Conditions + Treatments

Circumcision

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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 is most common in Jewish and Islamic faiths. In the United States, newborn circumcision is an elective procedure. The National Center for Health Statistics estimates that about 64 percent of newborn boys undergo circumcision. However, this number varies among socioeconomic, ethnic, and geographic groups.

Should I have my baby circumcised?

Whether or not you have your child circumcised is a deeply personal choice, and deciding if it’s right for your family will require consideration of many factors. In addition to personal, cultural and religious aspects associated with the decision, you may have medical questions as well. The following are answers the most commonly asked questions regarding circumcision.

What are the potential benefits of circumcision?

If your baby is circumcised, the penis becomes easier to clean for parents (and ultimately for the child), which helps reduce the risk of infection from bacteria. Other potential benefits include:

  • Near elimination of lifetime risk of penile cancer
  • Over 90 percent reduction in the risk of urinary tract infections (UTI) during infancy
  • Reduced incidence of balanitis, an infection of the glands or head of the penis, and posthitis, an infection of the prepuce (the skin covering the head of the penis)
  • Elimination of phimosis (inability to retract the foreskin)
Most researchers generally accept that circumcised men are less likely to acquire and transmit HIV and some sexually transmitted diseases. However, if your child is not circumcised, he can do well by learning to fully pull back his foreskin around the time of toilet training and taking care to keep the entire penis clean with soap and water every day.

How common a practice is circumcision?

Circumcision is quite common. The Centers for Disease Control and Prevention recently reviewed current trends of newborn circumcision in the US, and the national rate was approximately 60 percent. According to the data, circumcision rates are highest in the Midwest and Northeast and lowest in the West.

How old should my child be for circumcision?

Circumcision can be done at any age. Traditionally, the most common time to do it is soon after your baby is born, or within the first month of life. Because the process is painful, a local anesthetic is used to numb the area and the surgery is performed while the baby is still awake. If the baby is older, we recommend that he be given anesthesia so there is less pain and risk of injury to the penis. As children get older, they become more aware of their sexual organs, so there is more psychological impacts associated with the surgery, and children become fearful.

What are the risks associated with the procedure and how often do they occur?

  • The reported surgical complication rate is quite low (between two to three percent) and most of those are minor post-operative bleeding.
  • The most common complication is that not enough foreskin is removed, leading parents to request an operative circumcision revision.
  • Serious or life-threatening problems such as damage to the penis or major bleeding are extremely rare.

Are there any medical conditions that would make circumcision unsafe for my baby?

If your baby has active issues with heart or lung function or a bleeding disorder, circumcision may be unsafe and should be delayed. There are also congenital findings that may require more extensive repair. Circumcision should be delayed if the opening of the urethra is not at the tip of the penis, the penis is notably curved, or the penis is relatively small. Always consult a pediatrician when weighing whether or not you wish to circumcise your son, or when establishing a timeline for the procedure.

How is circumcision performed?

Most newborns are held still or placed into a circumcision brace. The baby is comforted and may receive a local anesthetic (numbing medication) to reduce discomfort. The skin covering the tip of the penis is removed with a protective device, and then gauze with petroleum jelly or antibiotic ointment is applied. In older children and adults, the procedure is commonly performed under general anesthesia.

Is it extremely painful for the child?

Despite what many people may believe, this is not an extremely painful procedure. If local anesthesia is given, the child will feel pressure and movement but not pain. The child may be briefly upset while he is being held in place. If the circumcision is performed under general anesthesia, he will not experience any pain during the procedure. Once the procedure is completed the child will not have pain with urination since the urethra (urinary tube from the bladder through the penis) is left untouched during circumcision.

What is the recovery process like and how long does it last?

Newborns and infants recover very quickly from the procedure, usually within 12 to 24 hours. Young children recover in 1 to 2 days. Older children and young adults recover in 3 to 4 days. After circumcision, there may be temporary skin bruising or mild swelling that can last for several weeks.

Is it only done on newborns?

Circumcision can be performed at any age. Newborn circumcisions are normally performed in the hospital nursery prior to discharge while the child is awake. When the child is more than three months old, parents should consider having the procedure performed under general anesthesia and wait until he is at least six months of age.

Understanding CircumcisionTo learn more, download our "Understanding Circumcision" e-book.

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