World Journal of Urology

, Volume 30, Issue 1, pp 3–13 | Cite as

Male circumcision and HIV infection risk

  • John N. KriegerEmail author
Topic Paper



Male circumcision is being promoted to reduce human immunodeficiency virus type 1 (HIV) infection rates. This review evaluates the scientific evidence suggesting that male circumcision reduces HIV infection risk in high-risk heterosexual populations.


We followed the updated International Consultation on Urological Diseases evidence-based medicine recommendations to critically review the scientific evidence on male circumcision and HIV infection risk.


Level 1 evidence supports the concept that male circumcision substantially reduces the risk of HIV infection. Three major lines of evidence support this conclusion: biological data suggesting that this concept is plausible, data from observational studies supported by high-quality meta-analyses, and three randomized clinical trials supported by high-quality meta-analyses.


The evidence from these biological studies, observational studies, randomized controlled clinical trials, meta-analyses, and cost-effectiveness studies is conclusive. The challenges to implementation of male circumcision as a public health measure in high-risk populations must now be faced.


Male circumcision HIV infection Risk Complications 


Conflict of interest

The author declares that he has no conflict of interest.


  1. 1.
    Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 trial. PLoS Med 2(11):e298PubMedCrossRefGoogle Scholar
  2. 2.
    Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, Williams CF, Campbell RT, Ndinya-Achola JO (2007) Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 369(9562):643–656PubMedCrossRefGoogle Scholar
  3. 3.
    Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, Kiwanuka N, Moulton LH, Chaudhary MA, Chen MZ, Sewankambo NK, Wabwire-Mangen F, Bacon MC, Williams CF, Opendi P, Reynolds SJ, Laeyendecker O, Quinn TC, Wawer MJ (2007) Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 369(9562):657–666PubMedCrossRefGoogle Scholar
  4. 4.
    Krieger JN (2010) Male circumcision and HIV infection risk. In: Naber KG, Schaeffer AJ, Heyns CF, Matsumoto T, Shoskes DA, Bjerklund Johansen TE (eds) Urogenital infections. European Association of Urology, Arnheim, pp 847–859Google Scholar
  5. 5.
    Weiss HA, Quigley MA, Hayes RJ (2000) Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis. Aids 14(15):2361–2370PubMedCrossRefGoogle Scholar
  6. 6.
    Siegfried N, Muller M, Volmink J, Deeks J, Egger M, Low N, Weiss H, Walker S, Williamson P (2003) Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev (3):CD003362Google Scholar
  7. 7.
    Price LB, Liu CM, Johnson KE, Aziz M, Lau MK, Bowers J, Ravel J, Keim PS, Serwadda D, Wawer MJ, Gray RH (2010) The effects of circumcision on the penis microbiome. PLoS One 5(1):e8422. doi: 10.1371/journal.pone.0008422
  8. 8.
    Patterson BK, Landay A, Siegel JN, Flener Z, Pessis D, Chaviano A, Bailey RC (2002) Susceptibility to human immunodeficiency virus-1 infection of human foreskin and cervical tissue grown in explant culture. Am J Pathol 161(3):867–873PubMedCrossRefGoogle Scholar
  9. 9.
    Soilleux EJ, Coleman N (2004) Expression of DC-SIGN in human foreskin may facilitate sexual transmission of HIV. J Clin Pathol 57(1):77–78PubMedCrossRefGoogle Scholar
  10. 10.
    McCoombe SG, Short RV (2006) Potential HIV-1 target cells in the human penis. Aids 20(11):1491–1495PubMedCrossRefGoogle Scholar
  11. 11.
    Fink AJ (1986) A possible explanation for heterosexual male infection with AIDS. N Engl J Med 315:1167PubMedGoogle Scholar
  12. 12.
    Moses S, Nagelkerke NJ, Blanchard J (1999) Analysis of the scientific literature on male circumcision and risk for HIV infection. Int J STD AIDS 10(9):626–628PubMedCrossRefGoogle Scholar
  13. 13.
    Drain PK, Halperin DT, Hughes JP, Klausner JD, Bailey RC (2006) Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. BMC Infect Dis 6:172PubMedCrossRefGoogle Scholar
  14. 14.
    Siegfried N (2005) Does male circumcision prevent HIV infection? PLoS Med 2(11):e393PubMedCrossRefGoogle Scholar
  15. 15.
    Weiss HA, Halpernr D, Bailey RC, Hayes RJ, Schmid G, Hankins C (2008) Male circumcision for HIV prevention: from evidence to action? AIDS 22(5):567–574PubMedCrossRefGoogle Scholar
  16. 16.
    Krieger JN, Bailey RC, Opeya J, Ayieko B, Opiyo F, Agot K, Parker C, Ndinya-Achola JO, Magoha GA, Moses S (2005) Adult male circumcision: results of a standardized procedure in Kisumu District, Kenya. BJU Int 96(7):1109–1113PubMedCrossRefGoogle Scholar
  17. 17.
    Krieger JN, Bailey RC, Opeya JC, Ayieko BO, Opiyo FA, Omondi D, Agot K, Parker C, Ndinya-Achola JO, Moses S (2007) Adult male circumcision outcomes: experience in a developing country setting. Urol Int 78(3):235–240PubMedCrossRefGoogle Scholar
  18. 18.
    Kahn JG, Marseille E, Auvert B (2006) Cost-effectiveness of male circumcision for HIV prevention in a South African setting. PLoS Med 3(12):e517PubMedCrossRefGoogle Scholar
  19. 19.
    Gray RH, Li X, Kigozi G, Serwadda D, Nalugoda F, Watya S, Reynolds SJ, Wawer M (2007) The impact of male circumcision on HIV incidence and cost per infection prevented: a stochastic simulation model from Rakai, Uganda. Aids 21(7):845–850PubMedCrossRefGoogle Scholar
  20. 20.
    Mehta SD, Gray RH, Auvert B, Moses S, Kigozi G, Taljaard D, Puren A, Agot K, Serwadda D, Parker CB, Wawer MJ, Bailey RC (2009) Does sex in the early period after circumcision increase HIV-seroconversion risk? Pooled analysis of adult male circumcision clinical trials. AIDS 23(12):1557–1564. doi: 10.1097/QAD.0b013e32832afe95 PubMedCrossRefGoogle Scholar
  21. 21.
    Van Howe RS (1999) Circumcision and HIV infection: review of the literature and meta-analysis. Int J STD AIDS 10(1):8–16PubMedCrossRefGoogle Scholar
  22. 22.
    O’Farrell N, Egger M (2000) Circumcision in men and the prevention of HIV infection: a ‘meta-analysis’ revisited. Int J STD AIDS 11(3):137–142PubMedCrossRefGoogle Scholar
  23. 23.
    Siegfried N, Muller M, Deeks JJ, Volmink J (2009) Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev (2):CD003362. doi: 10.1002/14651858.CD003362.pub2
  24. 24.
    Desai K, Boily MC, Garnett GP, Masse BR, Moses S, Bailey RC (2006) The role of sexually transmitted infections in male circumcision effectiveness against HIV–insights from clinical trial simulation. Emerg Themes Epidemiol 3:19PubMedCrossRefGoogle Scholar
  25. 25.
    Williams BG, Lloyd-Smith JO, Gouws E, Hankins C, Getz WM, Hargrove J, de Zoysa I, Dye C, Auvert B (2006) The potential impact of male circumcision on HIV in Sub-Saharan Africa. PLoS Med 3(7):e262PubMedCrossRefGoogle Scholar
  26. 26.
    Orroth KK, Freeman EE, Bakker R, Buve A, Glynn JR, Boily MC, White RG, Habbema JD, Hayes RJ (2007) Understanding the differences between contrasting HIV epidemics in east and west Africa: results from a simulation model of the Four Cities Study. Sex Transm Infect 83(Suppl 1):15–16Google Scholar
  27. 27.
    Hallett TB, Singh K, Smith JA, White RG, Abu-Raddad LJ, Garnett GP (2008) Understanding the impact of male circumcision interventions on the spread of HIV in southern Africa. PLoS ONE 3(5):e2212PubMedCrossRefGoogle Scholar
  28. 28.
    Londish GJ, Murray JM (2008) Significant reduction in HIV prevalence according to male circumcision intervention in sub-Saharan Africa. Int J Epidemiol 37(6):1246–1253Google Scholar
  29. 29.
    Bollinger LA, Stover J, Musuka G, Fidzani B, Moeti T, Busang L (2009) The cost and impact of male circumcision on HIV/AIDS in Botswana. J Int AIDS Soc 12(1):7. doi: 10.1186/1758-2652-12-7 PubMedCrossRefGoogle Scholar
  30. 30.
    Andersson KM, Owens DK, Paltiel AD (2010) Scaling up circumcision programs in Southern Africa: the potential impact of gender disparities and changes in condom use behaviors on heterosexual HIV transmission. AIDS Behav. doi: 10.1007/s10461-010-9784-y
  31. 31.
    Gebremedhin S (2010) Assessment of the protective effect of male circumcision from HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in sub-Saharan Africa. Afr J Reprod Health 14(2):105–113PubMedGoogle Scholar
  32. 32.
    Kelly R, Kiwanuka N, Wawer MJ, Serwadda D, Sewankambo NK, Wabwire-Mangen F, Li C, Konde-Lule JK, Lutalo T, Makumbi F, Gray RH (1999) Age of male circumcision and risk of prevalent HIV infection in rural Uganda. Aids 13(3):399–405PubMedCrossRefGoogle Scholar
  33. 33.
    Quinn TC, Wawer MJ, Sewankambo N, Serwadda D, Li C, Wabwire-Mangen F, Meehan MO, Lutalo T, Gray RH (2000) Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med 342(13):921–929Google Scholar
  34. 34.
    Reynolds SJ, Shepherd ME, Risbud AR, Gangakhedkar RR, Brookmeyer RS, Divekar AD, Mehendale SM, Bollinger RC (2004) Male circumcision and risk of HIV-1 and other sexually transmitted infections in India. Lancet 363(9414):1039–1040PubMedCrossRefGoogle Scholar
  35. 35.
    Meier AS, Bukusi EA, Cohen CR, Holmes KK (2006) Independent association of hygiene, socioeconomic status, and circumcision with reduced risk of HIV infection among Kenyan men. J Acquir Immune Defic Syndr 43(1):117–118PubMedCrossRefGoogle Scholar
  36. 36.
    Shaffer DN, Bautista CT, Sateren WB, Sawe FK, Kiplangat SC, Miruka AO, Renzullo PO, Scott PT, Robb ML, Michael NL, Birx DL (2007) The protective effect of circumcision on HIV incidence in rural low-risk men circumcised predominantly by traditional circumcisers in Kenya: two-year follow-up of the Kericho HIV Cohort Study. J Acquir Immune Defic Syndr 45(4):371–379PubMedCrossRefGoogle Scholar
  37. 37.
    Millett GA, Ding H, Lauby J, Flores S, Stueve A, Bingham T, Carballo-Dieguez A, Murrill C, Liu KL, Wheeler D, Liau A, Marks G (2007) Circumcision status and HIV infection among Black and Latino men who have sex with men in 3 US cities. J Acquir Immune Defic Syndr 46(5):643–650PubMedCrossRefGoogle Scholar
  38. 38.
    Auvert B, Buve A, Ferry B, Carael M, Morison L, Lagarde E, Robinson NJ, Kahindo M, Chege J, Rutenberg N, Musonda R, Laourou M, Akam E (2001) Ecological and individual level analysis of risk factors for HIV infection in four urban populations in sub-Saharan Africa with different levels of HIV infection. Aids 15(Suppl 4):S15–S30Google Scholar
  39. 39.
    Auvert B, Buve A, Lagarde E, Kahindo M, Chege J, Rutenberg N, Musonda R, Laourou M, Akam E, Weiss HA (2001) Male circumcision and HIV infection in four cities in sub-Saharan Africa. Aids 15(Suppl 4):S31–S40Google Scholar
  40. 40.
    MacDonald KS, Malonza I, Chen DK, Nagelkerke NJ, Nasio JM, Ndinya-Achola J, Bwayo JJ, Sitar DS, Aoki FY, Plummer FA (2001) Vitamin A and risk of HIV-1 seroconversion among Kenyan men with genital ulcers. Aids 15(5):635–639PubMedCrossRefGoogle Scholar
  41. 41.
    Gray R, Azire J, Serwadda D, Kiwanuka N, Kigozi G, Kiddugavu M, Nalugoda F, Li X, Wawer M (2004) Male circumcision and the risk of sexually transmitted infections and HIV in Rakai, Uganda. Aids 18(18):2428–2430PubMedGoogle Scholar
  42. 42.
    Agot KE, Ndinya-Achola JO, Kreiss JK, Weiss NS (2004) Risk of HIV-1 in rural Kenya: a comparison of circumcised and uncircumcised men. Epidemiology 15(2):157–163PubMedCrossRefGoogle Scholar
  43. 43.
    Jewkes R, Dunkle K, Nduna M, Levin J, Jama N, Khuzwayo N, Koss M, Puren A, Duvvury N (2006) Factors associated with HIV sero-positivity in young, rural South African men. Int J Epidemiol 35(6):1455–1460PubMedCrossRefGoogle Scholar
  44. 44.
    Kapiga SH, Sam NE, Mlay J, Aboud S, Ballard RC, Shao JF, Larsen U (2006) The epidemiology of HIV-1 infection in northern Tanzania: results from a community-based study. AIDS Care 18(4):379–387PubMedCrossRefGoogle Scholar
  45. 45.
    Johnson K, Way A (2006) Risk factors for HIV infection in a national adult population: evidence from the 2003 Kenya Demographic and Health Survey. J Acquir Immune Defic Syndr 42(5):627–636PubMedCrossRefGoogle Scholar
  46. 46.
    Talukdar A, Khandokar MR, Bandopadhyay SK, Detels R (2007) Risk of HIV infection but not other sexually transmitted diseases is lower among homeless Muslim men in Kolkata. Aids 21(16):2231–2235PubMedCrossRefGoogle Scholar
  47. 47.
    Mishra V, Assche SB, Greener R, Vaessen M, Hong R, Ghys PD, Boerma JT, Van Assche A, Khan S, Rutstein S (2007) HIV infection does not disproportionately affect the poorer in sub-Saharan Africa. Aids 21(Suppl 7):S17–S28Google Scholar
  48. 48.
    Klavs I, Hamers FF (2008) Male circumcision in Slovenia: results from a national probability sample survey. Sex Transm Infect 84(1):49–50PubMedCrossRefGoogle Scholar
  49. 49.
    Foglia G, Sateren WB, Renzullo PO, Bautista CT, Langat L, Wasunna MK, Singer DE, Scott PT, Robb ML, Birx DL (2008) High prevalence of HIV infection among rural tea plantation residents in Kericho, Kenya. Epidemiol Infect 136(5):694–702PubMedCrossRefGoogle Scholar
  50. 50.
    Mermin J, Musinguzi J, Opio A, Kirungi W, Ekwaru J, Hladik W, Kaharuza F, Downing R, Bunnell R (2008) Risk factors for recent HIV Infection in Uganda. JAMA 300(5):540–549PubMedCrossRefGoogle Scholar
  51. 51.
    Halperin DT, Fritz K, McFarland W, Woelk G (2005) Acceptability of adult male circumcision for sexually transmitted disease and HIV prevention in Zimbabwe. Sex Transm Dis 32(4):238–239PubMedCrossRefGoogle Scholar
  52. 52.
    Buchbinder SP, Vittinghoff E, Heagerty PJ, Celum CL, Seage GR 3rd, Judson FN, McKirnan D, Mayer KH, Koblin BA (2005) Sexual risk, nitrite inhalant use, and lack of circumcision associated with HIV seroconversion in men who have sex with men in the United States. J Acquir Immune Defic Syndr 39(1):82–89PubMedCrossRefGoogle Scholar
  53. 53.
    Warner L, Ghanem KG, Newman DR, Macaluso M, Sullivan PS, Erbelding EJ (2009) Male circumcision and risk of HIV infection among heterosexual African American men attending Baltimore sexually transmitted disease clinics. J Infect Dis 199(1):59–65. doi: 10.1086/595569 PubMedCrossRefGoogle Scholar
  54. 54.
    Halperin DT, Bailey RC (1999) Male circumcision and HIV infection: 10 years and counting. Lancet 354(9192):1813–1815PubMedCrossRefGoogle Scholar
  55. 55.
    Green EC (2000) Male circumcision and HIV infection. Lancet 355(9207):927PubMedCrossRefGoogle Scholar
  56. 56.
    Szabo R, Short RV (2000) How does male circumcision protect against HIV infection? Bmj 320(7249):1592–1594PubMedCrossRefGoogle Scholar
  57. 57.
    Quigley MA, Weiss HA, Hayes RJ (2001) Male circumcision as a measure to control HIV infection and other sexually transmitted diseases. Curr Opin Infect Dis 14(1):71–75PubMedCrossRefGoogle Scholar
  58. 58.
    Lerman SE, Liao JC (2001) Neonatal circumcision. Pediatr Clin North Am 48(6):1539–1557PubMedCrossRefGoogle Scholar
  59. 59.
    Shapiro RL (2002) Drawing lines in the sand: the boundaries of the HIV pandemic in perspective. Soc Sci Med 55(12):2189–2191PubMedCrossRefGoogle Scholar
  60. 60.
    Gisselquist D, Potterat JJ, Brody S (2004) Running on empty: sexual co-factors are insufficient to fuel Africa’s turbocharged HIV epidemic. Int J STD AIDS 15(7):442–452PubMedCrossRefGoogle Scholar
  61. 61.
    Sahasrabuddhe VV, Vermund SH (2007) The future of HIV prevention: control of sexually transmitted infections and circumcision interventions. Infect Dis Clin North Am 21(1):241–257 (xi)Google Scholar
  62. 62.
    Short RV (2004) The HIV/AIDS pandemic: new ways of preventing infection in men. Reprod Fertil Dev 16(5):555–559PubMedCrossRefGoogle Scholar
  63. 63.
    Short RV (2006) New ways of preventing HIV infection: thinking simply, simply thinking. Philos Trans R Soc Lond B Biol Sci 361(1469):811–820PubMedCrossRefGoogle Scholar
  64. 64.
    Nyindo M (2005) Complementary factors contributing to the rapid spread of HIV-I in sub-Saharan Africa: a review. East Afr Med J 82(1):40–46PubMedGoogle Scholar
  65. 65.
    Inungu J, MaloneBeach E, Betts J (2005) Male circumcision and the risk of HIV infection. AIDS Read 15(3):130–131 (135, 138)Google Scholar
  66. 66.
    Jones R, Gazzard B, Halima Y (2005) Preventing HIV infection. Bmj 331(7528):1285–1286PubMedCrossRefGoogle Scholar
  67. 67.
    Flynn P, Havens P, Brady M, Emmanuel P, Read J, Hoyt L, Henry-Reid L, Van Dyke R, Mofenson L (2007) Male circumcision for prevention of HIV and other sexually transmitted diseases. Pediatrics 119(4):821–822PubMedCrossRefGoogle Scholar
  68. 68.
    Van Howe RS, Svoboda JS, Hodges FM (2005) HIV infection and circumcision: cutting through the hyperbole. J R Soc Health 125(6):259–265CrossRefGoogle Scholar
  69. 69.
    Auerbach JD, Hayes RJ, Kandathil SM (2006) Overview of effective and promising interventions to prevent HIV infection. World Health Organ Tech Rep Ser 938:43–78 (discussion 317–341)Google Scholar
  70. 70.
    Chan DJ (2006) Fatal attraction: sex, sexually transmitted infections and HIV-1. Int J STD AIDS 17(10):643–651PubMedCrossRefGoogle Scholar
  71. 71.
    Mboto CI, Davies A, Fielder M, Jewell AP (2006) Human immunodeficiency virus and hepatitis C co-infection in sub-Saharan West Africa. Br J Biomed Sci 63(1):29–37PubMedGoogle Scholar
  72. 72.
    Isiugo-Abanihe UC (2006) Sociocultural aspects of HIV/AIDS infection in Nigeria. Afr J Med Sci 35(Suppl):45–55Google Scholar
  73. 73.
    Weiss HA (2007) Male circumcision as a preventive measure against HIV and other sexually transmitted diseases. Curr Opin Infect Dis 20(1):66–72PubMedCrossRefGoogle Scholar
  74. 74.
    Sawires SR, Dworkin SL, Fiamma A, Peacock D, Szekeres G, Coates TJ (2007) Male circumcision and HIV/AIDS: challenges and opportunities. Lancet 369(9562):708–713PubMedCrossRefGoogle Scholar
  75. 75.
    Schenker I, Gross E (2007) [Male circumcision and HIV/AIDS: convincing evidence and their implication for the state of Israel]. Harefuah 146(12):957–963 (997)Google Scholar
  76. 76.
    Sharp M (2007) 14th annual retrovirus conference (CROI). HIV prevention update. Some bad news, some good news. Posit Aware 18(3):26–27Google Scholar
  77. 77.
    Quinn TC (2007) Circumcision and HIV transmission. Curr Opin Infect Dis 20(1):33–38PubMedCrossRefGoogle Scholar
  78. 78.
    Schoen EJ (2007) Should newborns be circumcised? Yes. Can Fam Physician 53(12):2096–2098 (2100–2092)Google Scholar
  79. 79.
    Clark PA, Eisenman J, Szapor S (2007) Mandatory neonatal male circumcision in Sub-Saharan Africa: medical and ethical analysis. Med Sci Monit 13(12):RA205–RA213Google Scholar
  80. 80.
    Clark S (2000) Male circumcision could help protect against HIV infection. Lancet 356(9225):225PubMedCrossRefGoogle Scholar
  81. 81.
    Morris BJ (2007) Why circumcision is a biomedical imperative for the 21(st) century. Bioessays 29(11):1147–1158PubMedCrossRefGoogle Scholar
  82. 82.
    Mor Z, Kent CK, Kohn RP, Klausner JD (2007) Declining rates in male circumcision amidst increasing evidence of its public health benefit. PLoS ONE 2(9):e861PubMedCrossRefGoogle Scholar
  83. 83.
    Jayasuriya A, Robertson C, Allan PS (2007) Twenty-five years of HIV management. J R Soc Med 100(8):363–366PubMedCrossRefGoogle Scholar
  84. 84.
    Landovitz RJ (2007) Recent efforts in biomedical prevention of HIV. Top HIV Med 15(3):99–103PubMedGoogle Scholar
  85. 85.
    Vardi A, Guy L, Boiteux JP (2008) Circumcision and HIV. Prog Urol 18(6):331–336Google Scholar
  86. 86.
    Cohen MS, Hellmann N, Levy JA, DeCock K, Lange J (2008) The spread, treatment, and prevention of HIV-1: evolution of a global pandemic. J Clin Invest 118(4):1244–1254PubMedCrossRefGoogle Scholar
  87. 87.
    Gray RH, Wawer MJ, Polis CB, Kigozi G, Serwadda D (2008) Male circumcision and prevention of HIV and sexually transmitted infections. Curr Infect Dis Rep 10(2):121–127PubMedCrossRefGoogle Scholar
  88. 88.
    Potts M, Halperin DT, Kirby D, Swidler A, Marseille E, Klausner JD, Hearst N, Wamai RG, Kahn JG, Walsh J (2008) Public health. Reassessing HIV prevention. Science 320(5877):749–750Google Scholar
  89. 89.
    Fieno JV (2008) Costing adult male circumcision in high HIV prevalence, low circumcision rate countries. AIDS Care 20(5):515–520PubMedCrossRefGoogle Scholar
  90. 90.
    Uthman OA, Popoola TA, Yahaya I, Uthman MM, Aremu O (2011) The cost-utility analysis of adult male circumcision for prevention of heterosexual acquisition of HIV in men in sub-Saharan Africa: a probabilistic decision model. Value Health 14(1):70–79. doi: 10.1016/j.jval.2010.10.011 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Urology, School of MedicineUniversity of WashingtonSeattleUSA

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