Circumcision – To Do or Not To Do

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Definition: The surgical removal of the foreskin covering the glans of the penis.

History: Some scholars believe that circumcision can be traced back over 6,000 years, making it the oldest-known surgical procedure. The procedure has been done over the years for various reasons – cultural, social, religious, medical. According to the authors of Pregnancy, Childbirth, and the Newborn – The Complete Guide, Fourth Edition the practice is not routine in many places around the globe and most cases of circumcision are found in North America, Africa, and the Middle East.

Impact on Disease and Infection: It is important for the expectant parents to consider and weigh the risks and benefits before making a decision as to whether a child should be circumcised. Some researchers, such as the authors of  this article from the Canadian Medical Association Journal, suggest that there may be medical benefits to circumcising infant boys. Researchers concluded that uncircumcised boys have a slightly increased risk of developing  urinary tract infections in their first year. Still others argue that evidence such as this does not necessitate circumcision, primarily because breastfeeding significantly reduces the risk of UTIs in boys by up to 300 percent.

The Centers for Disease Control and Prevention also state that the foreskin is one of the most susceptible tissues to HIV infection, and maintain that circumcision could lower risk for contracting HIV through sexual interaction. Even with this research, however, the CDC does not recommend circumcision for the mere purpose of preventing HIV infection and encourage proper condom use to prevent the spread of HIV. The CDC does conclude, however, that circumcision may prevent spread of bacteria and other illnesses or infections from male to female partners. See this fact sheet from the CDC for more information about this.

Care Tips For the Circumcised Penis:

• Ask hospital staff or your baby’s pediatrician how to care for the penis upon discharge and follow directions provided.
• A vaseline-covered gauze may have been placed on the circumcised area by medical staff. This should fall off within 24 hours. If it doesn’t, wrap the area in a warm, wet wash cloth or give baby a bath. Gently remove the gauze once it is soaked through.
• Once gauze is removed, place a diaper rash cream on the diaper in the area where the penis will come in contact with the diaper. This will help prevent irritation of the area.
• If your medical provider used a Plastibell device for the circumcision, you will notice a small plastic ring on his penis. This uses a suture to tie the foreskin to the Plastibell. Baby’s foreskin and the device will both fall off within 10 days of the circumcision procedure. DO NOT pull this ring off.
• Call your caregiver immediately if you notice bleeding, swelling, difficulty urinating, or pus-like discharge in or around the circumcision site.

Care Tips for the Uncircumcised Penis:

• The foreskin on an infant’s uncircumcised penis will not retract, but will be tight against the glans. Bathe the area regularly and treat it like a finger. Do not attempt to force the foreskin to retract, because it will loosen as baby matures. Once the foreskin is retractable – by 4 to 8 years of age, cleaning with soap and water is sufficient. 

This is a very basic overview of the issue of circumcision. Other things to consider include fatherhood and the father’s perspective on the issue, whether or not circumcision should be considered a human rights violation, social implications of being circumcised vs. not, religion and cultural customs, etc. Please make sure you consider all aspects of the issue before making a decision as to whether or not your son is circumcised!

Tags: boys, Canadian Medical Association Journal, Circumcision, HIV, infants, Surgery, UTI