Circumcision: Pros and Cons

What is a circumcision?

Circumcision means cutting off the foreskin, or ring of tissue, that covers the head of the penis.

Fewer children in the US are being circumcised now than several years ago. In 1980, 90% of American males were circumcised. In 2010, about 60% of American males are circumcised. Discuss the issue with your family and healthcare provider before your baby is born.

The following information should help you decide what is best for your son.

What is the history of circumcision?

Followers of the Jewish and Muslim faiths perform circumcision for religious reasons. Nonreligious circumcision became popular in English-speaking countries between 1920 and 1950. At this time it was thought that circumcision might help prevent sexually transmitted diseases. Circumcision never became a common practice in most parts of the world. Only 20% of the men in the rest of the world are circumcised.

What is the purpose of the foreskin?

The foreskin on the penis is not some cosmic error. The foreskin has a purpose.

• It protects the glans (head of the penis) against urine, feces, and other types of irritation.
• It protects against infection or scarring of the urinary opening (although this is rare).
• It protects the sensitivity of the glans. However, there is no evidence that circumcision reduces sexual function or pleasure.

What are the pros?

Some of the reasons you may want to circumcise are:

• Lowers the risk of urinary tract infections (UTIs) during the first year of life. However, UTIs are rare and can be treated.
• Prevents infections under the foreskin. It also prevents persistent tight foreskin. Both of these problems are uncommon and are usually due to pulling back the foreskin too hard or with dirty hands.
• Decreases the risk of getting some sexually transmitted diseases (STDs) later in life Reduces the incidence of HIV by about 40%, genital warts by about 35%, and herpes simplex type 2 by about 30%.
• Lowers the risk of carrying the HPV virus. HPV causes cervical cancer in females and penile cancer in males.
• Keeps your son's appearance "like other boys" or "like his dad." Boys may not mind looking different from other men in their family. However, they do mind being harassed in the locker room or shower about their foreskin. This could happen if most of their buddies are circumcised.

What are the cons?

Some of the reasons not to circumcise include:

• Problems with surgery. Problems that may occur are skin or bloodstream infections, bleeding, and various surgical accidents. One study showed that 1 of every 500 circumcised newborns suffered a serious side effect.
• Pain. The procedure causes some pain. However, the doctor can inject a local anesthetic around the area to block the pain.
• Cost. You may have to pay for the surgery yourself because some insurance companies do not cover the cost.
• You must decide quickly. If you initially decide not to have your son circumcised, and then change your mind after your son is 2 months old, the procedure will require a general anesthesia. So try to make your final decision before your child is born. At least, decide during the first month of life.

When is it done?

The circumcision is normally done on the day your newborn goes home from the hospital. It will be postponed if your baby is premature or has medical problems. It will not be done if your baby has any abnormal findings of the penis. Examples are a urine opening in the wrong place or a penis that is curved or twisted. Such problems will be referred to a pediatric urologist.

Recommendations

Circumcision of boys for religious purposes will continue. The need to circumcise other boys is a parent decision. The American Academy of Pediatrics 2012 policy now states that the preventive health benefits of elective circumcision outweigh any risk of the procedure. Parents need to decide whether circumcision is in the best interests of their male newborn. The benefits are a lower risk of some urinary tract infections and sexually transmitted diseases. Discuss the issue with your family and doctor before your baby is born.