Male circumcision is a
surgery to remove the foreskin, a fold of skin that covers and protects the
rounded tip of the penis. The foreskin provides sensation and lubrication for
the penis. After the foreskin is removed, it can't be put back on again. See a picture of the
penis before and after circumcision.
If circumcision is done, it's usually done soon
after birth. In the United States, about 60
out of 100 boys are circumcised, and about 40 out of 100 are not.1 Worldwide, the rate of circumcision is much lower. Circumcision has both risks and benefits. The decision about whether to have a baby circumcised is often based on the personal preference of the parents.
Some older boys and men need circumcision to treat problems with the foreskin of the penis (such as
paraphimosis) or for swelling of the tip of the penis
This topic focuses on the circumcision of newborns.
It's up to you whether you have your baby circumcised or keep your son's penis natural. The American Academy of Pediatrics says the health benefits of circumcision outweigh the risks of the surgery. They also say that parents should be the ones to decide what is in the best interest of their child.2 When you make this
decision, it may help you to think about your personal and cultural
preferences. For example, you may want to consider your religious and family
traditions while you weigh the pros and cons of the surgery.
Circumcision is not just done in newborns. Keep in mind that your son can decide on his own later in life if he wants a circumcised penis.
Problems from circumcision are not common. If they occur, they are
usually minor. The most common circumcision problems are:
More serious problems are rare. They include damage to the
opening of the urethra, heavy bleeding that requires stitches, severe
infection, and scarring.
Circumcisions usually are done by a
family medicine doctor,
urologist. Circumcisions that are performed for
religious reasons are sometimes done by others trained in the procedure. For your baby's safety, it is best that the person doing the surgery is well trained, uses sterile techniques, and knows how to manage your baby's pain during and after the surgery.
Learning about circumcision:
How it is done:
Care after circumcision:
Health Tools help you make wise health decisions or take action to improve your health.
Circumcision is usually done by a doctor at a clinic,
in the hospital, or at an outpatient surgery center. During the
circumcision, the groin, penis, and scrotum may appear
reddish brown because of the liquid used to clean the skin before surgery. The
shaft of the penis where the skin was removed will look raw and slightly
Your baby will stay in the hospital or clinic for 2 to 4 hours
after the procedure. His penis will be checked for bleeding, and the
circumcision area may be covered with petroleum jelly and gauze. If gauze is
used, it stays on for about 24 hours. Before you take it off, soak it in warm
water and gently loosen it.
You will likely take your baby home
the same day he is circumcised. Some swelling around the penis is normal in the
first few days after the surgery. Some slight bleeding may occur. If this
happens, apply direct but gentle pressure to the area with a clean cloth or
bandage for about 5 to 10 minutes.
After surgery, your baby will
feel some pain. He may be fussy and have trouble sleeping.
yellow film will form over the circumcision site after surgery. This is part of
the normal healing process and should go away in a few days. Although the penis
is beginning to heal, it may look worse a few days after circumcision. The
penis should look like it's getting better about a week after surgery.
Here are some things you can do
to help your baby feel more comfortable:
Ask your doctor about giving your baby
acetaminophen (such as Tylenol) for pain. Call your
doctor anytime your baby seems to be in a lot of pain.
Your son's penis will be
checked during routine
well-baby visits. But it is important to call your
doctor if your baby has problems after
Call your doctor right away if after circumcision:
Plastibell device was used for the circumcision, call
your doctor if the ring has not fallen off after 10 to 12 days.
Doctors who usually perform
circumcisions on infants include:
A urologist or surgeon normally will do circumcisions on
older infants, children, and adults.
Some parents may make the decision about circumcision based on
religious and family traditions, personal preferences, or the social norms
of their communities. Often these cultural reasons affect the decision more than the medical risks and benefits of circumcision.
The American Academy of Pediatrics (AAP) says the health benefits of circumcision outweigh the risks of the surgery. But it's up to you whether you have your baby circumcised.2
Health benefits of circumcision include being less likely to get urinary tract infections (UTIs) or sexually transmitted infections (STIs). For example, in a
baby's first year of life,
UTIs happen less often in
circumcised boys than in boys who are not circumcised. But UTIs are not common.
There may be reasons later in life when your son may need a
circumcision. A boy or man may have problems retracting the foreskin or may
have swelling of the foreskin that requires circumcision.
All surgical procedures have risks. Problems
circumcision are not common. Minor problems are
short-term and may include:
Long-term problems can include:
Major problems are very rare but can include:
As a parent, you will decide whether you want to keep
your son's penis natural or want him to be
circumcised. This decision often is a personal one based on your own values and religious or cultural beliefs.
good idea to think about your decision before your baby is born. If you wait,
the excitement and fatigue of the delivery can affect your ability to carefully
consider the benefits and risks of each choice.
Your son's values
Circumcision is not just done in newborns. Keep in mind that your son can
decide on his own later in life if he wants a circumcised penis.
Circumcision and STIs
Some studies have shown that circumcised men are a little
less likely than men who have not been circumcised to get a
sexually transmitted infection (STI), including
Any man, especially if he has
high-risk sex, can get STIs or HIV. The best way to
prevent STIs is to teach people about risk factors and the importance of
avoiding high-risk sex.
Some people have concerns that circumcision can decrease sensation in the
penis. Some people also wonder if circumcision disrupts the bonding that occurs
between mother and son during breast-feeding. But there is not a lot of
research about these concerns.
Keeping your son's penis clean may
help prevent infection and other problems. It's important to keep your son's
penis clean whether he has been circumcised or not. When
cleaning a natural (uncircumcised) penis, be careful
not to force the foreskin to retract.
If you choose circumcision
If you decide that you would like to
have your baby circumcised, talk with your doctor. Discuss any concerns you may
have about pain and your preferences for
anesthesia. Ask your doctor about giving your baby
acetaminophen (such as Tylenol) for pain relief after
When is circumcision not done?
Your doctor may not do circumcision if your baby has a medical
condition that makes him more likely to have problems from the surgery, such
The website FamilyDoctor.org is sponsored by the American Academy of Family Physicians. It offers information on adult and child health conditions and healthy living. There are topics on medicines, doctor visits, physical and mental health issues, parenting, and more.
The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.
American Congress of Obstetricians and Gynecologists
(ACOG) is a nonprofit organization of professionals who provide health care for
women, including teens. The ACOG Resource Center publishes manuals and patient
education materials. The Web publications section of the site has patient
education pamphlets on many women's health topics, including reproductive
health, breast-feeding, violence, and quitting smoking.
UrologyHealth.org is a website written by urologists
for patients. Visitors can find specific topics by using the "search"
The website provides information about adult and
pediatric urologic topics, including kidney, bladder, and prostate conditions.
You can find a urologist, sign up for a free quarterly newsletter, or click on
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The National Organization of Circumcision Information
Resource Centers (NOCIRC) is a group that opposes circumcision. The group gives
out pamphlets, hosts conferences, and has a Web site dedicated to its mission.
The subjects NOCIRC focuses include the functions of the foreskin and research
related to the medical, ethical, and legal reasons that the sexual organs of
children should be left intact.
NOCIRC offices are open to the
public, and they are available to answer requests for information by phone and
CitationsMerrill CT, et al. (2008). Circumcisions performed in U.S. community hospitals, 2005. HCUP Statistical Brief #45, pp. 1–9. Rockville, MD: Agency for Healthcare Research and Quality. Also available online: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb45.jsp.Task Force on Circumcision, American Academy of Pediatrics (2012). Circumcision policy statement. Pediatrics, 130(3): 585–586.Other Works ConsultedAmerican Urological Association (1989, revised 2007). Circumcision. Available online: http://www.auanet.org/content/guidelines-and-quality-care/policy-statements/c/circumcision.cfm.Centers for Disease Control and Prevention (2008). Male circumcision and risk for HIV transmission and other health conditions: Implications for the United States. Available online:Steadman B, Ellsworth P (2006). To circ or not to circ: Indications, risks, and alternatives to circumcision in the pediatric population with phimosis. Urologic Nursing, 26(3): 181–194.Task Force on Circumcision, American Academy of Pediatrics (2012). Technical report: Male circumcision. Pediatrics, 130(3): e756–e785.Towers HM (2006). Circumcision. In FD Burg et al., eds. Current Pediatric Therapy, 18th ed., pp. 313–315. Philadelphia: Saunders Elsevier.Wiysonge CS, et al. (2011). Male circumcision for prevention of homosexual acquisition of HIV in men. Cochrane Database of Systematic Reviews (6).
January 26, 2012
Adam Husney, MD - Family Medicine & John Pope, MD - Pediatrics
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