There has been a great deal of discussion
about circumcision in medical and lay circles in recent years. Information presented here is an
effort to make our position clear and to briefly summarize the medical information
available for people considering circumcision.
Over 30 years ago, on the information then
available, most physicians in the U.S. felt circumcision was indicated and
urged parents to have it done in the newborn period. Since then the medical
evidence has swung the other way.
Now, most men in the world are not circumcised, and probably about half of boys born in the US are
circumcised. When your newborn son
is in high school, he will likely know boys who are circumcised and boys who
are not circumcised.
UNCIRCUMCISED PENIS CARE
In a newborn and beyond, the uncircumcised
penis needs no special care. During routine bathing the penis and foreskin need
to be washed with no special attention. The foreskin needs to be retracted as
far as it goes very easily with no discomfort, which in a newborn and the first few years of life
is usually not very far. Natural oils and shedding of dead skin sometimes form
little white, cottage cheese-type secretions that may come out from under the
foreskin in chunks. These lumps and the little pockets under the foreskin they
come from are normal and should cause no particular concern. With only a quick cleaning at bath
Pretty much left alone, the uncircumcised penis will do fine. There is no need
to have the foreskin pulled back by first grade or any other arbitrary age.
CIRCUMCISION DISCUSSION
For religious purposes, Muslims, Jews and
some other groups have practiced circumcision for thousands of years.
Circumcision became popular in the United States early in the 1900's and by the
end of World War II the vast majority of men were circumcised. However, old
theories about less cancer in the circumcised male or his sex partner or better
sensation have been disproved. There has been some evidence that circumcised
men are less apt to catch sexually transmitted diseases if they have multiple
sex partners. In a truly tropical zone uncircumcised men may have infections of
the foreskin. There is no significant increased risk of foreskin infections in
the United States. Some adolescents or grown men express regret they were
circumcised; some wish they were and a few have it done later in life. The vast
majority of men accept their parents decision about circumcision without second
thought.
Circumcision in the first few weeks of life
carries some risk. There is a small possibility of infection or significant
bleeding. Though quite rare, these risks can lead to extended hospitalization
or the use of medication. Also, though I use a local anesthetic, a circumcision
causes some pain or discomfort and some babies may be fussy for a day or two
afterwards. The least expensive time to do a circumcision is in the newborn
period. The chance of a circumcision needing to be done later in life for
medical reasons in the United States is less than 1/2 of 1 percent.
Most parents who decide to have a
circumcision done do so for personal or religious reasons. Family pressure
should not be an important factor in deciding to circumcise.
We will do a circumcision usually after the baby
is at least 12 hours old and up to six weeks of age. It can be done in the
hospital or in the clinic. In the hospital, in addition to our fee for doing
the circumcision, there is a hospital charge of about $75.00 for the use of
their facilities, supplies and equipment. Medi-Cal and some insurances do not
cover the cost of circumcision.
If a circumcision is to be done in our
clinic, do not feed the baby for 2 hours before the procedure. The procedure
takes about 15 minutes and we may ask you to stay after the circumcision the
clinic for another 15 minutes to be sure there is no significant immediate
bleeding.
AFTER CIRCUMCISION CARE
After circumcision, the Vaseline gauze needs
to be unwrapped and removed in an hour. The diaper may be kept lightly lubricated where the penis will
rub with a little Vaseline or Neosporin ointment for the first day or two. No
other special attention is necessary. Light bleeding leaving a spot in the
diaper is fairly common in the first day. Also, a yellow-white membrane may form in patches over
the head of the penis and around the cut edge. After about ten days the
circumcision should look pretty well healed. The underside of the penis is
usually the last to heal. If there is redness going down the shaft of the penis
onto the abdomen, or if there is a rash with blisters or the baby's behavior
changes remarkably, let us know.
There may be bruising at the base of the penis where the local
anesthetic was given. You may give the baby 40 mgm of acetominophen (up to the
first line on the infant dropper) every four hours if the baby seems
uncomfortable
After the circumcision is well healed, at bath time you should pull the
foreskin back to completely expose the head of the penis, wash it off, and let
go. This practice will prevent
minor adhesions from forming.
ONE LAST THOUGHT
Baby boys, circumcised or not, grow up. How
they do in life depends on many considerations, and whether they are
uncircumcised or circumcised will likely not be a very important factor in the
long run. We'd be happy to discuss these things further with you if you have
questions or if other concerns about circumcisions should arise.
839-2677
this information last updated 03/09