What is a circumcision?

Circumcision means cutting off the foreskin, or ring of tissue, that covers the head of the penis. It is usually done the day your newborn goes home from the hospital.

Fewer children in the U.S. are being circumcised now than several years ago. In 1979, 90% of American males were circumcised compared to 60% now.

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

What is the history of circumcision?

Followers of the Jewish and Moslem 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. Over 80% of the men in the world are not 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 (top 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.

What are the pros?

Some of the reasons you may want to circumcise are:

• Protects against urinary tract infections (UTIs) during the first year of life. However, UTIs are rare and easily treated.
• Prevents infections under the foreskin. It also prevents persistent tight foreskin. Both of these problems are rare and are usually due to pulling back the foreskin too often or too hard.
• Decreases the risk of getting some sexually transmitted diseases (STDs) later in life, including HIV. However, it does not completely prevent any STD.
• Lowers the risk of cancer of the penis. However, good hygiene offers equal protection against this very rare cancer.
• 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, gangrene, scarring, and various surgical accidents. One study showed that 1 of every 500 circumcised newborns suffered a serious side effect.
• Pain. The procedure causes pain. However, the doctor can use some anesthetic around the area to block some of the pain.
• Cost. You may have to pay for the surgery yourself because many 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 during the first month of life.

Recommendations

Circumcision of boys for religious purposes will continue. The need to circumcise other boys is open to question. Just because a father was circumcised doesn't mean that the son needs to be. Because the foreskin comes as standard equipment, you might consider leaving it intact, unless your son will be going to a school where everyone else is likely to be circumcised. The risks and benefits are both too small to swing the vote either way. This is a parental decision, not a medical decision.