Circumcision

Deciding About Circumcision

What Is Circumcision?
Circumcision is a surgical procedure to remove the foreskin from the head of the penis.  Some parents choose to circumcise their sons.  Others choose not to.  This brochure can help you make the best choice for you and your son.

When Is Circumcision Done?
Circumcision is most often done just before a baby boy goes home from the hospital.  But you can also choose to have it done later.  However, when the child is older, circumcision requires anesthesia and costs more.  If a baby is born early (premature) or is ill, circumcision will not be done until he is stronger.

Who Does the Circumcision?
For a newborn, circumcision may be done by:

  • An obstetrician (a doctor who delivers babies)
  • A pediatrician (a doctor who cares for children)
  • A neonatologist (a doctor who cares for newborns)
  • A family doctor

When the boy is older, circumcision is usually done by a urologist (a doctor who cares for the urinary tract).  The doctor can discuss the procedure with you and answer your questions.  If you decide to have your son circumcised, you will be asked to sign a consent form. 

The Foreskin
A boy is born with a layer of skin (foreskin) that covers the head of the penis.  At birth, the foreskin is fully attached to the head.  The foreskin can be removed (circumcision), or it can be left on.  If it is left on, the foreskin separates from the head and can be pulled back by about 3 years of age. 

Considering Your Options
There are good reasons to choose circumcision, and good reasons not to.  Some doctors are in favor of circumcision.  Others are not.  Sometimes the choice is based on religious, social, or cultural beliefs.  Parents want their son to be like his father or like other boys.  In the end, it is up to you to decide what's best for your son.

Arguments in Favor of Circumcision

  • The head of the penis is easier to wash when the foreskin is removed.  This makes odor, swelling, and infection less likely.
  • When the foreskin is removed, it cannot get pulled back and trapped behind the head of the penis.
  • Some studies show that circumcised men are less likely to carry the virus for genital warts (HPV).  This virus can cause cancer of the cervix in women.  Some studies also suggest that circumcised men are not as likely to get other sexually transmitted diseases (STDs), such as syphilis or gonorrhea.
  • Circumcised men almost never develop cancer of the penis.  Some studies suggest this is because the circumcised penis is easier to keep clean.
  • Circumcision may reduce the risk of getting urinary infections.  Studies show that bacteria are not as likely to get into the urinary tract if the foreskin is removed.

Arguments Against Circumcision

  • The penis can easily be washed by pulling back the foreskin.  When the penis is washed daily, odor, swelling, and infection are not likely to occur.
  • The chance of the foreskin ever getting trapped behind the head of the penis is very slight.
  • Other studies show that uncircumcised men are no more likely to get STDs than circumcised men are.  Limiting the number of sexual partners and using a condom play the biggest role in preventing STDs.  Still other studies question the link between men who are uncircumcised and cancer of the cervix in women.
  • Cancer of the penis is very rare.  And it may be more closely linked to not washing the penis than to being uncircumcised.
  • Circumcision has risks.  The penis may become infected or bleed.  Too little or too much foreskin may be removed.  The procedure is also most likely painful for the infant.

It's Your Choice
It's up to you to weigh the arguments for and against circumcision.  Then you can decide what's best for you and your son.  Remember: There is no right or wrong choice.  Circumcised or uncircumcised, your son can lead an active, healthy childhood and adult life.

 

Circumcision Care

Care After Circumcision

Circumcision is a quick, simple procedure.  It is most often done in the nursery before a baby boy goes home from the hospital.  It can also be done later, but then it is a little more complicated.  There are a number of ways to do circumcision.  The healthcare provider will explain the procedure and tell you what to expect.

 

For a Newborn: The Plastibell Device

The head of the penis is first cleaned.  Then a plastic cap is put over the head, and the foreskin is removed.  The cap remains on until the penis heals.  To care for your son after circumcision:

  • Keep his penis clean.  Gently wash it with warm water and a soft washcloth.  Let the skin air-dry.
  • Change diapers often.  This helps prevent infection.  Coat the head of the penis with petroleum jelly if the healthcare provider says to. 
  • Let the cap fall off by itself.  This takes 3 to 10 days.
  • Call the healthcare provider if the cap falls off within the first 2 days or stays on for more than 10 days.

 

For a Newborn: the Gamco or Morgan Clamp

The head of the penis is first cleaned.  Then a clamp is used to remove the foreskin.  To care for your son after circumcision:

  • Keep his penis clean.  Gently wash it with warm water and a soft washcloth.  Let the skin air-dry.
  • Cover the head of the penis with a lubricant, such as petroleum jelly.  This will help keep the diaper from rubbing against the circumcision site.
  • Change diapers often.  If there is gauze or a bandage on the penis, you may be asked either to remove it the next day, or to change it each time you change diapers.

 

For an Older Child

If circumcision is done when a boy is older, a urologist or other specialist surgically removes the foreskin.  The incision is then closed with stitches in most cases.  Often the penis is covered with a dressing.  To care for your son after circumcision:

  • If your son goes home with a dressing on the penis, remove it the next day.  You can sit the child in warm water just long enough to loosen the dressing if it sticks to the penis.
  • Sponge bathe your son with warm water and a soft washcloth until the stitches dissolve.  This usually takes 7 to 10 days.

 

What to Expect

During the first few days, any of the following is normal:

  • A crust of blood or a yellowish coating appears around the head of the penis.
  • The head of the penis is red or slightly black-and-blue.
  • The penis swells a little around the incision.
  • Your child cries at first when he urinates, or is fussy for the first few days.

 

When to Call a Healthcare Provider

Call the healthcare provider if any of the following occurs:

  • The discharge becomes heavy, is a greenish color, or lasts more than a week.
  • The penis is very red or sells a lot.
  • Bleeding cannot be stopped by applying gentle pressure.
  • Your child does not urinate, or he cries a lot when he urinates after the first day.
  • Your child has a fever over 100.2 degrees Fahrenheit

 

Removing the Foreskin

A boy is born with a layer of skin that covers the rounded head (glans) of the penis.  This is called the foreskin.  During circumcision, the foreskin is removed.  This can make it easier to keep the penis clean.  It may also help prevent urinary tract infections.

 

After Circumcision

Your son's penis will heal in 1 to 2 weeks.  Be sure to gently wash his penis with warm water and mild soap when you bathe him.