Many new parents face the decision about whether to have their newborn son circumcised.
It’s a choice that has both pros and cons. But there are some things you should take into account before you make your final decision.
“The question of whether to circumcise or not to circumcise, I think, as pediatricians, as urologists, in health care, this is something that we all encounter in conversations with parents,” says Rajeev Chaudhry, MD, pediatric urologist, UPMC Children’s Hospital of Pittsburgh. “If any of you have had sons, it’s also probably something you’ve had to decide, or talk about, or think about yourselves.”
What Is Circumcision?
Circumcision is the surgical removal of the foreskin that covers the head of the penis. The procedure usually takes place within the first 10 days of a healthy baby boy’s life, often within the first 48 hours. Premature babies or those born with health conditions may not be able to get circumcised right away.
Pediatricians, family doctors, and obstetricians can perform circumcisions. For religious circumcisions, a hired professional can perform them.
Parents may choose to have their babies circumcised for many reasons. Those include religious or cultural reasons, hygiene, appearance, potential health benefits, and more.
According to the Centers for Disease Control and Prevention (CDC), about 58% of newborn boys were circumcised in 2010. In Africa and the Middle East, rates of circumcision are much higher. Rates in Europe and Asia are much lower.
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Benefits and Risks of Circumcision
According to the American Urological Association (AUA), “neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks.” The American Academy of Pediatrics (AAP) says “the health benefits of newborn male circumcision outweigh the risks.”
Neither the AUA nor the AAP specifically endorses circumcision for newborn boys.
Possible benefits of circumcision include:
- Lower risk of urinary tract infections (UTIs). Studies show a significantly lower rate of UTIs in circumcised boys during the first year of life. The most protection comes when the babies are between 3 months and 6 months old. However, UTIs even in uncircumcised baby boys are rare. And, after the first year of life, there is no difference in the risk of UTIs in circumcised versus uncircumcised boys. Pediatric urologists do recommend circumcision if your baby has a urologic condition that puts them at higher risk of UTIs.
- Lower risk of HIV. Multiple studies conducted in Africa showed a significantly lower risk of HIV infection and transmission in circumcised men. The CDC reported circumcision can lower the risk of HIV in American men by 15.7%. Dr. Chaudhry notes that the overall risk of HIV among U.S. heterosexual men is very low. Circumcision does not offer extra protection against HIV in homosexual men. Also, safe sex practices (such as wearing condoms and avoiding multiple partners) can lower your risk of HIV.
- Lower risk of sexually transmitted infections (STIs). Some data show a link between circumcision and a lower risk of certain STIs. These include human papilloma virus (HPV) and ulcerative STIs like syphilis and chancroid. Circumcision does not protect against other STIs, like gonorrhea and chlamydia. Also, there are additional protections against STIs, like the HPV vaccine, sex education, and safe sex practices.
- Lower risk of penile cancer. Penile cancer is more than twice as common in uncircumcised men compared to circumcised men. However, the overall risk of penile cancer is low in the U.S.
Dr. Chaudhry says many people believe circumcision also provides better hygiene — but no evidence backs that up, he says. An uncircumcised penis is not necessarily unclean.
“I would argue that proper hygiene and care for an uncircumcised penis would actually alleviate this issue,” Dr. Chaudhry says.
The AUA says circumcision should be offered “as an option for health benefits.”
“The data for health benefits aren’t really compelling enough to warrant circumcision in all male infants,” Dr. Chaudhry says. “It’s a case-by-case situation. A lot of this should be done prenatally, with the ob-gyns talking with the parents.”
The AUA says circumcision is “generally a safe procedure when performed by an experienced operator.”
There is a very small risk of complications from the procedure. Those include:
- Penile injury.
There also are some potential long-term complications, including:
- Buried penis (too much or not enough foreskin is removed, and surrounding skin covers the penis).
- Meatal stenosis (narrowing of the opening of the urethra).
- Skin bridges (shaft skin is attached to the head of the penis).
- Chordee (bending of the penis).
- Poor appearance of the penis.
But complications from circumcision are rare. Severe complications are extremely rare.
“Complication rates are pretty low,” Dr. Chaudhry says. “It’s very safe when done properly.”
When Should I Talk to a Doctor About Circumcision?
Circumcision is a personal choice. Dr. Chaudhry recommends talking to an ob-gyn about circumcision before birth. You also can discuss circumcision with a pediatric urologist.
You should ask any questions you might have about the potential health benefits and risks of circumcision. Those conversations and your own cultural, religious, and personal beliefs can help you make a decision.
“I have an informed conversation with my parents about circumcision and the reasons for and against,” Dr. Chaudhry says.
If you do choose to have your child circumcised, it’s best to do it within 10 days of birth unless they are premature or have another health condition preventing circumcision at that time. Waiting longer to have a circumcision can make the procedure more complicated.
You also should talk to a pediatrician or pediatric urologist about caring for your baby after a circumcision. Follow their recommendations for cleaning and bandaging in order to prevent infection.
UPMC Children’s Hospital of Pittsburgh’s Division of Pediatric Urology provides urological care to infants, children, and adolescents. For more information, visit our website.
American Academy of Family Physicians, Circumcision. Link
American Academy of Pediatrics, Circumcision Policy Statement. Link
American Urological Association, Circumcision. Link
National Library of Medicine, Circumcision. Link
Maria Owings, PhD, Sayeedha Uddin, MD, MPH, and Sonja Williams, MPH, Centers for Disease Control and Prevention, Trends in Circumcision for Male Newborns in U.S. Hospitals: 1979–2010. Link
From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.