Circumcision

Circumcision is a surgical procedure to remove the skin covering the end of the penis, called the foreskin. In many cultures, circumcision is a religious rite or a ceremonial tradition. It's most common in Jewish and Islamic faiths.

How old should my child be for circumcision?

Circumcision can be done at any age. However, the safest time to do it is right after your baby is born, when he is about 2 days old. Because the process is painful, we use a cream to numb the area and perform the surgery while your baby is still awake.

If the baby is older, we recommend that he be given some sort of anesthesia so there is less risk of injury to the penis. As babies get older, they become more aware of their sexual organs, so there is more psychological impact associated with the surgery and some kids tend to perceive it as some sort of punishment.

What are the potential benefits of circumcision?

The health benefits of circumcision are an ongoing source of debate, but potential benefits include:

• near-elimination of the lifetime risk of penile cancer
• nearly 100 times reduction in the risk of urinary tract infections (UTI) during infancy.
• reduced incidence of balanitis and phimosis, both conditions affecting the foreskin of the penis
• Most researchers generally accept that circumcised men are less likely to acquire and transmit  HIV and some sexually transmitted diseases.

What are the risks associated with circumcision?

• The reported complication rate is low—2 to 3 percent—and most of those are minor issues, such as bleeding or infection.
• The most common complication is that not enough foreskin is removed, leading parents to request a second circumcision procedure.
• Serious or life-threatening problems such as damage to the penis or hemorrhaging are extremely rare.

Is there any evidence showing that one choice is better than the other?

The American Academy of Pediatrics (AAP) issued statements in 1999 and 2005 on the use of circumcision. They reported information from studies of both circumcised and uncircumcised males and found the following:

• Problems with the penis such as irritation can occur with or without circumcision.
• There is no difference in hygiene, as long as proper care is followed.
• There may or may not be difference in sexual sensation or practices in adult men.

The AAP did not find enough information to recommend circumcision for all babies as a routine procedure, and instead recommends that parents should be given information on the benefits and risks of newborn circumcision and should decide what is best for their baby.

How does Boston Children's Hospital handle circumcision?

The majority of circumcisions we perform at Children's are for cultural, religious or parental preferences. Deciding whether or not to have your child circumcised is an extremely personal decision. We try to educate parents on the risks and benefits associated with circumcision so you can make an informed choice.

How is circumcision performed?

Circumcision is usually performed by an obstetrician, in the hospital. When it is done for religious reasons, other persons may do the surgery as part of a ceremony after your baby is discharged from the hospital.

There are several ways to perform a circumcision.

• Some methods use a temporary clamp device while others use a plastic bell that stays on the penis for a certain length of time.
• Each method requires separating the foreskin from the head of the penis, cutting a small slit in the foreskin and placing the clamp on the foreskin. The clamp is left in place for a few minutes to stop the bleeding.
• The foreskin can then be cut and removed.

How do I care for my son after his circumcision?

Your baby's physician will give you specific instructions on the care of the circumcision.

• Most importantly, keep the area clean.
• Immediately following the procedure, your baby may have a gauze dressing with petroleum jelly or an antibiotic cream. This may be removed at the first diaper change.
• Your baby's physician may recommend applying a new dressing.
• The head of the penis may be raw and red looking.
• There may be a small amount of blood at first or yellow-colored drainage later. These are part of normal healing.
• Your baby may have some discomfort with diaper changes the first few days.
• Keep the penis clean with soap and water.
• Your baby may be fussy after circumcision. Cuddling him close and breastfeeding can help comfort him.
• Circumcisions usually heal within one to two weeks.
• Most boys don't require special care of the penis after the circumcision is healed.