Male circumcision is a surgery to remove the foreskin, a fold of skin that covers and protects the rounded tip of the penis. The foreskin provides sensation and lubrication for the penis. In most cases, circumcision is elective surgery, which means there isn't a medical reason for it. If it is done, circumcision is usually done soon after birth. After the foreskin is removed, it can't be put back on again.
On average in the United States, about 60 out of 100 boys are circumcised, and about 40 out of 100 are not.1 Worldwide, the rate of circumcision is much lower.
See a picture of the penis before and after circumcision.
There are some cases where circumcision is done for medical reasons. Circumcision may be done in older boys and men to treat problems with the foreskin of the penis (such as phimosis or paraphimosis) or for swelling of the tip of the penis (balanitis).
This topic focuses on the circumcision of newborns.
Circumcision is not usually medically needed. The American Academy of Pediatrics (AAP) does not recommend circumcision as a routine procedure for newborn males. When making this policy, the AAP looked at the possible benefits, risks, and costs of the procedure.2 Other major medical organizations, including the American Medical Association (AMA) and the American Congress of Obstetricians and Gynecologists, agree with the AAP policy.
When you make this decision, it may help you to think about your personal and cultural preferences. For example, you may want to consider your religious and family traditions while you weigh the pros and cons of the surgery. It is your decision whether to keep your son's penis natural or have your son circumcised.
Problems from circumcision are not common. If they occur, they are usually minor. The most common circumcision problems are:
More serious problems are rare. They include damage to the opening of the urethra, heavy bleeding that requires stitches, severe infection, and scarring.
Circumcisions usually are done by a pediatrician, obstetrician, family medicine doctor, surgeon, or urologist. Circumcisions that are performed for religious reasons may be done by others trained in the procedure.
Frequently Asked Questions
Learning about circumcision:
How it is done:
Care after circumcision:
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|Circumcision: Should I Keep My Son's Penis Natural?|
Circumcision is usually done by a doctor at a clinic, in the hospital, or at an outpatient surgery center. During the procedure:
After the circumcision, the groin, penis, and scrotum may appear reddish brown because of the liquid used to clean the skin before surgery. The shaft of the penis where the skin was removed will look raw and slightly swollen.
Your baby will stay in the hospital or clinic for 2 to 4 hours after the procedure. His penis will be checked for bleeding, and the circumcision area may be covered with petroleum jelly and gauze. If gauze is used, it stays on for about 24 hours. Before you take it off, soak it in warm water and gently loosen it.
You will likely take your baby home the same day he is circumcised. Some swelling around the penis is normal in the first few days after the surgery. Some slight bleeding may occur. If this happens, apply direct but gentle pressure to the area with a clean cloth or bandage for about 5 to 10 minutes.
After surgery, your baby will feel some pain. He may be fussy and have trouble sleeping.
A thin yellow film will form over the circumcision site after surgery. This is part of the normal healing process and should go away in a few days. Although the penis is beginning to heal, it may look worse a few days after circumcision. The penis should look like it's getting better about a week after surgery.
Here are some things you can do to help your baby feel more comfortable:
Ask your doctor about giving your baby acetaminophen (such as Tylenol) for pain. Call your doctor anytime your baby seems to be in a lot of pain.
Your son's penis will be checked during routine well-baby visits. But it is important to call your doctor if your baby has problems after circumcision.
Call your doctor right away if after circumcision:
If a Plastibell device was used for the circumcision, call your doctor if the ring has not fallen off after 10 to 12 days.
Doctors who usually perform circumcisions on infants include:
A urologist or surgeon normally will do circumcisions on older infants, children, and adults.
Because it's not usually medically needed, circumcision is done on newborns mainly for cultural reasons. For example, parents may make the decision about circumcision based on religious and family traditions, personal preferences, or the social norms of their communities.
There may be some health benefits for circumcised males, but these benefits must be weighed against the risks. Medical experts in the United States agree that these health benefits alone are not good enough reasons to have circumcision.
The American Academy of Pediatrics (AAP) does not recommend circumcision as a routine procedure for newborn males. When making this policy, the AAP looked at the possible benefits, risks, and costs of the procedure.2 Other major medical organizations, including the American Medical Association (AMA) and the American Congress of Obstetricians and Gynecologists, agree with this policy.
In a baby's first year of life, urinary tract infections (UTIs) happen less often in circumcised boys than in boys who are not circumcised. But UTIs are not common. No studies support healthy babies having circumcision to prevent UTIs.3, 4, 5
There may be reasons later in life when your son may need a circumcision. A boy or man may have problems retracting the foreskin or may have swelling of the foreskin that requires circumcision.
All surgical procedures have risks. Problems after circumcision are not common. Minor problems are short-term and may include:
Long-term problems can include:
Major problems are very rare but can include:
As a parent, you will decide whether you want to keep your son's penis natural or want him to be circumcised. Because circumcision is usually not medically needed, this decision often is a personal one based on your own values and religious or cultural beliefs.
It's a good idea to think about your decision before your baby is born. If you wait, the excitement and fatigue of the delivery can affect your ability to carefully consider the benefits and risks of each choice.
Your son's values
Circumcision is not just done in newborns. Keep in mind that your son can decide on his own later in life if he wants a circumcised penis.
Circumcision and STIs
Some studies in other countries have shown that circumcised men are a little less likely than men who have not been circumcised to get a sexually transmitted infection (STI), including HIV.6, 7 But circumcision should not be done solely to prevent STIs or HIV.
Any man, especially if he has high-risk sex, can get STIs or HIV. The best way to prevent STIs is to teach people about risk factors and the importance of avoiding high-risk sex.
Some people have concerns that circumcision can decrease sensation in the penis. Some people also wonder if circumcision disrupts the bonding that occurs between mother and son during breast-feeding. But there is not a lot of research about these concerns.
Keeping your son's penis clean may help prevent infection and other problems. It's important to keep your son's penis clean whether he has been circumcised or not. When cleaning a natural (uncircumcised) penis, be careful not to force the foreskin to retract.
If you choose circumcision
If you decide that you would like to have your baby circumcised, talk with your doctor. Discuss any concerns you may have about pain and your preferences for anesthesia. Ask your doctor about giving your baby acetaminophen (such as Tylenol) for pain relief after surgery.
When is circumcision not done?
Circumcision is only done if you choose it for your baby. But your doctor may not do circumcision if your baby has a medical condition that makes him more likely to have problems from the surgery, such as:
|American Academy of Family Physicians|
|P.O. Box 11210|
|Shawnee Mission, KS 66207-1210|
The American Academy of Family Physicians offers information on adult and child health conditions and healthy living. Its Web site has topics on medicines, doctor visits, physical and mental health issues, parenting, and more.
|American Academy of Pediatrics|
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The American Academy of Pediatrics (AAP) offers a variety of educational materials about parenting, general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other organizations are also available.
|American Congress of Obstetricians and Gynecologists (ACOG)|
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|P.O. Box 96920|
|Washington, DC 20090-6920|
American Congress of Obstetricians and Gynecologists (ACOG) is a nonprofit organization of professionals who provide health care for women, including teens. The ACOG Resource Center publishes manuals and patient education materials. The Web publications section of the site has patient education pamphlets on many women's health topics, including reproductive health, breast-feeding, violence, and quitting smoking.
|KidsHealth for Parents, Children, and Teens|
|10140 Centurion Parkway North|
|Jacksonville, FL 32256|
This website is sponsored by the Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This website offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly emails about your area of interest.
|National Organization of Circumcision Information Resource Centers|
|P.O. Box 2512|
|San Anselmo, CA 94979-2512|
The National Organization of Circumcision Information Resource Centers (NOCIRC) is a group that opposes circumcision. The group gives out pamphlets, hosts conferences, and has a Web site dedicated to its mission. The subjects NOCIRC focuses include the functions of the foreskin and research related to the medical, ethical, and legal reasons that the sexual organs of children should be left intact.
NOCIRC offices are open to the public, and they are available to answer requests for information by phone and mail.
|UrologyHealth.org, American Urological Association|
|1000 Corporate Boulevard|
|Linthicum, MD 21090|
UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option.
The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology Resource Center to find materials about urologic problems.
- Merrill CT, et al. (2008). Circumcisions performed in U.S. community hospitals, 2005. HCUP Statistical Brief #45, pp. 1–9. Rockville, MD: Agency for Healthcare Research and Quality. Also available online: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb45.jsp.
- Task Force on Circumcision, American Academy of Pediatrics (1999, reaffirmed 2005). Circumcision policy statement. Pediatrics, 103(3): 686–693.
- Singh-Grewal D, et al. (2005). Circumcision for the prevention of urinary tract infection in boys: A systematic review of randomised trials and observational studies. Archives of Disease in Childhood, 90(9): 853–858.
- Malone P, Steinbrecher H (2007). Clinical review: Medical aspects of male circumcision. BMJ, 335(7631): 1206–1209.
- Van Howe RS (2005). Effect of confounding in the association between circumcision status and urinary tract infection. Journal of Infection, 51(1): 59–68.
- Siegfried N, et al. (2009). Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database of Systematic Reviews (2).
- Tobian AAR, et al. (2009). Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. New England Journal of Medicine, 360(13): 1298–1309.
Other Works Consulted
- Centers for Disease Control and Prevention (2008). Male circumcision and risk for HIV transmission and other health conditions: Implications for the United States. Available online: http://www.cdc.gov/hiv/resources/factsheets/PDF/circumcision.pdf.
- Steadman B, Ellsworth P (2006). To circ or not to circ: Indications, risks, and alternatives to circumcision in the pediatric population with phimosis. Urologic Nursing, 26(3): 181–194.
- Towers HM (2006). Circumcision. In FD Burg et al., eds. Current Pediatric Therapy, 18th ed., pp. 313–315. Philadelphia: Saunders Elsevier.
- Wiysonge CS, et al. (2011). Male circumcision for prevention of homosexual acquisition of HIV in men. Cochrane Database of Systematic Reviews (6).
|Primary Medical Reviewer||Adam Husney, MD - Family Medicine|
|Specialist Medical Reviewer||John Pope, MD - Pediatrics|
|Last Revised||January 27, 2012|
Last Revised: January 27, 2012
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