Trends in pediatric circumcision in Belgium and the Brussels University Hospital from



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Trends in pediatric circumcision in Belgium and the Brussels University Hospital from

1994 to 2012



FACULTY OF MEDICINE AND FARMACY



Trends in pediatric circumcision in Belgium and the Brussels University Hospital from 1994 to 2012


A thesis submitted in partial fulfillment of the requirements for the degree of Master of Medicine


Dana Van Gassen

Academic year: 2012 - 2013


Promoter: Dr. Veerle De Boe



Table of Contents


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





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