Benefits of Circumcision
Several studies have tried to find out if there are medical benefits to infant circumcision. The results of these studies vary. There seems to be some evidence that infant circumcision may help reduce the risk for the following:
- Urinary tract infections (UTIs)
- Penile cancer
- Sexually transmitted diseases, including HIV/AIDS
Other studies looked at the effect of circumcision on cervical cancer risk in female sex partners and on other problems, such as infection. The results of these studies are mixed and inconclusive.
The most significant benefit to infant circumcision is a lower rate of urinary tract infection (UTI). During the first 3 to 6 months, UTIs are 10 times more common in uncircumcised boys than in circumcised boys. UTIs in infancy can lead to kidney problems later in life. However, they are easily treated with antibiotics and may not be enough of a reason to circumcise an infant.
Some studies have shown a slightly higher rate of penile cancer among men who were not circumcised as infants. However, penile cancer is extremely rare among all men, circumcised or not.
There is some evidence that circumcision may reduce the risk of getting or passing on a sexually transmitted disease (STD). However, it is not clear whether circumcision is the key factor, or if other factors, such as condom use and the number of sex partners, play a larger role.
Circumcision Risks & Complications
Complications from infant circumcision are extremely rare, estimated at less than 3 percent of all cases. However, as with all surgical procedures, there are risks associated with neonatal circumcision, including the following:
- Complications due to faulty surgical technique
- Poor cosmetic appearance
- Rash and irritation
Other things to consider are that circumcision is a permanent surgical procedure that cannot be reversed, and that some insurance companies may not cover the expense. Some people claim that circumcision reduces the ability to feel sexual pleasure later in life, but the effect of circumcision on sexual pleasure, either positive or negative, has not been established.Circumcision Procedure
Circumcision is generally performed on the first or second day after birth. Jewish babies are circumcised when they are eight days old. At the very latest, circumcision is normally performed within 2 or 3 weeks of birth.
Circumcision may be delayed if the baby is born prematurely or with medical issues. Babies born with penile abnormalities will also have a delayed circumcision, as the foreskin is often used in reconstructive surgery.
The procedure takes from 5 to 15 minutes to perform. The baby is placed on his back with his arms and legs restrained and the penis and surrounding area are cleaned. A local anesthetic (e.g., cream applied to the skin, injection to the shaft or base of the penis) is used to prevent pain. Anesthetic cream takes effect in about 20-40 minutes. The injection takes less time to work, but the aftereffects may last longer. Sometimes the baby is given a sweetened pacifier to reduce stress.
The foreskin is pulled down (retracted) from the head of the penis and clamped in place using a metal or plastic ring. If a metal ring is used, the foreskin is cut off and the ring is removed. An antibiotic cream is applied and the penis is wrapped in loose gauze. Healing usually takes 5 to 7 days.
If a plastic ring (called a Plastibell) is used, the foreskin is slit and wrapped back around the ring. A piece of thread (suture) is tied around the cut foreskin, pushing it into a groove in the plastic. This is left on the penis for 5 to 7 days, after which it falls off, leaving a completely healed circumcision. An antibiotic cream is applied to the penis.
Complications following infant circumcision are rare. The most common are excessive bleeding and infection. Other complications are caused by faulty surgical technique, and include the following:
- Buried penis (penile shaft buried below the surface of the pubic skin)
- Chordee (abnormal downward bend of the penis)
- Meatal stenosis (narrowing of the urine channel [urethra] at the top of the penis)
- Poor cosmetic appearance
- Skin bridges (foreskin reattaching to the glans)
The circumcised penis must be cleaned with soap and water every day and each time the diaper is soiled. If the penis has been wrapped in gauze, clean gauze must be applied every time the diaper is changed. Petroleum jelly can be applied to the newly exposed head of the penis, which may be irritated by diapers and urine.
Slight swelling and bleeding may occur and a clear crust often forms over the area. In most cases, the circumcision will heal normally within 5 to 7 days.
Call the doctor if:
- Bleeding doesn't stop or is excessive (larger than the size of a quarter).
- Diaper is dry 6 to 8 hours after the circumcision.
- Redness or swelling doesn’t go away, or gets worse, after 3 to 5 days.
- There is a yellowish discharge or coating after 7 days.
- The baby has a temperature of 100.4° or above.
- The Plastibell device doesn't fall off within 7 to 12 days.