Circumcision
Why It Is Done
Circumcision is performed on newborns mainly for cultural reasons. For example, parents may make the decision about circumcision based on religious and family traditions, personal preferences, or the social norms within their communities. It is also important to consider the benefits and risks of the procedure.
Circumcision is not medically necessary. There may be some slight health benefits for circumcised males. But medical experts in the United States generally agree that these health benefits alone are not significant reasons to have circumcision. A 1999 study by the American Academy of Pediatrics (AAP) Task Force on Circumcision concluded that circumcision should not be recommended as a routine procedure for newborn males. Before making this recommendation, the task force looked at the possible health benefits of circumcision, such as a lower risk for urinary tract infections (UTIs) in the first year and a lower risk for getting STDs.2
- In the first year of life, urinary tract infections (UTIs) happen less often in circumcised boys than in boys who are not circumcised.3, 4 But UTIs are not common. Researchers in one large study concluded that the lower risk for UTIs is not significant enough to justify circumcision when balanced against the risk of bleeding and infection from circumcision surgery.4 About 111 boys would need to be circumcised to prevent one UTI. About 2 out of 100 boys (2%) have bleeding or infection after circumcision.4 Circumcision is more clearly a health benefit if a boy has a history of UTIs or is at a higher risk for developing UTIs (such as if his urinary tract is not normal).3, 4
- Some studies have shown that circumcised males are a little less likely than males who have not been circumcised to get a sexually transmitted disease (STD), including HIV.5, 6 But circumcision should not be done to prevent STDs or HIV. All men who have high-risk sex can get STDs or HIV, regardless of whether or not they are circumcised. It is most effective to prevent STDs by teaching people about risk factors and about the importance of practicing low-risk sexual behavior.3 Male circumcision to help prevent HIV is more likely to be considered in areas where the disease is common and safe sex is not widely practiced.3, 6
In the past, circumcision was considered necessary when a newborn's foreskin could not be retracted (phimosis). But now, this condition is considered normal because the foreskin of newborns is still developing. By age 3, most boys who have not been circumcised can retract the foreskin of the penis without any problems.7 (In rare cases, the foreskin of the natural penis [uncircumcised] cannot be retracted after a boy has reached puberty, in which case circumcision may be recommended.)
Do not have your baby circumcised if he has a medical condition that makes him more likely to have problems from the procedure. For example, do not have your baby circumcised if he:
- Is sick or in an unstable condition (such as not eating well, having difficulty passing urine or stool, or having difficulty maintaining his body temperature).
- Has any abnormality of the penis, such as having the opening of the urethra on the side of the penis shaft instead of on the tip of his penis (hypospadias or epispadias). Your baby may need to have an intact foreskin so that this irregularity can be surgically corrected when he is older.
- Has swelling or protrusion of the spinal cord (myelomeningocele or spina bifida).
- Has an abnormal opening of the rectum (anus).
- Has a family history of bleeding difficulties. (Blood tests should be done to confirm that the baby does not have this problem.)
- Was born prematurely and is not yet able to go home.
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| Author: | Debby Golonka, MPH | Last Updated: February 19, 2008 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Peter Anderson, MD, FRCS(C) - Pediatric Urology | |
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