One of the first health decisions new parents of boys face is whether or not to circumcise their son. You and your partner may begin debating the pros and cons of circumcision from the moment you find out you're having a boy, or you may not even consider it until they ask you in the hospital.
Craig Peters, M.D., a pediatric urologist at Children's Health℠ and Professor at UT Southwestern, says the procedure is optional and it's a decision completely up to parents.
"Circumcision is the parents' decision," says Dr. Peters. "Your choice could be based on cultural, aesthetic or religious reasons. We support families and help guide them if there are any medical reasons to circumcise or not circumcise a baby boy."
He works closely with parents to answer their questions about circumcision, so they feel informed and confident in their decision.
What is circumcision?
Circumcision is a surgical procedure used to remove the normal foreskin covering the head of the penis. It's estimated that approximately two-thirds of all newborn males are circumcised in the United States.
Are there health benefits to circumcision?
The American Academy of Pediatrics (AAP) does not make a recommendation for or against circumcision in newborn boys, but they do say that health benefits outweigh the risks of the procedure.
Circumcision can help reduce the risk of several infections and diseases, including:
- Balanitis (inflammation of the glans – the tip of the penis)
- Balanoposthitis (inflammation of the glans and inability to pull back the foreskin)
- Paraphimosis (inability to return the foreskin to its original location)
- Penile cancer
- Phimosis (inability to pull back the foreskin)
- Some sexually transmitted infections
- Urinary tract infections (UTIs)
Are there risks of circumcision?
Circumcision procedures have low risks. Risks of the surgery include:
- Increased risk of meatitis (inflammation of the opening of the penis)
- Irritation of the glans (the head of the penis)
- Risk of injury to the penis
How is circumcision performed?
Circumcisions are routine, but the procedure does vary slightly based on your child's age. When newborns are circumcised in the nursery, the penis should be numbed with a topical anesthetic. A pediatrician, obstetrician-gynecologist, pediatric urologist or nurse practitioner then uses a special tool to clamp the penis and cleanly remove the foreskin. At Children's Health, our compassionate team also swaddles the baby and plays soothing music as additional comfort measures. Another method includes a plastic ring that is tied to the foreskin to allow safe removal and the ring falls off in 5 to 7 days.
After children are 2-3 months, circumcisions are typically performed under general anesthesia. This is usually done after the age of 6 months. A caudal or penile nerve block may also be given to help reduce pain below the waist during and after surgery. An anesthesiologist closely monitors children while a pediatric urologist removes the foreskin. Sutures (stitches) reduce the risk of bleeding and dissolve on their own a few days after surgery.
How do you care for a circumcision?
It may take a week to 10 days for a newborn's penis to heal after a circumcision. Stitches dissolve a few days after the procedure.
Help your child heal after circumcision with a few simple care tips:
- Keep gauze on the penis for 24 hours
- Change dressing with every diaper change
- Gently apply petroleum-based ointment to the end of the penis with each diaper change and after every bath
- Clean stool off the penis gently with warm, soapy water
- Change his diaper frequently and fasten it loosely
Be sure to call your child's pediatrician with any questions or if you notice:
- No wet diapers within 12 hours of the procedure
- Blood in the diaper larger than a quarter
- Redness or swelling that gets worse
- Signs of infection
- Cloudy, foul-smelling drainage from the tip of the penis
How do I care for an uncircumcised baby?
It's important to keep a baby's penis clean. An uncircumcised newborn's foreskin won't retract (pull back) fully. Be gentle with the foreskin and avoid forcing it back. This could cause pain and bleeding. A boy's foreskin may not be able to be pulled back until they are 6 or 8 years. As long as they are not having problems with inflammation or pain, there is no real need for it to retract.
When your baby's foreskin can retract, clean it regularly by:
- Gently pulling back the foreskin
- Using mild soap and water to clean the glans (the head of the penis) beneath the foreskin
- Rinsing and drying the area
- Gently pulling the foreskin back over the glans
The Pediatric Urology department at Children's Health offers comprehensive care from prenatal to adolescence and beyond. Learn more about our Urology program and services.