Deciding About Circumcision

WHAT IS CIRCUMCISION?

ExitCare ImageA boy is born with a sleeve of skin (foreskin), with a lining of mucous membrane, that covers the head of the penis. At birth, the foreskin is attached to the head of the penis. The foreskin can be removed shortly after birth by surgery (circumcision), or it may be left on. If left on, the foreskin separates from the head of the penis and can be pulled back when the child is about 3 years of age. Circumcision is a surgical procedure to remove the foreskin. The following information will help you to decide whether circumcision is the correct choice for your baby.

WHEN IS CIRCUMCISION DONE?

Circumcision is most often done in the first few days of life. It can also be done later; however, when the child is out of the newborn period, circumcision requires anesthesia and costs more. If a baby is born early (premature) or is ill, circumcision should not be done until he is older or stronger. Circumcision should not be done in some instances of deformity of the penis or deformity of the opening of the penis (urethra).

WHO DOES THE CIRCUMCISION?

A circumcision may be done by physicians involved in newborn care. If the circumcision is done when the boy is older, it is usually done by a doctor who cares for the urinary tract (urologist). Your caregiver can discuss the procedure with you and answer questions.

YOUR OPTIONS

There are reasons for and against circumcision. Caregiver's opinions vary. The choice is a personal one and may be based on religious, social, or cultural beliefs. Parents may want their son to be like his father or like other boys. In the end, it is your decision.

ARGUMENTS FOR CIRCUMCISION

  • The head of the penis is easier to wash when the foreskin is removed. This makes odor, swelling, and infection less likely.

  • When the foreskin is removed, it cannot get pulled back and trapped behind the head of the penis.

  • Some studies show that circumcised men are less likely to carry the virus for genital warts (human papillomavirus). This virus can cause cancer of the cervix in women.

  • Some studies also suggest that circumcised men have a slightly lower risk of getting other sexually transmitted diseases (STDs), such as syphilis, human immunodeficiency virus (HIV), or gonorrhea.

  • Circumcised men almost never develop cancer of the penis. Some studies suggest this is because the circumcised penis is easier to keep clean.

  • Circumcision may reduce the risk of getting urinary infections. Studies show that germs (bacteria) are not as likely to get into the urinary tract if the foreskin is removed.

ARGUMENTS AGAINST CIRCUMCISION

  • The penis can easily be washed by pulling back the foreskin. Note that in the first 3 years or more, the foreskin should not be pulled back. When the penis is washed daily, odor, swelling, and infection are not likely to occur.

  • The chance of the foreskin ever getting trapped behind the head of the penis is very slight.

  • Some research shows that uncircumcised men are no more likely to get STDs than circumcised men are. Limiting the number of sexual partners and using a condom play the biggest role in preventing STDs.

  • Some research questions the link between men who are uncircumcised and cancer of the cervix in women.

  • Cancer of the penis is very rare, and it may be more closely linked to not washing the penis than to being uncircumcised.

  • Circumcision has risks. The penis may become infected or bleed. Too little or too much foreskin may be removed. The urinary opening may get irritated and narrowed. Scarring of the penis may occur.

  • The procedure is painful for the infant. Local anesthesia should be used to avoid the pain.

It is up to you to decide about having your baby circumcised. There is no right or wrong choice. Your son can lead an active, healthy childhood and adult life regardless of your decision.