Circumcision

Facts on Circumcision

Circumcision is the surgical removal of the foreskin of the penis. The foreskin is a fold of skin that covers the tip of the penis (called the glans). Circumcision of infants has been practiced for centuries. Historically, circumcisions have been done for religious or social reasons.

  • Recently, controversy has emerged about circumcision.
    • Advocates recommending circumcision argue that circumcised males can practice better hygiene and display lower risk of developing cancer of the penis or urinary tract infections. Circumcision may also decrease risk of developing foreskin problems, such as phimosis (inability to retract the foreskin) or paraphimosis (retracted foreskin that cannot be put back into place). Those opposed to circumcision argue that it is cruel, that few medical benefits are proven, that circumcised males will have decreased sexual feeling due to removing the sensitive foreskin, that it unnecessarily exposes male infants to potential surgical complications, and that children have rights to autonomy over their own bodies.
    • Newborn circumcision is performed in the hospital's nursery or the doctor's office. Usually, a numbing cream is placed on the penis about 40 minutes before the penis is further numbed with a long-acting, local anesthetic. The surgery involves one of various ring-like clamps that are tightened over the foreskin. The foreskin is then removed with a scalpel or scissors. Alternately, a particular clamp that looks like a ring may be left on and will fall off on its own in five to eight days.

What Is the Treatment for Circumcision after the Procedure?

After the circumcision, the doctor will dress the wound. If there are problems, the doctor may prescribe antibiotics and might have to perform surgery.

When to Seek Medical Care after Circumcision

A small amount of oozing, soreness (an irritable baby), bleeding, swelling, and yellow crust formation around the incision is normal after circumcision. Call the doctor if these conditions develop:

  • discoloration of the penis (could be signs of insufficient blood flow or infection);
  • bleeding that does not stop within a few minutes, or a spot of blood in the diaper larger than a silver dollar;
  • discharge that includes pus, or spreading redness;
  • fever (typically a rectal temperature of 100.4 F or more);
  • not making urine; or
  • unable to be comforted.

Go to the hospital's emergency department to have your baby checked if your child shows signs of infection (such as spreading redness, pus, swelling, or fever), displays blood-flow problems, has bleeding that does not stop, or if you are unable to reach the baby's doctor.

What Is the Medical Treatment for Circumcision?

Depending on the problem, the doctor may start your baby on antibiotics, cauterize or seal off the bleeding, or in some instances, perform surgery to fix the problem.

Self-Care at Home for Circumcision

The care after circumcision of your infant depends on the method that was used to perform the circumcision. Consult your doctor as that care varies. You may need to keep his penis wrapped in gauze that is dabbed with petroleum jelly or ointment and change this every time you change his diaper. You may simply be asked to keep the area clean and dry like the surrounding skin of the diaper area. Use sponge baths instead of tub baths to avoid getting his penis wet until healing is complete or the “ring” falls off, typically about one week after the surgery.

Follow-up for Circumcision

Take your child for follow-up care with his pediatrician at two weeks if no complications arise.

How Do You Prevent Circumcision Complications?

You can prevent some of the complications of circumcision by very carefully keeping the area clean during diaper changes.

Circumcision Outlook

Few infants have complications from circumcision (as few as 2%). Most complications are easy to treat. To reduce the risk of complications, be sure the doctor performing the circumcision is experienced.

Reviewed on 5/16/2018

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

"Neonatal circumcision: Risks and benefits"
UpToDate.com

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