Dr. M.J. Bazos MD,
Patient
Handout
Circumcision
How do I decide about
circumcision?
Deciding whether to
have your newborn son circumcised may be difficult. You will need to consider
both the benefits and the risks of circumcision. Other factors, such as your
culture, religion and personal preference, will also affect your
decision.
The information about
circumcision in this handout may help you make your decision. After you have
read the handout, talk with your doctor about any concerns you have. The
decision about whether to have your son circumcised should be made before your
baby is born.
What is
circumcision?
During a
circumcision, the prepuce of the foreskin, which is the skin that covers the tip
of the penis, is removed. Circumcision is usually performed on the first or
second day after birth. It becomes more complicated and riskier in infants older
than 2 months and in boys and men. The procedure takes only about 5 to 10
minutes. A local anesthetic (numbing medicine) can be given to your baby so
he does not feel pain from the
procedure.
Are there any benefits
from circumcision?
Studies about
the benefits of circumcision have provided conflicting results. Some studies
show certain benefits, while other studies do not. The American Academy of
Pediatrics (AAP) says the benefits of circumcision are not significant enough
to recommend circumcision as a routine procedure and that circumcision is not
medically necessary. The American Academy of Family Physicians believes parents
should discuss with their son's doctor the potential benefits and the risks
involved when making their decision.
A
recent AAP report stated that circumcision does offer some benefit in preventing
urinary tract infections in infants. Circumcision also offers some benefit in
preventing penile cancer in adult men. However, this disease is very rare in all
men, whether or not they have been circumcised. Circumcision may reduce the risk
of sexually transmitted diseases. A man's sexual practices (e.g., if he uses
condoms, if he has more than one partner, etc.) has more to do with STD
prevention than whether or not he is
circumcised.
Study results are mixed
about whether circumcision may help reduce the risk of cervical cancer in female
sex partners, and whether it helps prevent certain problems with the penis, such
as infections and unwanted swelling. Some studies show that keeping the penis
clean can help prevent these problems just as well as circumcision. Infections
and unwanted swelling are not serious and can usually be easily treated if they
do occur.
What are the risks of
circumcision?
Like any surgical
procedure, circumcision has some risks. However, the rate of problems after
circumcision is low. Bleeding and infection in the circumcised area are the most
common problems. Sometimes the skin of the newly exposed glans becomes
irritated by the pressure of diapers and ammonia in the urine. The irritation is
usually treated with petroleum ointment (Vaseline) put directly on the area.
This problem will usually lessen after a few days.
How do I care for my baby's penis
after a circumcision?
Gently clean
the area with water every day and whenever the diaper area becomes soiled. Some
swelling of the penis is normal after a circumcision. A clear crust will
probably form over the area. It normally takes 7 to 10 days for the penis to
heal after a circumcision.
After the
circumcision, you may notice a small amount of blood on the baby's diaper. If
the bloodstain is larger than the size of a quarter, call your doctor right
away. In addition, you should call your doctor if a Plastibell device was used
during the circumcision and the device doesn't fall off within 10 to 12 days. If
there is a bandage on the penis instead of a Plastibell, the bandage should be
changed each time you change your son's diaper. This will help prevent
infection. Signs of infection also signal the need to call your doctor. These
signs include a temperature of 100.4°F or higher, redness, swelling and/or
a yellowish discharge.
When to call
your doctor
- If the wound does not stop bleeding.
- If your son does not have a wet diaper within 6
to 8 hours after the circumcision.
- If the redness and swelling around the tip of the
penis do not go away or get worse after 3 to 5 days.
- If there is a yellow discharge or coating around
the tip of the penis after 7 days.
- If the Plastibell device does not fall off within
10 to 12 days.
How do I
care for my baby's penis if I choose not to have him
circumcised?
Simply keeping the
penis clean with soap and water helps reduce the risk of problems or infections.
In older boys and adult men, the
foreskin slides back and forth over the penis, allowing the area underneath to
be cleaned. The foreskin doesn't retract in boys for a few years. Don't try to
force the foreskin to retract, because this can damage the penis and cause
problems. When the foreskin is ready to retract, you can teach your son how to
retract it himself and clean the skin underneath. He should wash his foreskin
everyday while bathing.