Male Circumcision Revisited: A Narrative Review of Techniques, Therapeutic Indications, and Preventive Benefits

Male circumcision (MC) is a common pediatric operation and is undertaken for religious, cultural, therapeutic, and preventive reasons. Over the past two decades, MC has been investigated as a method that may reduce heterosexual acquisition of HIV and other sexually transmitted infections, lower the risk of penile carcinoma, and decrease urinary tract infections in early childhood. This narrative review revisits MC by integrating embryologic and anatomic concepts with contemporary operative techniques, therapeutic indications, and proven preventive benefits across age groups. Conventional open procedures (including dorsal slit, sleeve resection, and forceps-guided circumcision) and device-based methods (such as Plastibell {Caledonia, MI: Aspen Surgical Products, Inc.} and other ring devices) are summarized with emphasis on appropriate anesthesia, perioperative care, and prevention and management of complications. MC is an effective definitive treatment for pathologic phimosis, recurrent balanitis, selected cases of balanitis xerotica obliterans, and recurrent urinary infections, and it may be considered in specific high-risk urologic and dermatologic conditions. Beyond these therapeutic indications, robust data support MC as a durable preventive intervention. When performed by trained providers using standardized techniques, adequate analgesia, and sterile conditions, MC is a safe procedure with predominantly minor, early complications and very low rates of severe adverse events. Ongoing research is needed to refine device selection, expand access in low-resource settings, and clarify long-term functional and sexual outcomes to inform shared decision-making among patients, families, clinicians, and public health policymakers.