The authors reported that eight RCTs were included in the review, but there were eight published papers covering five RCTs (n=11,046 participants). Four RCTs reported using blinded outcome assessors, three reported using opaque sealed envelopes for allocation concealment, and three clearly reported using a power calculation.
Adults (three RCTs, n=10,904 participants): Circumcised sub-Saharan African men had a significantly lower risk of acquiring HIV/AIDS than uncircumcised men (OR 0.44, 95% CI 0.32 to 0.59; I2=0); all three trials were stopped early, with numbers of events ranging from 19 to 22 in the circumcision groups and from 45 to 49 in the delayed circumcision groups. The perioperative adverse event rate across the three trials in participants receiving immediate circumcision was 4.8%; the rate of reported pain was 13.5%. No trials reported penile cancer or urinary tract infection outcomes.
Neonates (two RCT; n=138 neonates): One trial of circumcision, with or without paracetamol use, reported no significant differences in pain during the surgery, but the "percentage of cry" was significantly higher in the placebo group when comparing pre- and post-circumcision crying. No perioperative adverse events were reported in the two trials. No trials assessed clinical efficacy.