Circumcision/Intact: Considerations

  • Avoiding the need to do it later on -- Most complication involving foreskin can be resolved without surgical intervention. Very rarely, someone has a problem with recurrent infections in the foreskin that need antibiotic treatment. Some of these men may need to be circumcised in an operating room under general anesthesia.

  • Avoiding bladder infections -- Urinary tract infections seem to be slightly less common in circumcised babies (the rates of UTI are low in both groups -- a recent population-based study found a relative risk of 3.7 for hospitalization for UTI in the first year of life in uncircumcised boys). They are easily treated with antibiotics. After age one, circumcision status ceases to affect UTI rates.

  • Decreasing risk of sexually transmitted diseases -- In general, circumcised individuals appear to have somewhat lower susceptibility to STD's. According to the AMA Policy Statement, "behavioral factors are far more important risk factors for acquisition of HIV and other sexually transmissible diseases than circumcision status, and circumcision cannot be responsibly viewed as "protecting" against such infections."

  • Religious Reasons
    Some people choose to circumcise for religious or cultural reasons.

    Teasing
    While an intact child may have been teased in the U.S. decades ago, the truth is that your uncircumcised son will be in good company in the locker room when he is a teenager. Today, the circumcision rate is less than 60% nationally and less than 35% in the western states. Parents don't need to worry about children being different in the locker room because there will be both circumcised and intact boys.

    Penis Care
    Some people think that an intact penis is too much trouble to clean, especially during childhood. The uncircumcised penis is easy to keep clean. No special care is required! No attempt should be made to forcibly retract the foreskin. There is no need for special cleansing with Q-tips, irrigation, or antiseptics; soap and water externally will suffice.

    Look Like Dad
    With today's looser circumcision, boys may not necessarily look like their Daddies. The main difference a young child will likely notice between him and dad is the hair. When he is old enough, you can explain.

    Risks of circumcision

    Problems from the surgery are usually minor. Although serious complications are rare, they do occur. Newborn circumcision has been associated with surgical mistakes, such as having too much skin removed.

    Of every 1,000 boys who are circumcised:

    • 20 to 30 will have a surgical complication, such as too much bleeding or infection in the area
    • 2 to 3 will have a more serious complication that needs more treatment. Examples include having too much skin removed or more serious bleeding
    • 2 will be admitted to hospital for a urinary tract infection (UTI) before they are one year old
    • About 10 babies may need to have the circumcision done again because of a poor result

    In rare cases, pain relief methods and medicines can cause side effects and complications. Read Circumcision: Information for parents, (CPS).

    Summary

    When making this decision, ask yourself, "Do I have any good reason to circumcise my baby?" If your answer is for religious reasons, then follow your faith. If not, and you can't think of any other significant reason, then consider the above information as you make your decision. Editor's note: If you chose to circumcise your baby, insist on proper pain relief measures.

    Resources:
    Care of the Uncircumcised Penis: Guidelines for Parents (pamphlet). Elk Grove Village, IL: American Academy of Pediatrics, 1984.
    Trends in circumcisions among newborns, National Center for Health Statistics; February 08,2005
    Dickey, Nancy W. M.D., "To Circumcise or Not to Circumcise ... Many Parents Are Asking the Question". Medem.com; 2002

    Peron JE. "Care of the intact penis". Midwifery Today (November) 1991; Issue 17:24
    Milne, Celia, "Weighing the foreskin's value: New studies suggest the foreskin is more sexually important than once thought". The Medical Post.com (January 09) 2001; Volume 37 Issue 01

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