Circumcision in Children

Circumcision Benefits and Risks

Parents may choose to circumcise their children for cultural, religious or health-related reasons. In the U.S., circumcision is not required for newborns. According to the American Academy of Pediatrics (AAP) the health benefits of circumcision outweigh the risks, but not enough to routinely recommend circumcision for all male children.

Potential benefits of circumcision:

• Hygiene: Circumcision makes washing the penis easier; however, there is little difference in hygiene if uncircumcised boys are taught how to properly clean themselves.
• Risk of urinary tract infections (UTIs): The overall risk of UTIs in male children is low, but they are more common in males who are not circumcised and are diagnosed with vesicoureteral reflux (VUR).
• Preventing penile problems: Sometimes, the foreskin on a penis that hasn’t been circumcised can be hard or impossible to pull back (phimosis), which can lead to inflammation. Nearly all male infants have phimosis, but the foreskin usually begins to loosen between ages 2 and 6. Boys will usually be evaluated for this condition after ages 4 –5.
• Risk of sexually transmitted diseases (STIs): Men who are circumcised have a lower risk of some STIs, including HIV.

Potential Risks of Circumcision

The overall risk of circumcision in newborns under local anesthesia is low. However, there are some risks. Potential problems may include:

• Bleeding
• Infection
• Scar tissue formation
• Sensitivity or irritation after procedure
• Problems during healing that cause adhesions or skin bridges to form; this may require the procedure to be redone.

There may be other risks depending on your child’s health. You can discuss your child’s individual risks with their doctor.

Circumcision Procedure

Circumcision is usually performed before a baby leaves the hospital after birth. If circumcision is done for religious reasons, it may be performed after the baby comes home.

There are some cases in which circumcision may be not performed after birth or is delayed. This can happen in cases of premature birth, physical problems with the penis like curvature, hypospadias, penile webbing, or other health-related issues.

The AAP recommends the use of a local anesthetic during circumcision to help prevent pain. This can be in the form of an injection or a cream to numb the area of the penis where the incision will be made. Older children who undergo circumcision are usually given general anesthesia, so they are asleep during the procedure.

The procedure usually takes about 30 minutes. Prior to the procedure, the UH Rainbow pediatric urology nurse practitioner, who is properly trained in performing the surgery, will discuss the procedure with the parents and get the proper consent for the surgery.