Should I have my son circumcised?

Source:medicine Author:tcm Date:2008-05-20

Introduction

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

Key points about circumcision

In 1999, an expert group from the American Academy of Pediatrics (AAP) looked carefully at the medical facts about circumcision. The AAP is an organization of doctors who specialize in child health issues. They concluded that both the benefits and risks of circumcision are very small. Based on the findings, the AAP does not recommend routine circumcision.1

Circumcision is not needed for medical reasons, so the choice is up to you. Deciding whether to have your son circumcised may be hard. You may want to weigh a number of factors. Consider the following when making your decision:

  • Your religion, traditions, or culture. The decision may be clear if circumcision is a part of your belief system. Some parents choose for or against circumcision so their son will look like other males in their family or like other boys their age. On average in the United States, about 65 out of 100 boys are circumcised; about 35 out of 100 are not.2 Worldwide, the rate of circumcision is much lower.3
  • Your feelings. Parents may worry about the pain their baby will feel during and after the surgery. They may also be concerned about the slight chance that the surgery will lead to problems. Some parents feel that their baby is perfect just the way he was born, but they may worry about the very small risk of problems later in life if he is not circumcised early. It may help to discuss these concerns with your baby’s doctor.

Medical Information

What is circumcision?

Circumcision is a surgery to remove the foreskin, the fold of skin that covers and protects the tip of the penis. It is most commonly done when a baby is 1 day old. A baby may be circumcised when he is a little older if he was born early (premature) or if circumcision is part of a religious ritual.

See a picture of a penis before and after circumcision.

For the surgery, the baby is placed on his back, and his arms and legs are held still with straps. The penis and the area around it are cleaned. A protective device is placed over the head of the penis, and the doctor cuts the foreskin using a scalpel or scissors.

Circumcision causes pain both during and after the surgery. Make it clear that you want pain relief for your baby, and talk to your doctor about which type is best. The baby can be given a local anesthetic to numb the penis before the surgery. Choices may include a ring block, dorsal penile nerve block (DPNB), or EMLA cream. Ask the doctor about giving your baby acetaminophen (such as Tylenol) for pain after the surgery.

When should a baby not be circumcised?

A baby should not be circumcised if he is sick or weak, has a problem with his penis, has a family history of bleeding problems, or was premature and is not yet ready to go home.

Who performs circumcisions?

Circumcisions usually are done by family medicine doctors, pediatricians, surgeons, or urologists.

What can I expect after circumcision?

Some swelling and slight bleeding is normal after circumcision. Your baby may be fussy and have trouble sleeping for the first few days. It will probably hurt for a few days when he urinates . For about 2 weeks, it can hurt whenever urine or stool touches the tip of the penis.

Your baby will probably start feeling better within 3 to 4 days after circumcision. Even though he may feel better, his penis may look worse. The penis will usually look better about 7 to 10 days after circumcision.

What are the risks of circumcision?

Problems from circumcision are rare. If they occur, they are usually minor and short-term. About 2 out of 100 babies who are circumcised have minor bleeding or infection. Other possible problems include pain and irritation of the tip of the penis.

Long-term problems are even more rare, but they can include damage to the opening of the urethra, heavy bleeding, severe infection, or scarring.

Are there benefits to circumcision?

If your son is healthy, circumcision most likely will not affect his health either way. There may be some slight health benefits for circumcised males. But most experts in the United States agree that these possible benefits are not reason enough to choose circumcision.

  • In the first year of life, circumcised boys have fewer urinary tract infections (UTIs) than boys who have not been circumcised. But UTIs are not common in either group. They affect only about 7 to 14 out of 1,000 uncircumcised boys and about 1 or 2 of 1,000 circumcised boys.1 The benefit of circumcision is more clear if a boy is at a higher risk for UTIs because of a urinary tract problem.
  • Circumcised males may be slightly less likely to get a sexually transmitted disease (STD), including HIV.4, 5 But circumcision should not be done to prevent STDs. Any man who has high-risk sex can get STDs or HIV, whether or not he is circumcised.

What if I decide not to have my baby circumcised?

Keeping the penis clean can lower the already small risk of infection or other problems.

There is a slight chance that a male might need to be circumcised later if he develops a problem with the foreskin (such as phimosis) or inflammation of the tip of the penis (balanitis). But these problems are rare.

If you need more information, see the topic Circumcision.

Wise Health Decision

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about circumcision. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

I feel that my baby is perfect just the way he was born.

Yes No Unsure

My religious beliefs make circumcision the right choice.

Yes No Unsure

My son is healthy, so the possible health benefits are too small to justify getting him circumcised.

Yes No Unsure

I am confident that my doctor will use pain relief medicine to keep my son comfortable during and after his circumcision.

Yes No Unsure

I don't think it is important for my son to be circumcised just because his father is.

Yes No Unsure

I prefer the look of a circumcised penis.

Yes No Unsure

Most of the men in our family are not circumcised.

Yes No Unsure

I am not very worried about the low risk for problems from circumcision.

Yes No Unsure

I don't want to put my baby through a surgery that is not needed.

Yes No Unsure

Having my son circumcised now avoids the very small chance that he might have to be circumcised when he is older.

Yes No Unsure

Use the following space to list any other important concerns you have about this decision.

 

 

 

 

 

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to decide for or against circumcision.

Check the box below that represents your overall impression about your decision.

Leaning toward having my son circumcised

 

Leaning toward NOT having my son circumcised

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