The practice of circumcision started about 4,000 years ago for religious reasons. Today, many Jews and Muslims have their sons circumcised for the same religious reason. However, most Americans have their sons circumcised for other, more common psychological and social reasons: Grandfathers, fathers, uncles and brothers were circumcised, so the son is circumcised. Hygiene is another popular reason for circumcision.
One does not need to be circumcised to have a normal healthy life, but circumcision does make hygiene much easier for the parents and caregivers of a young boy. It is also easier for the personal hygiene of a male adult. What do I mean by hygiene? For a male with retractable foreskin, good personal hygiene is the daily gentle retraction of the foreskin for bathing with soap and water, then returning the foreskin to its normal position. One does not need to do this daily if circumcised.
While there are some health benefits for circumcision, the benefits are minimized with age and good hygiene. A newborn boy is at a higher risk of urinary infection if not circumcised, but this risk becomes equal with a circumcised boy by six months to a year of age. An adult male is at higher risk for cancer of the penis if he is uncircumcised and has poor personal hygiene. If the adult male has good hygiene, the risk is similar to that of an uncircumcised adult male.
What factors should one consider when deciding on having your son circumcised?
Cost: Most insurance plans do cover newborn circumcision, but not all plans do or cover the entire cost. It will be more expensive to have a circumcision done later in life, as it will involve general anesthesia in boys older than a month.
Convenience: It is more convenient to have it done as a newborn. You will not need to be concerned about the care of the foreskin or hygiene of the boy as he grows.
Pain: Most providers today use a local anesthetic to numb the penis at the time of newborn circumcision. An older boy will require a general anesthetic, but will be able to go home the same day from the hospital or surgical center. Infants usually only require over the counter pain medication like Tylenol. Older boys may need something stronger for pain relief once the numbing medicine used during surgery has worn off.
Care involved: Your primary care provider will give you advice on the care of the foreskin or the circumcision, as applicable.
Where you live: More boys who are born in the Midwest are circumcised (75 percent) than are boys on the coasts (50 percent). If you want a newborn circumcised, you will need to discuss that with your provider before you deliver your son.
Medical concerns: Some boys are born prematurely or are too small to have a circumcision done as a newborn. The same is true with a boy born with a serious, life-threatening heart condition. Some boys are born with birth defects of the penis such as hypospadias and epispadias and should not be circumcised.
Remember, circumcision involves some risks: bleeding, infection, taking too much — or not enough — foreskin, and possible injury to the penis. Visit with your provider to learn more.
John M. Donovan is a board-certified pediatric urologist at Wesley Children’s Hospital.