Center for General Pediatric Urology
A Q&A with Hiep Nguyen, MD, co-director of the Center for Robotic Surgery, director of Robotic Surgery Research and Training, and Associate in Urology.
What are the medical benefits of circumcision?
It decreases the risk of urinary tract infection (UTI) in young boys by nearly 100 times, especially patients with structural abnormalities with their urinary tract who are at risk of contracting kidney infections. Most researchers also generally accept that removing the foreskin can also reduce the transmission of HIV and some sexually transmitted diseases (STD), because the foreskin contains special islands of cells that tend to harbor the virus and make for rich bacterial breeding grounds.
Should all males be circumcised?
Not necessarily. The total number of UTI cases is relatively small, so we would have to perform a huge number of circumcisions in order to reduce an already low rate of UTI. Also, studies have shown that with better foreskin hygiene and by using safe sex practices, you can dramatically reduce the rate of STDs without needing to perform circumcision.
Are there advantages to being uncircumcised?
Foreskin has special benefits: It's both protective and allows for preserved sensitivity.
What are the reasons that parents choose circumcision for their sons?
The majority of circumcisions we perform at Children's are for cultural, religious and parental preferences, and we try to educate parents on the risks associated with circumcision. So deciding whether to get circumcised is a very personal, subjective decision.
What are the risks of circumcision?
The most serious risks are amputation of the penis and injury to the urethra, but these are quite rare. The problems we see more routinely are bleeding and infection. We often see cases in which not enough foreskin was removed so parents come back for us to re-do the procedure.
What is the best age to perform a circumcision?
Circumcision can be done at any age. However, the older the boy or man gets, the greater the risk of complications. The safest time to do it is right after a baby is born, when he is about 2 days old. During that stage, we use a cream to numb the area and perform the surgery while the 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.
Do young boys feel a pressure to be circumcised?
In young boys, there is what is called the "locker room effect" - boys who want to be circumcised because they see other boys who are circumcised. We try and alleviate this anxiety with proper education and by reminding them that the majority of the global population is not circumcised.
Can circumcision be reversed?
We have seen a few adults who have wanted to get their circumcision reversed. The chances of reversing a circumcision are very low. Most people are comfortable with the choices their parents made for them and have no regrets.
