Circumcision

Alternative names

Foreskin removal; Removal of foreskin

Definition

Circumcision is the surgical removal of the foreskin of the penis. It is often performed in healthy boys for cultural or religious reasons. In the U.S., circumcision of a newborn boy is usually done before he leaves the hospital. Among the Jewish population, circumcision is done on the eighth day.

The merits of circumcision are currently under debate. There is NOT a compelling medical rationale for the procedure in healthy boys. However, some boys have medical conditions where circumcision may be needed.

Many physicians, rather than routinely recommending circumcision for healthy boys, allow the parents to make the decison after presenting them with the "pros" and "cons."

Description

A numbing medication (local anesthesia) is recommended during the procedure. It might be injected at the base of the penis, in the shaft, or applied as a cream to reduce pain.

There are a variety of ways to perform a circumcision. Most commonly, the foreskin is pushed from the head of the penis and clamped with a metal or plastic ring-like device.

If the ring is metal, the foreskin is cut off and the metal device removed. The circumcision heals in 5-7 days.

If the ring is plastic, a piece of suture is tied tightly around the foreskin. This pushes the tissue into a groove in the plastic over the head of the penis. Within 5-7 days, the plastic covering the penis falls free, leaving a completely healed circumcision.

Sometimes a sucrose (sugar) pacifier is given to infants during the procedure, and Tylenol (acetominonphen) may be given after the procedure for any pain or anxiety.

Circumcision of older and adolescent boys is usually done while the child is completely asleep and pain-free (using general anesthesia). The foreskin is removed and stitched onto the remaining skin of the penis. Stitches that will dissolve (absorbable sutures) are used and will be absorbed within 7 to 10 days.

Indications

Some faiths, such as Judaism and Islam, commonly have ritual circumcisions performed. For some areas in the world it is uncommon, such as Europe, Asia, and South and Central America.

There are varied opinions among physicians regarding the need for circumcision in healthy boys. Some place great value on the benefits of an intact foreskin, including a more natural sexual response during adulthood. However, some studies suggest that uncircumcised male infants have an increased risk for getting urinary tract infections. Other studies show correlations between uncircumcised males and penile cancer, some sexually transmitted diseases including HIV, infections of the penis, and phimosis (tightness of the foreskin, not allowing it to retract over the glans penis).