Circumcision

The decision to circumcise your child is a big personal decision. There are many factors to think about to decide if it’s right for your family.

Whether you are thinking about circumcision for personal, religious, cultural or medical reasons, we are here to help you make the best decision for your child. At Banner Children’s, our goal is to create a safe and comfortable environment for families to explore their options.

What is circumcision?

Circumcision is a brief surgery to remove the foreskin, the retractable fold of skin that covers the tip of the penis (or glans).

When your baby is born, the foreskin is completely attached to the penis. Over time, the foreskin separates from the head of the penis and can be pulled back.

When is circumcision done?

Circumcision can be done at any age, but most are done during the first few days of a baby’s life.

The procedure is done by a health care provider before one month of age, usually in the hospital or a medical office. In Jewish culture, circumcision (or bris) is performed on the eighth day and is usually performed by a provider at the family’s home. Muslims also practice circumcision (khitan), though the age of the child may vary based on the family’s branch and tradition.

While circumcision can be performed later in life, it’s best to do it as soon as possible. The procedure becomes more complicated and riskier in older babies, children and adults because it must then be performed under general anesthesia.

Deciding on circumcision

Before your baby is born, you will be asked if you’d like to have them circumcised.

In the United States, newborn circumcision is not required. The American Academy of Pediatrics (AAP) considers circumcision a parent’s choice. The AAP has found that the health benefits of circumcision are greater than the risks, but the benefits aren’t large enough to say it should be required.

Although religion, culture or personal choice may come into play when thinking about circumcision for your baby, you should also be aware of these benefits and risks.

What are the benefits of circumcision?

Those who are circumcised have a lower risk of:

• Urinary tract infections (UTIs): According to the AAP, an uncircumcised baby has about a one in 100 chance of developing a UTI in the first year of life, versus one in 1,000 for those circumcised.
• Certain sexually transmitted infections (STIs): such as HIV, HPV, syphilis and herpes.
• Balanitis: an inflammation of the glans.
• Penile cancer (cancer of the penis).
• Prevention of phimosis: a condition where it is impossible to pull back the foreskin.

What are the risks of circumcision?

Like any surgical procedure, circumcision carries some risks. However, the rate of problems is low. The most common risks are minor bleeding, infection and pain.

Another complication is damage or deformity to the penis. Serious injuries are very rare, though, occurring in approximately 0.2% of procedures (usually those done outside the hospital).

Conditions that may delay circumcision

There are a few situations that may cause circumcision to be delayed. These include:

• If your baby has a blood disorder, congenital heart disease or lung disease.
• If there is a lack of adequate skin length between the scrotum and the head of the penis – this may be related to a buried (hidden) penis or webbed penis (scrotal tethering).
• If the opening of the urethra (urine duct) is not at the tip of the penis (hypospadias/epispadias), the penis is notably curved (penile torsion/chordee), or if the penis is relatively small.

Your child’s health care provider can help you weigh the benefits and risks and determine if circumcision is right for your baby.

How is a circumcision performed?

During a circumcision, the penis and foreskin are cleaned and the foreskin is removed. The procedure takes about 15 to 30 minutes.

There are different methods for performing circumcision. The choice of technique depends on the health care provider’s preference and experience. The three primary methods are the Gomco clamp, the Plastibell device and the Mogen clamp.

The steps for performing circumcision may differ, but your child’s provider will generally follow these steps:

• A local anesthetic will be given to numb the area of the penis where the incision will be made.
• The penis is then cleaned with an antiseptic.
• The foreskin is gently loosened and separated from the head of the penis.
• A cap is placed over the head of the penis for protection.
• A clamp is then placed and the foreskin is pulled into the clamp. The clamp is left in place for varying time periods to prevent bleeding.
• A scalpel is used to remove the foreskin.
• The clamp and cap are removed from the penis.
• Ointment is applied and the penis is wrapped in gauze.

Your health care provider may recommend oral sucrose, a simple sugar solution given as a liquid on your child’s tongue or inside their cheek. It can comfort infants and toddlers during this brief medical procedure.

How do you care for your child after circumcision?

After the circumcision, you will need to care for your baby’s penis until it heals. Recovery can take up to 10 days.

Your provider will give you aftercare directions. These include:

• Gently wash the area at least once a day, especially after bowel movements.
• Apply Vaseline or petroleum jelly at each diaper change.
• If recommended by your provider, your baby may take infant acetaminophen (Tylenol) liquid for pain management

The penis may appear swollen and red after the surgery. After a few days, a soft yellow scab may develop. These side effects are normal and will go away in a few days.

However, contact your child’s provider if you see signs the penis isn’t healing well, such as:

• Bleeding that won’t stop
• Fever
• Leaking, oozing and/or a bad smell
• Not peeing within 12 hours

Learn more about circumcision aftercare.

Our expert specialists

Deciding to circumcise your child can be a difficult decision. You may have many reasons for or against it, whether personal, religious, cultural or medical.

If you have questions, contact Banner Children’s. Our team of specialists offers a specialized approach to this procedure and can help you decide if it’s the right choice for your baby.