Circumcision

Circumcision



How do I decide about circumcision?

Deciding whether to have your newborn son circumcised may be difficult. You will need to consider both the benefits and the risks of circumcision. Other factors, such as your culture, religion and personal preference, will also affect your decision.

The information about circumcision in this handout may help you make your decision. After you have read the handout, talk with your doctor about any concerns you have. The decision about whether to have your son circumcised should be made before your baby is born.

What is circumcision?

During a circumcision, the prepuce or the foreskin, which is the skin that covers the tip of the penis, is removed. Circumcision is usually performed on the first or second day after birth. It becomes more complicated and riskier in infants older than 2 months and in boys and men. The procedure takes only about 5 to 10 minutes. A local anesthetic (numbing medicine) can be given to your baby to lessen the pain from the procedure.


Are there any benefits from circumcision?

Studies about the benefits of circumcision have provided conflicting results. Some studies show certain benefits, while other studies do not. The American Academy of Pediatrics (AAP) says the benefits of circumcision are not significant enough to recommend circumcision as a routine procedure and that circumcision is not medically necessary. The American Academy of Family Physicians believes parents should discuss with their son's doctor the potential benefits and the risks involved when making their decision.

A recent AAP report stated that circumcision does offer some benefit in preventing urinary tract infections in infants. Circumcision also offers some benefit in preventing penile cancer in adult men. However, this disease is very rare in all men, whether or not they have been circumcised. Circumcision may reduce the risk of sexually transmitted diseases. A man's sexual practices (e.g., if he uses condoms, if he has more than one partner, etc.) has more to do with STD prevention than whether or not he is circumcised.

Study results are mixed about whether circumcision may help reduce the risk of cervical cancer in female sex partners, and whether it helps prevent certain problems with the penis, such as infections and unwanted swelling. Some studies show that keeping the penis clean can help prevent these problems just as well as circumcision. Infections and unwanted swelling are not serious and can usually be easily treated if they do occur.

What are the risks of circumcision?

Like any surgical procedure, circumcision has some risks. However, the rate of problems after circumcision is low. Bleeding and infection in the circumcised area are the most common problems. Sometimes the skin of the newly exposed glans becomes irritated by the pressure of diapers and ammonia in the urine. The irritation is usually treated with petroleum ointment (Vaseline) put directly on the area. This problem will usually lessen after a few days.

How do I care for my baby's penis after a circumcision?

Gently clean the area with water every day and whenever the diaper area becomes soiled. Some swelling of the penis is normal after a circumcision. A clear crust will probably form over the area. It normally takes 7 to 10 days for the penis to heal after a circumcision.

After the circumcision, you may notice a small amount of blood on the baby's diaper. If the bloodstain is larger than the size of a quarter, call your doctor right away. In addition, you should call your doctor if a Plastibell device was used during the circumcision and the device doesn't fall off within 10 to 12 days. If there is a bandage on the penis instead of a Plastibell, the bandage should be changed each time you change your son's diaper. This will help prevent infection. Signs of infection also signal the need to call your doctor. These signs include a temperature of 100.4°F or higher, redness, swelling and/or a yellowish discharge.

When to call your doctor

• If the wound does not stop bleeding.
  
• If your son does not have a wet diaper within 6 to 8 hours after the circumcision.
  
• If the redness and swelling around the tip of the penis do not go away or get worse after 3 to 5 days.
  
• If there is a yellow discharge or coating around the tip of the penis after 7 days.
  
• If the Plastibell device does not fall off within 10 to 12 days.
  
  How do I care for my baby's penis if I choose not to have him circumcised?
  
  Simply keeping the penis clean with soap and water helps reduce the risk of problems or infections.
  
  In older boys and adult men, the foreskin slides back and forth over the penis, allowing the area underneath to be cleaned. The foreskin doesn't retract in boys for a few years. Don't try to force the foreskin to retract, because this can damage the penis and cause problems. When the foreskin is ready to retract, you can teach your son how to retract it himself and clean the skin underneath. He should wash his foreskin every day while bathing.