Benefits and Risks of Circumcision

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Circumcision is the surgical removal of the foreskin of the penis. In the United States, circumcision is often performed soon after birth. In other parts of the world, circumcision is rare.

Like all medical procedures, there are both potential benefits and risks to circumcision. Because circumcision is most commonly performed on infants, the decision to circumcise or not falls to the parents. Learning more about the circumcision procedure, pros and cons of circumcision, and circumcision practices and recommendations around the world, can help you make an informed decision.

Most circumcisions are performed a day or two after birth. The procedure is usually done in the hospital by an obstetrician/gynecologist, pediatrician or family doctor. In the Jewish tradition, circumcision is performed by a mohel on the eighth day of life.

Babies are usually awake during the procedure. Their hands and legs may be secured to eliminate the possibility of flailing. Pain medication is usually administered prior to circumcision.

Immediately after circumcision, the head of the penis is usually wrapped gauze. With each diaper change, you’ll remove the gauze and apply a small amount of petroleum jelly before covering the area with fresh gauze. The penis is usually fully healed in about a week.

The American Academy of Pediatrics (AAP) states that “because circumcision is not essential to a child’s health, parents should choose what is best for their child by looking at the benefits and risks.” The AAP’s 2012 Circumcision Policy Statement says that, “evaluation of the current evidence indicates that the health benefits of newborn male circumcision outweigh the risks.”

The Canadian Paediatric Society does not recommend newborn circumcision but notes that “there may be benefits for some.” Similarly, the Royal Australasian College of Physicians “believes that the frequency of disease modifiable by circumcision, the level of protection offered…and the complication rates of circumcision do not warrant routine infant circumcision. However, it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their son.”

According to medical research, potential benefits of circumcision include:

• Decreased risk of sexually transmitted infections (STIs), including HIV. Circumcision of adult males is currently recommended in some African countries with high rates of HIV infection, as evidence shows that male circumcision may decrease the risk of heterosexually acquired HIV infection in men by 60%. It’s not yet clear if newborn circumcision in countries with lower rates of HIV infection has similar benefits.

Circumcision is related to a “significantly lower risk” of contracting herpes, human papillomavirus (HPV), and syphilis, according to the AAP. Individuals can also decrease the risk of STIs by practicing safer sex and using condoms during sexual encounters.

• Decrease risk of urinary tract infections (UTIs). According to AAP, a circumcised baby boy has about a 1 in 1000 chance of developing a UTI in the first year of life, an uncircumcised boy has a 1 in 100 chance. UTIs can be treated with antibiotics.

• Decreased risk of penile cancer. Cancer of the penis is very rare. Circumcision can decrease this risk, but most males will never develop penile cancer. According to an article published in Pediatrics, between 909 to 322,000 circumcisions are necessary to prevent 1 case of penile cancer.

• Prevention of phimosis, a condition in which the foreskin adheres to the head of the penis. At birth, it is normal for the foreskin to be tightly attached to the penis. The foreskin separates and becomes retractable over a period of years. By the teenage years, almost all uncircumcised males can fully retract their foreskin. Some, however, cannot, and may need surgical treatment.

There are a few risks to circumcision:

• Bleeding. As with all surgical procedures, there is a risk of excess blood loss. When performed by a medically trained provider, the risk of bleeding is minimalInfection. All surgical wounds are prone to infection. You can prevent infection by cleaning and caring for the circumcised penis as directed.

• Potential sexual impact. Some men who are circumcised later in life say that circumcision negatively affects their sexual pleasure. An article published in Pediatrics describes the foreskin as “a richly innervated structure that plays an important role in the mechanical function of the penis during sex.” However, most circumcised men report satisfaction with their sex lives.

Weighing the pros and cons of circumcision will help you make the right decision for your son and your family.