Circumcision

In a 2005 policy statement regarding newborn circumcision, The American Academy of Pediatrics states: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child."

In order to make an informed decision regarding circumcision, we feel it is important to weigh the risks and benefits. Also, research has been published since the latest AAP policy statement supporting a decrease risk for contracting sexually transmitted diseases, including HIV, for males that are circumcised.

Potential Medical Benefits of Circumcision:

• Circumcised male infants are 10-20 times less likely to contract a urinary tract infection (UTI) in the first year of life than uncircumcised infants. The risk is highest in the first two months after birth, and usually requires hospitalization at this age. Approximately 1/100 uncircumcised male infants versus 1/500-1/1,000 circumcised male infants develop a UTI in infancy.
• Circumcised adults have a decreased incidence of penile cancer. Penile cancer is quite rare, only occurring in 1/100,000 men in the United States. It is three times more likely to occur in uncircumcised versus circumcised males.
• Circumcised males are less likely to contract STD's including HIV. Recent research in on adults in Africa report a 60% decreased incidence of HIV in circumcised versus uncircumcised males. Circumcised males appear to have decreased rates of other STD's including syphilis, herpes, and human papilloma virus (which leads to penile and cervical cancer).
• Uncircumcised males can have problems with the foreskin being too tight, a condition called phimosis. Usually, the tight foreskin of an uncircumcised boy loosens and becomes retractable over time. If it does not, or if the tight foreskin causes infection or urine obstruction, circumcision can become necessary.

Potential Risks associated with Circumcision:

• The surgical complication rate reported with newborn circumcision is 0.2-0.6%. These complications are mostly minor, and include bleeding and infection. Bleeding can usually be handled with local measures. Infection is also usually minor, requiring topical treatment. Rarely serious infection, significant bleeding, or even amputation of a portion of the penis has occurred.
• Circumcision is a painful procedure. However, appropriate use of local anesthesia (such as anesthetic creams) and sugar pacifiers are safe and effective.
• Circumcision may decrease penile sensation and sexual satisfaction. There are anecdotal reports that removing the sensitive foreskin results in decreased sensation. Alternatively, there are also reports that circumcised males have less sexual dysfunction than their uncircumcised counterparts.

What do most parents choose?

Circumcision rates in the United States are estimated to be 60-90%. The rates are highest among Jewish and Caucasian Americans. Rates are lower among African and Hispanic Americans, and people of Eastern European descent. Cultural, religious, and racial factors, as well as the circumcision status of the father often factor heavily in the decision whether to circumcise.

If you have further questions regarding circumcision, don't hesitate to contact our office to discuss further.