ArticleBMC urology2021
Circumcision and its alternatives in Germany: an analysis of nationwide hospital routine data.
Article in BMC urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Practice patterns of paediatric surgeons on treating pilonidal sinus disease - a national survey study.International journal of colorectal disease · 2025Article
- [Development of circumcision rates in Germany since the approval of ritual circumcision : A population-based analysis from 2013 to 2018].Urologie (Heidelberg, Germany) · 2023Article
- Inguinal hernia repair in inpatient children: a nationwide analysis of German administrative data.BMC surgery · 2021Article
- Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany.International journal of colorectal disease · 2021Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background/purposeCircumcisions are among the most frequent operations in children. Health service data on circumcision in the United States has documented an increase in neonatal circumcisions since 2012. We investigated whether a similar effect could be found in Germany, which does not endorse neonatal circumcision.
methodsWe analysed German routine administrative data for operations conducted on the preputium in order to analyse the frequency, age distribution, and time-trends in hospital-based procedures on a nationwide basis.
resultsThere were 9418 [95% confidence interval (CI) 8860-10,029] procedures per year, of which 4977 (95% CI 4676-5337) were circumcisions. Age distributions were highly different between both circumcisions (van der Waerden's χ² = 58.744, df = 4, P < 0.0001) and preputium-preserving operations (van der Waerden's χ² = 58.481, df = 4, P < 0.0001). Circumcisions were more frequent in the first 5 years of life and above 15 years of age, whereas preputium-preserving procedures were preferred in the age groups between 5 and 14 years of age. The number of circumcisions and preputium-preserving operations decreased in absolute and relative numbers.
conclusionsThe increasing trend towards neonatal circumcision observed in the United States is absent in Germany. The majority of patients were operated after the first year of life and absolute and relative numbers of hospital-based procedures were decreasing. Other factors such as increasing use of steroids for the preferred non-operative treatment of phimosis may play a role. As operations in outpatients and office-based procedures were not covered, additional research is necessary to obtain a detailed picture of circumcision and its surgical alternatives in Germany. LEVEL OF EVIDENCE: III.
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