Circumcision is the removal of the foreskin of the penis. The foreskin is a flap of skin that covers the tip of the penis.
In the US, the procedure is mostly done for cultural and/or religious reasons. It is usually done on babies within the first few days of life. It may be done on older boys or men if there is a medical reason.
Certain health benefits are thought to be associated with circumcision. Many health professionals believe these benefits are slim. Circumcision may be associated with decreased risks of:
Complications are rare, but no procedure is completely free of risk. If you are planning to have your son circumcised, your doctor will review a list of possible complications which may include:
Factors that may increase the risk of complications include:
Research shows that the best method of anesthesia is a nerve block. This is an injection of anesthetic into an area around the penis where the nerves run to the penis. This causes the penis to become numb.
The baby will be carefully restrained on an infant board or by a chosen individual. The anesthesia will be injected.
The doctor will pull the foreskin away from the body of the penis. Any areas where tissue still adheres to the penis will be swept away. The excess, unwanted foreskin will then be cut away. Rarely, stitches may be used to sew the remaining bit of foreskin into place. Petroleum jelly or antibiotic ointment will be smeared on the penis. A bandage may be applied.
The foreskin can be removed a number of ways. Some use a simple scalpel to remove foreskin. Others may use one of several devices to ensure an even circumcision and clamp blood vessels. These devices include the Gomco clamp, Plastibell device, or Mogen clamp. The Plastibell device is left in place instead of a bandage. It falls off on its own within 5-8 days.
About 15–30 minutes
With appropriate anesthesia, the baby should feel only minimal pain.
After the procedure, be sure to follow your doctor's instructions, which may include:
There may be significant swelling of the penis and/or a clear scab over the area of circumcision. The penis should be healing well within 7-10 days of the circumcision. If a Plastibell device was left in place, it should fall off on its own within 10 days.
After arriving home, contact your doctor if any of the following occurs:
RESOURCES:
Familydoctor.org—The Academy of Family Physicians
http://familydoctor.org/
Kids Health
http://kidshealth.org/
CANADIAN RESOURCES:
AboutKidsHealth
http://www.aboutkidshealth.ca/
Caring for Kids
http://www.caringforkids.cps.ca/
References:
American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html. Accessed July 16, 2008.
American Academy of Pediatrics (AAP) Task Force on Circumcision. Circumcision policy statement. Pediatrics.1999;103:686-93.
Brady-Fryer B, Wiebe N, Lander JA. Pain relief for neonatal circumcision. The Cochrane Database of Systematic Review. 2004;3.
Lander J, Brady-Ryer B, Metcalfe JB, Nazarali S, Muttitt S. Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision: a randomized controlled trial. JAMA. 1997 Dec 24-31;278(24):2157-62.
Leef KH. Evidence-based review of oral sucrose administration to decrease the pain response in newborn infants. Neonatal Network. 2006; 25(4):275-284.
Sorrells ML, Snyder JL, Reiss MD, et al. Fine-touch pressure thresholds in the adult penis. BJU Int. 2007 Apr;99(4):864-9.
Last reviewed October 2009 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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