Circumcision (Male)

Circumcision is the surgical removal of the skin covering the tip of the penis.

Circumcision is fairly common for newborn boys in particular parts of the world, including the United States. Circumcision following the newborn period is possible, but it is a more complex procedure.

For certain 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 is not generally possible to re-create the appearance of an uncircumcised penis.

Here are the most common reasons to undergo a circumcision procedure.

Circumcision is a religious or cultural ritual for many individuals including Jewish and Islamic families, as well as certain aboriginal tribes in Africa and Australia. Circumcision can also be part of a family tradition, personal hygiene or preventive health care.

In some cases, there is 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 outweigh the risks. However, the AAP does not recommend routine circumcision for all male newborns.

The AAP leaves the circumcision decision in the hands of the baby's parents and supports the use of anesthetics for infants who have the procedure.

Circumcision might have a number of health benefits including:

• Easier hygiene: Circumcision simplifies washing the penis. Washing beneath the foreskin of an uncircumcised penis is generally easy, circumcision will greatly simplify this process.
• Decrease the risk of urinary tract infections: The overall risk of urinary tract infections in males is quite low. However, these infections are more common in uncircumcised males. Severe infections early in life can lead to kidney problems later on.
• 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.
• 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 quite rare, it is less common in circumcised men. In addition, cervical cancer is less common in the female sexual partners of circumcised men.

Circumcision might not be an option for males who have certain blood-clotting disorders. In addition, circumcision might be inappropriate for premature babies who still require medical care in the hospital nursery.

Circumcision does not have anything to do with fertility, nor is circumcision generally thought to enhance or detract from sexual pleasure for men or their partners.

Circumcision is accompanied by various potential risks. The most known complications related to circumcision are bleeding and infection.

Side effects related to anesthesia are also possible. In rare cases, circumcision might result in foreskin problems.

For example, the foreskin might be cut too short of too long. The foreskin might fail to heal properly. The remaining foreskin might reattach to the end of the penis, which requires minor surgical repair.

To prepare for a circumcision, the doctor will thoroughly explain the risks and benefits of the procedure.

Whether you have plans of having your son circumcised, or you are pursuing circumcision for yourself, you will likely need to provide written consent for the procedure.

Read on to learn more about what to expect before, during, and after your circumcision procedure.

In most cases, newborn circumcision is performed in hospital nurseries. It is done within one to ten days after birth.

• For newborn circumcision, your son will lie on his back with his arms and legs restrained.
• An anesthetic will be injected into the base of the penis or applied to the penis as a cream. This is done after the penis and the surrounding area is cleaned.
• A special clamp or plastic ring will then be attached to the penis, and the foreskin will be removed.
• After this, the penis will be covered with an ointment, such as petroleum jelly, and wrapped loosely with gauze.

This procedure usually takes about ten minutes.

Circumcision is similar for older boys and adults. However, the procedure might need to be performed under general anesthesia with some additional steps, such as suturing, to prevent excessive bleeding.

After the procedure

It usually takes about seven to ten days for the penis to fully heal. The tip of the penis is likely to be sore initially and the penis might have a red appearance, 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 not to put any pressure on the penis. It is not a problem 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 prevent it from sticking to the diaper. Change your baby's diaper often and make sure the diaper is not tightly fastened.

If there is a plastic ring instead of a bandage, it will drop off on its own, usually within a week. Once the penis has fully healed, wash it with soap and water during normal bathing.

Problems after circumcision are uncommon.

However, contact the doctor if:

• Normal urination does not resume within 12 hours after the circumcision.
• There is persistent bleeding.
• There is foul-smelling drainage from the tip of the penis.
• The plastic ring remains on for a period of two weeks after the circumcision.