Circumcision is the surgical removal of some or all of the skin covering the tip of the penis. The word “circumcision” comes from the Latin word circum (meaning “around”) and cædere (meaning “to cut”). Circumcisions are controversial. For some parents, the procedure is a religious ritual. It can also be a matter of family tradition, personal hygiene or preventive health care. For others, the procedure is disfiguring and unnecessarily painful.
Opinions are mixed
In 1999, the American Academy of Pediatrics (AAP) issued a policy statement that says the benefits aren’t strong enough to recommend routine circumcision for all male newborns. Today, the AAP leaves the decision up to parents – and supports use of pain relief for infants who have the procedure. This information will focus mostly on the indications for a circumcision procedure and the post-operative period.
Indications for circumcision
Phimosis, from the Greek word phimos (φῑμός) for “muzzle”, is a condition where the foreskin cannot be fully retracted from the head of the penis. This is normal in the neonatal period. Only approximately half of boys can retract their foreskin at age 1, while 90 percent of boys are able to retract their foreskin by 3 years of age.
Phimosis is the most common reason for consideration of a circumcision. For adults, diabetes is the most common cause for phimosis. Poor hygiene can also lead to narrowing of the skin. A urologist should perform a careful examination and before giving advice on treatment options.
During the first year of life it is more common for an uncircumcised boy to develop a urinary tract infection or balanitis – an infection of the glans penis. Initial treatment of balanitis is antibiotics and warm compress.
A child may develop a phimosis as result of the infection. Adults can also develop recurrent infections of the foreskin. This is usually from a fungal infection and can be treated with anti-fungal ointment. Sometimes the skin becomes very damaged and a circumcision procedure is necessary.
Health benefits of circumcision
- Easier hygiene. Circumcision makes it easy to wash the penis.
- Decreased risk of urinary tract infections. The risk of urinary tract infections in the first year is low, but these infections may be up to 10 times as common in uncircumcised baby boys.
- Prevention of penile problems. Occasionally, the foreskin on an uncircumcised penis may be difficult or impossible to retract (phimosis). This can also lead to inflammation of the head of the penis.
- Decreased risk of penile cancer. Although cancer of the penis is rare, it’s less common in circumcised men.
- Decreased risk of sexually transmitted diseases. Safe sexual practices remain essential, but circumcised men may have a slightly lower risk of certain sexually transmitted diseases – including HIV, the virus that causes AIDS.