Circumcision

Questions and answers for parents about newborn circumcision

If you are expecting a boy, you’ll need to decide whether to have him circumcised. This can be a difficult decision, with both potential benefits and complications to the procedure. We hope that the information below will answer some of your questions about circumcision and help you to make the best choice for you and your son.

What is circumcision?

Circumcision is a surgical procedure to remove the foreskin covering the end of the penis. It is an elective procedure that is often performed for cultural, social or religious reasons.

Are there any health benefits related to circumcision?

The American Academy of Pediatrics has concluded the following, based on current research:

"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal [newborn] circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child’s current well-being, parents should determine what is in the best interest of the child."

What are the potential benefits?

Literature suggests that possible medical benefits include:

• Prevention of phimosis (inability to retract the foreskin at a later age when it should be able to draw back from the end of the penis)

• Reduction in the incidence of urinary-tract infections

• Reduction in the incidence of sexually transmitted diseases

• Reduction in the risk for cancer of the cervix in future sexual partners

• Reduction in the risk for cancer of the penis, a rare form of the disease (10 cases per year in one million American men)

What are the potential complications or disadvantages?

As with any surgical procedure, there are possible risks. With circumcision, the risks are typically small (ranging between 0.2 percent and 0.6 percent), but can include:

• Bleeding

• Infection

• Injury to the penis or urethra 

• Removal of excess foreskin

Is it painful?

Research indicates that infants feel pain. Therefore, as with any surgical procedure, anesthesia is essential. Local anesthesia should be used; either an injection or topical anesthetic will be applied in preparation for the procedure. A sucrose solution may also be given through a nipple during the procedure.

How is circumcision performed?

A trained, experienced practitioner — such as an obstetrician, urologist, pediatric surgeon, family physician or pediatrician — should perform the circumcision. It is typically performed on healthy infants. Circumcision can be accomplished using a surgical clamp or a disposable plastic device called a Plastibell. Results are equally good with either device. The method used depends on the medical provider’s preference.

How do I care for my baby after the procedure?

During the first one to two hours after circumcision, watch for bleeding. If the bleeding saturates the gauze dressing or continues beyond one and one-half hours, notify the baby’s medical provider. A thin yellow film may form over the end of the penis. This is normal and will disappear within seven to 10 days. Contact your baby’s care provider immediately if you notice any of the following:

• Redness of the surrounding tissue

• Swelling

• Fever

• Thick, yellow drainage with a foul odor

• No urination within 12 hours after the circumcision

Who can perform the circumcision?

If you decide to have your baby circumcised, the following options are available for performing the circumcision, depending on your particular medical providers and insurance coverage. Speak with your individual provider about the options:

• Swedish Pediatric Specialty Care, 1101 Madison, Suite 800 in Seattle. For an appointment, call 206-215-2700.

• Swedish Family Medicine Residency Clinic/First Hill Campus, 1401 Madison, in Seattle. For an appointment, call 206-386-6111.

• Swedish Family Medicine Residency Clinic/Cherry Hill Campus, 550-16th Ave., #100, in Seattle. For an appointment, call 206-320-2484.

• Your obstetrician, pediatrician or family physician may perform a circumcision for your baby. Find a physician who performs circumcision.  Speak with the individual provider about the options.