve faster healing rates than conventional iodine-based approaches. So why didn't they compare these too?

You can read the abstract at PubMed or the full paper, which is open access, at Translational Andrology and Urology, which seems to be becoming the go-to journal for circumcision papers. Thanks to the BM weekly newsletter for the link.

21st May 2026. Circumcision in Poland - a rarity.

Poland probably has the lowest circumcison rate of any country in the world - 0.11% aaccording to a paper by Michael Falis and colleagues "Adult Circumcision for Symptomatic Phimosis in Poland: Six-Month Patient-Reported Sexual Function and Psychosocial Outcomes from a Central European Low-Circumcision Setting". The reason for the low rate is not exactly surprising - remember the 1940s and Auschwitz. But nevertheless some men still need to be circumcised because of phimosis. How do they feel about it? The answer turns out to be overwhelmingly positive - better sex, better self-image. Maybe this will help to make circumcision more popular,

Again this paper is open acceess (maybe paywalls are going out of fashion) at Journal of Clinical Medicine. Thanks to Prof. BM's weekly round-up for this one.

20th May 2026. A circumcision policy for the UK?

Professor Brian Morris and colleagues have recently published a major review "Does the evidence support circumcision of infant males in the United Kingdom?—a systematic review." It goes through all the benefits from infancy through childhood to adulthood and old age. Their conclusion? "In summary, the medical evidence supports early circumcision as a public health recommendation in the UK." Whether it will have much effect is another question, but at least the factual evidence is laid bare.

The paper is open access at Tranlational Andrology and Urology. No prizes for guessing where the information came from.

11th May 2026. More harassment of mohels in Belgium.

Last year on 28th May and 19th October we reported on Belgian attacks on the right of Jewish parents to have their sons circumcised with a traditional bris. Now two mohelim, one of them American, have been accused of "illegal practice of medicine and intentional bodily harm". They will appear in a pre-trial hearing, held behind closed doors, on 18th June and this will decide whether to lay formal charges. Both Israel and the US have fotmally protested about this - in the current climate this is probably counter-productive!

Thanks to German reader LMS for the news. You can read stories about the case on Deutschlandfunk radio (in German) and MSN (in English)/

23rd April 2026. Are antibiotics necessary post-circumcision?

It has become common in pediatric circumcisions to give a course of antibiotics afterwards 'just in case'. However, general medical policy is to only use antibiotics when actually necessary, so as to avoid the spread of resistance. So Drs Armean Saema and Chinnakhet Ketsuwan, in Thailand, decided to test whether they really did any good. 115 boys aged 5-15 were randomly assigned into antibiotic or no antibiotic groups. The result? Just one circumcision site infection in each group. The conclusion is clear - don't give precautionary antibiotics.

The full paper, in Journal of Pediatric Urology is behind a paywall but the abstract, which you can also read at PubMed really says it all. Thanks once again to BM and his weekly publicatiion list from the Circumcision Academy of Australia.

12th April 2026. Penile Cancer-A Preventable Cause of Death in Elderly Men

Just a month ago we reported that penile cancer rates had doubled in Australia in the past 20 years - now we have a British review paper showing that this is happening in other high-income countries as well. They call it a rare disease but, as so oftem, they quote the annual incidence rather than the lifetime risk. A lifetime risk of ~1 in 1,000 for an uncircumcised man is not that rare. The study reports that the main causes are lichen sclerosus (aka BXO) and oncogenic strains of HPV (wart virus). Both are prevented by infant circumcision, which the authors state, though they do not go so far as to call for routine circumcision. Maybe they hope that medical authorities will take the hint.

The paper, by a tean based at University College, London, is open access in Brisish Journal of Hospital Medicine. Thanks to BM and his weekly publicatiion list from the Circumcision Academy of Australia.

12th April 2026. Do not let a barber circumcise your son!

"Effective composite grafting of sub coronal penile amputation after ritual circumcision(khatna) in a 3-year-old child" is the title of a paper by Mishra et al.. A Muslim Indian family got the local barber to circumcise their son and he cut off the entire glans (head) of the penis. The child was rushed to the local hospital, then to a more major one, where they found that simple re-attachment wasn't possible. So they had to do a more complicated 'composite graft' operation. The final picture shows the boy pissing normally from a good-looking repaired penis three weeks later. But it would have saved the parents a lot of money, and the little boy a lot of trauma, if they had got him a hospital circumcision in the first place.

The paper is open access in Urology Case Reports. Thanks again to BM and his weekly publicatiion list from the Circumcision Academy of Australia.

31st March 2026. "Surprising male G-spot found in most detailed study of the penis yet"

That is the headline to a piece by Alice Klein in the latest New Scientist. The 'spot' is the area under the frenulum and it's hardly new - almoost all men and most women will be well aware of how sensitive it is. The 'most detailed study' is a paper by Alfonso Cepeda-Emiliani and colleagues at Santiago de Compostela in Spain and while it does indeed focus on this area they are not remotely claiming that this is new, just more detailed. As they state (but Klein doesn't) the dense concentration of nerve endings in this region was first shown 40 years ago in a paper by Halata and Munger. And as for a G-spot (they make no such claim) - hardly! (Anatomically the G-spot seems to correspond to the prostate gland).

The New Scientist article is online at New Scientist but may require payment to read in full. Or you can buy the magazine at your newsagent. Cepeda-Emiliani's paper 'The Sensory Penis' is open access at Andrology. But be warned it is vehemently anti-circumcision, quoting heavily the totally discredited work of Cold and Taylor. Thanks to reader TAC for the story.

25th March 2026. "When zippers attack"

The subtitle is "the first documented case of penile zipper entrapment requiring emergency circumcision in a resource-limited setting". A 10-year old Ethiopian boy, dressing in a hurry and not wearing underpants, got 4cm of the upper part of his forekin caught in the zipper of his jeans. His parents took him to the University Hospital in the town of Gondar, where attempts to free the skin were unsuccessful, so they cut off the trapped skin and then completed a circumcision. They still could not remove the trapped skn from the zipper!

The penis trapped	The skin still stuck in the zip	Circumcised

The moral seems to be that if you are going to wear western jeans you should also wear western underpants! The paper, by Kinfemicheal Tilahun Yigzaw and colleagues, is open access at BMC Pediatrics. Thanks again to BM for the link.

18th March 2026. How do you reconstruct an eyelid?

A 55-year-old man in Shanxi, China, lost one lower eyelid in an acccident. In the past, techniques to reconstruct an eyelid have not been very successful. Skin from the face will make the outer layer, but what can you use for the delicate, moist inner layer? The Shanxi surgeons had a novel idea - they circumcised the man and used inner foreskin skin for the inner layer of the eyelid. A year later, the result is still good - the eyelid works and is adquately lubricated.

11th March 2026. Penile cancer rates double in Australia.

The Sydney Morning Herald on March 7 ran an article "I don't feel like a man any more" about a man who had his penis amputated because of cancer.

The chilling facts behind this are shown in the accompanying graph. Since 2005 the rate of penile cancer has doubled in Australia. Penile cancer typically only affects older men, and absolutely only uncircumcised men. The newborn circumcision rate fell from around 90% to less than 20% between 1960 and 1980, so men born in 1975 are now over 50 - and suffering the consequences of stupid medical fashion. The story in the Sydney Morning Herald requires payment (but not much compared to academic journals). Thanks to BM for the link.

4th March 2026. Democratic Republic of the Congo.

As we see regularly, circumcisiion is seen as an important intervention for combating HIV in Africa. This study (carried out in 2014 but only just published), looked at circumcision status in the Democratic Republic of Congo. The male circumcision rate there is over 97% and the operation is typically carried out between ages 2 and 3. This seems prety ideal for HIV prevention but the authors note that this was not on the mothers' minds - to them it was a cultural issue. Nevertheless, it will work.

The paper - Vanessa Dochynets et al, Afr J Reprod Health 2026 Mar 2;30(4):131-137 has an abstract available at PubMed and the whole thing is available (select download pdf) at African Journal of Reproductive Health. Thanks to BM for the story.

4th Febuary 2026. Glue vs sutures.

This debate has been going on for a while but now a new Indian study of pre-school boys has been published. Only 50 boys, randomly assigned into suture or glue wound closure. Tissue glue won out handsomely, with fewer complications, fewer infectons, and better cosmetic outcome. And, of course no need to remove sutures which must be a plus for both hospital and patient.

The paper, by Soni and colleagues in Karnataka, is in Bioinformation, 21(10):3755–3759, and open access at PubMed Central. Thanks to BM for the link.

15th January 2026. Rwanda's circumcision rate quadruples.

Rwanda is one of many African countries which have initiated programmes of voluntary medical male circumcision (VMMC) to combat the HIV epidemic. A team led by Theogene Kubahoniyesu at the University of Rwanda has now analysed data from the government's Rwanda Demographic and Health Surveys to see how well it is working. "The prevalence of male circumcision among Rwandan men increased from 13.3% in 2010 to 30.6% in 2015 and further to 52.4% in 2020." That is, it almost quadrupled in 20 years. VMMC programmes in other African countries have been stalling, so this is pretty good news.

To be effective in HIV prevention circumcision needs to happen before first intercourse, and the median age for circumcision in the three surveys varied between 15 and 17. Most men reported first intercourse between age 15 and 24, which is a pretty wide band, and the median age was given as 22.4, whch seems improbably high. Maybe married men didn't want to admit to intercourse before marriage.

The English is a bit quaint - 'hazard' is used for 'likelihood' but the paper is still a preprint. Read the abstract at PubMed. The full paper is open access at AIDS Research and Therapy, but you have to download the pdf. Thanks to BM for the link.

5th January 2026. Following flood disaster in Aceh, UMY offers free circumcision.

Disastrous floods in the Aceh province of Indonesia have left many people homeless and destitute. Aceh, in Sumatra, is the most solidly Muslim province of Indonesia and as part of the humanitarian relief effort Universitas Muhammadiyah Yogyakarta (UMY) provided a free circumcision service for children in late December. The school holiday is the favourite time for this, giving the boys time to recover before school resumes. Without this initiative many would have missed out since medical facilities were destroyed, and families had no money. A morale booster more than an essential service, maybe, but morale boosting was sorely needed. Read the story at the UMY website. Thanks to regular Indonesian contributor AT for the story.

3rd January 2026. Baby dies after Islamic circumcision in England

Somehow the New Year always seems to start with bad news. 6-month-old Mohamed Abdisamad was circumcised on 12 February 2023, by a circumciser who had been recommended to his parents. At first he seemed fine but then became ill and was taken to Hillingdon Hospital in west London, where he died the same day. The cause was a Streptococcus infection. The inquest ended in October, but on 28th December Assistant Coroner Anton van Dellen issued a report calling for regulation of circumcisers. While not disagreeing with that one must note that if the NHS provided circumcision the problem would not occur. It would also save the cash-strapped NHS millioms of pounds currently spent on treating diseases which circumcision would have prevented.

The case was reported by the BBC and the Telegraph (and others). All the reports show photos of Hillingdon Hospital, as if it were to blame rather than having tried to save the boy's life. The name of the circumciser is not given so the case is presumably sub judice. Thanks to regular correspondent AK and new correspondent Alan for the news.

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