Circumcision is the procedure of removing the foreskin of the penis, a sheath of skin that covers the head (glans) of the penis. Historically it was done to improve hygiene and for religious reasons.
There are medical benefits of circumcision including a lower risk of UTI (urinary tract or bladder infection), a lower risk of penile cancer, and a lower risk of inflammation of the tip of the penis. However, these conditions are quite uncommon even in uncircumcised boys and men. In circumcised men there may be a lower rate of some STDs (sexually transmitted diseases), and a lower risk of cervical cancer in female sexual partners compared to uncircumcised men.
Arguments against newborn circumcision include lack of infant’s choice, claims of psychological damage or reduced sexual pleasure.
The United States is the only developed country where the majority of newborn boys are circumcised for non-religious reasons. It is being done less often over the last 20 years, but still the majority of newborn boys are circumcised in the area and nationally. The American Academy of Pediatrics acknowledges the potential medical benefits but does not consider the evidence strong enough to recommend routine circumcision. You may want to discuss this with your baby’s doctor before delivery.
We at Moreland OB/GYN consider the parents’ decision regarding whether or not to circumcise a newborn boy primarily a personal, cultural, or religious decision rather than a medical decision.
If you chose to have your newborn boy circumcised it will be done either by your baby’s doctor (pediatrician or family doctor) or by us. Many of the baby doctors do not do circumcisions, so they ask that we do the procedure. The nurse will have you sign a consent form that acknowledges that you understand the information in this handout and have discussed it with your doctor. There is an area on the form to designate whether you would like the baby to be numbed for the procedure.
Traditionally babies were circumcised without using anesthesia. It was thought that since the procedure is brief that it could be done without harm to the baby. More recent studies show that a newborn does receive pain from the procedure, and use of anesthetic is recommended. The most frequently used method is injection of numbing medicine into the base of the penis with a small needle.
We usually do circumcisions the morning after the baby is born. One of the doctors in our group is assigned to do any circumcisions that need to be done that day (rotating schedule). The nurse or assistant will bring the baby to the procedure room for the procedure. When she returns the baby to you afterward, she will show you how to care for the area, which primarily involves keeping it coated with Vaseline so that it doesn’t stick to the diaper.
Risks of the procedure include bleeding, infection, and injury to adjacent structures. If there is bleeding we apply pressure to stop it, but if it persisted we apply a medicine that may leave a grey-
black residue temporarily. Infection of the area is uncommon but possible. Theoretically the tip of the penis could be injured in the process of doing the procedure, but this is very rare.
The amount of foreskin to be removed varies. We try to remove just the right amount (so that the rim of the head of the penis is exposed), but sometimes it appears a little more or a little less could have been removed. This variation is not important for penile function, and the appearance will change as the child grows. Sometimes there is swelling of the area right after the procedure, which can lead to the skin riding up over the rim of the head of the penis. If allowed to heal there, it will not look right. We recommend that during the first two weeks after the procedure you push the skin down the shaft of the penis toward the base to prevent the skin from healing onto the head of the penis.
Circumcision is generally covered by insurance, but we recommend that you check you policy to be certain.