Circumcision is the surgical removal of the skin covering the tip of the penis. Circumcision is fairly common for newborn boys in certain parts of the world, including the United States. Circumcision after the newborn period is possible, but it's a more complicated procedure.
For some families, circumcision is a religious ritual. Circumcision can
also be a matter of family tradition, personal hygiene or preventive health
care. For others, however, circumcision seems unnecessary or disfiguring. After
circumcision, it isn't generally possible to re-create the appearance of an
uncircumcised penis.
Why it's done
Circumcision is a religious or cultural ritual for many Jewish and
Islamic families, as well as certain aboriginal tribes in Africa and Australia.
Circumcision can also be a matter of family tradition, personal hygiene or
preventive health care. Sometimes there's a medical need for circumcision, such
as when the foreskin is too tight to be pulled back (retracted) over the glans.
In other cases, particularly in certain parts of Africa, circumcision is
recommended for older boys or men to reduce the risk of certain sexually
transmitted infections.
The American Academy of Pediatrics (AAP) says the benefits of
circumcision aren't strong enough to recommend routine circumcision for all
male newborns. The AAP leaves the circumcision decision up to parents — and
supports use of anesthetics for infants who have the procedure. Circumcision might have various health benefits, including:
- Easier hygiene. Circumcision makes it simpler to wash the penis. Washing beneath the foreskin of an uncircumcised penis is generally easy, however.
- Decreased risk of urinary tract infections. The overall risk of urinary tract infections in males is low, but these infections might be more common in uncircumcised males. Severe infections early in life can lead to kidney problems later on.
- Prevention of penile problems. Occasionally, the foreskin on an uncircumcised penis can be difficult or impossible to retract (phimosis). This can lead to inflammation of the foreskin or head of the penis.
- Decreased risk of penile cancer. Although cancer of the penis is rare, it's less common in circumcised men. In addition, cervical cancer is less common in the female sexual partners of circumcised men.
- Decreased risk of sexually transmitted infections. Circumcised men might have a lower risk of certain sexually transmitted infections, including HIV. Still, safe sexual practices remain essential.
Circumcision might not be an option if certain blood-clotting disorders
or penis abnormalities are present. In addition, circumcision might not be
appropriate for premature babies who still require medical care in the hospital
nursery.
Circumcision doesn't affect fertility, nor is circumcision generally
thought to enhance or detract from sexual pleasure for men or their partners.
Risks
The most common complications associated with circumcision are bleeding
and infection. Side effects related to anesthesia are possible as well. Rarely,
circumcision might result in foreskin problems. For example:
- The foreskin might be cut too short or too long
- The foreskin might fail to heal properly
- The remaining
foreskin might reattach to the end of the penis, requiring minor surgical
repair
How you prepare
Before circumcision, the doctor will explain the risks and benefits of
the procedure. Whether you're planning to circumcise your son or you're
pursuing circumcision for yourself, you'll likely need to provide written
consent for the procedure.
During the procedure
Newborn circumcision is often done in the hospital nursery, usually
within one to 10 days after birth.
For newborn circumcision, your son will lie on his back with his arms
and legs restrained. After the penis and surrounding area are cleansed, an
anesthetic will be injected into the base of the penis or applied to the penis
as a cream. A special clamp or plastic ring will be attached to the penis, and
the foreskin will be removed. Afterward, the penis will be covered with an
ointment, such as petroleum jelly, and wrapped loosely with gauze. The
procedure generally takes about 10 minutes.
The procedure is similar for older boys and adults, but it might need to
be done under general anesthesia with additional steps to prevent excessive bleeding
or suture the affected area.
After the procedure
It usually takes about seven to 10 days for the penis
to heal. The tip of the penis is likely to be sore at first, and the penis
might look red, swollen or bruised. You might notice a yellow crust on the tip
of the penis as well.
If your newborn is fussy as the anesthetic wears off, hold him gently —
being careful to avoid putting pressure on the penis. If necessary, the doctor
might recommend an over-the-counter pain reliever to help manage pain after the
procedure.
It's OK to wash the penis as it heals. For newborns, change the bandage
with each diaper change, and apply a dab of petroleum jelly to the tip of the
penis to keep it from sticking to the diaper. Change your baby's diaper often,
and make sure the diaper is loosely fastened. If there's a plastic ring instead
of a bandage, it will drop off on its own — usually within about a week. Once
the penis heals, wash it with soap and water during normal bathing.
Problems after circumcision are uncommon. Contact the doctor if:
- Normal urination doesn't resume within 12 hours of the circumcision
- There's persistent bleeding or redness around the tip of the penis
- There's foul-smelling drainage from the tip of the penis
- The plastic ring remains in place two weeks after the circumcision
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