Health Tips

If you have a baby boy, you'll need to decide whether to have him circumcised. Consider the pros and cons.

Circumcision is the surgical removal of the skin covering the tip of the penis. The procedure is fairly common in certain parts of the world, including the United States and Canada. But is it right for your son? Here's help making an informed decision.

Opinions are mixed

For some parents, circumcision is a religious ritual. It can also be a matter of family tradition, personal hygiene or preventive health care. For others, however, the procedure seems unnecessary or disfiguring.

In 1999, the American Academy of Pediatrics (AAP) issued a policy statement that says the benefits aren't strong enough to recommend routine circumcision for all male newborns. Today, the AAP leaves the decision up to parents — and supports use of pain relief for infants who have the procedure.

The benefits

Circumcision may have health benefits, including:

• Easier hygiene. Circumcision makes it easy to wash the penis — although it's simple to clean an uncircumcised penis, too.
• Decreased risk of urinary tract infections. The risk of urinary tract infections in the first year is low, but these infections may be up to 10 times as common in uncircumcised baby boys. Severe infections early in life can lead to kidney problems later on.
• Prevention of penile problems. Occasionally, the foreskin on an uncircumcised penis may be difficult or impossible to retract (phimosis). This can also lead to inflammation of the head of the penis.
• Decreased risk of penile cancer. Although cancer of the penis is rare, it's less common in circumcised men.
• Decreased risk of sexually transmitted diseases. Safe sexual practices remain essential, but circumcised men may have a slightly lower risk of certain sexually transmitted diseases — including HIV, the virus that causes AIDS.

The drawbacks

Circumcision also has drawbacks, including:

• Surgical risks. Excessive bleeding and infection are uncommon, but possible. The foreskin may be cut too short or too long or fail to heal properly. If the remaining foreskin reattaches to the end of the penis, minor surgery may be needed to correct it.
• Pain. Circumcision hurts. Local anesthesia can block nerve sensations during the procedure.

Other considerations

Circumcision may not be an option if your son has certain medical conditions, such as an abnormality of the penis that requires surgical treatment. In this case, the foreskin may be needed for repair. Circumcision doesn't affect fertility, nor is circumcision thought to enhance or detract from sexual pleasure for men or their partners. After a circumcision, it may be impossible to re-create the appearance of an uncircumcised penis.

The procedure

Circumcision is often done in the hospital nursery. It may also be done in an outpatient setting within the first few weeks after birth.

Your son will lie on his back with his arms and legs restrained. After the penis and surrounding area are cleansed, an anesthetic will be injected into the base of the penis or applied to the penis as a cream. A special clamp or plastic ring will be attached to the penis, and the foreskin will be removed. Afterward, the penis will be covered with an ointment, such as petroleum jelly, and wrapped loosely with gauze.

The procedure takes about five to 10 minutes.

Circumcision care

It usually takes about seven to 10 days for the penis to heal. The tip of the penis may seem raw at first, and you may notice a yellowish mucus or crust. A small amount of bleeding also is common the first day or two.

It's OK to wash your son's penis as it's healing. Change the bandage with each diaper change, and apply a dab of petroleum jelly to the tip of the penis to keep it from sticking to the diaper. If there's a plastic ring instead of a bandage, it will drop off on its own — usually within a week. Once your son's penis heals, wash it with soap and water during each bath.

Problems after circumcision are rare. Contact your son's doctor if:

• Your son doesn't urinate normally within six to eight hours after the circumcision
• There's persistent bleeding or redness around the tip of the penis
• There's foul-smelling drainage from the tip of the penis or crusted sores fill with fluid

If you skip the circumcision

If you choose not to have your son circumcised, simply wash your son's penis with soap and water during each bath. There's no need to clean beneath the foreskin until it retracts on its own, often by age 5. Then teach your son to clean beneath the foreskin during each bath — gently pull back the foreskin, clean the area with soap and water, rinse and pull the foreskin back over the head of the penis. After each bath, pull back the foreskin again to dry the area.