Should I Circumcise my Son?

Q: I am pregnant with a boy. Should I circumcise my son?

A: Circumcision is a surgical procedure in which the skin covering the end of the penis is removed. At birth, boys have skin that covers the end of the penis, called the foreskin. Circumcision surgically removes the foreskin, exposing the tip of the penis. Circumcision is usually performed by a doctor in the first few days of life. An infant must be stable and healthy to safely be circumcised. Because circumcision may be more risky if done later in life, parents should decide before or soon after their son is born if they want it done.

Scientific studies show a number of medical benefits of circumcision. Parents may also want their sons circumcised for religious, social, or cultural reasons. Because circumcision is not essential to a child's health, parents should choose what is best for their child by looking at the benefits and risks.

Circumcision has been practiced as a religious rite for thousands of years. In the United States, most boys are circumcised for religious or social reasons. There is discussion over whether circumcision is advisable from a medical standpoint. There are potential medical benefits to circumcision as well as risks.

A recent analysis by the American Academy of Pediatrics that published in August 2012 concluded that the medical benefits of circumcision outweigh the risks. Studies have concluded that circumcised infants have a slightly lower risk of urinary tract infections, although these are not common in boys and occur less often in circumcised boys mostly in the first year of life. Neonatal circumcision also provides some protection from penile cancer, a very rare condition. Some research also suggests a reduced likelihood of developing sexually transmitted diseases and HIV infections in circumcised men, and possibly a reduced risk for cervical cancer in female partners of circumcised men. Some other medical benefits or circumcision include prevention of foreskin infections, prevention of phimosis, a condition in uncircumcised males that makes foreskin retraction impossible, and easier genital hygiene.

However, while there are potential medical benefits, these data are not sufficient to recommend routine neonatal circumcision of all boys.  It is recommended the decision to circumcise is one best made by parents in consultation with their physician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions and personal beliefs.

If the baby is born prematurely, has an illness at birth, or has congenital abnormalities or blood problems, he should not be circumcised immediately. In fact, circumcision should be performed only on stable, healthy infants.

Complications of circumcision are rare and usually minor but may include bleeding, swelling, infection, cutting the foreskin too short or too long, and improper healing. Circumcision is painful. However, there are pain medicines (local anesthesia) that are safe and effective.

If you choose not to have your son circumcised, talk with your pediatrician about how to keep your son's penis clean. Keep in mind that the foreskin will not fully retract for several years and should never be forced. When your son is old enough, he can learn how to keep his penis clean just as he will learn to keep other parts of his body clean.

 

By Lachin Hajosseini, MD, family physician, ThedaCare Physicians-North, at Encircle Health in Appleton.