Table of Contents 1
List of figures and tables 3
Abstract 4
Introduction 5
History of male circumcision 5
Potential benefits of male circumcision 6
Prevention of urinary tract infections 7
Prevention of sexually transmitted infections (STIs) 7
Prevention of penile cancer 8
Prevention of cervical cancer 8
Prevention of penile problems including phimosis 9
Potential disadvantages of male circumcision 9
Indications for pediatric circumcision 10
Phimosis 10
Balanoposthitis 11
Preventive health benefits 11
Religious and cultural motives 12
Social determinants 13
Trends in pediatric circumcision 13
Trends in the United States of America 13
Trends in Australia and New Zeeland 15
Trends in Europe 16
Objective of the study 20
Methods 21
Trends in pediatric circumcision in the Brussels University Hospital 21
Objective of the study 21
Patients included 21
Material and methods 21
Statistical analysis 22
Trends in pediatric circumcision in Belgium 23
Objective of the study 23
Patients included 23
Material and methods 23
Statistical analysis 24
Results 25
Trends in pediatric circumcision in the Brussels University Hospital 25
Trends in pediatric circumcision in Belgium 30
Discussion 35
Shortcomings of the study 39
Trends in pediatric circumcision in the Brussels University Hospital 39
Trends in pediatric circumcision in Belgium 40
Conclusion 42
Attachments 43
Attachment 1: Permission of the Ethical Comitee of the Brussels University Hospital to perform this study 43
Attachment 2: Estimating the 2008 catchment area of the Brussels University Hospital 44
Data of the Brussels Capital Region 44
Data of Flanders 45
Estimating the 2008 catchment area of the Brussels University Hospital using the Norris-Bailey proportionate flow method 46
Attachment 3: Estimating the yearly total number of circumcisions in Belgium of boys aged 0 to 15 years from 2002 to 2005 48
References 50