At birth, boys have skin that covers the tip of the penis called a foreskin. Circumcision is the surgical removal of the foreskin. The first report of a circumcision occurs in the Bible. But circumcisions have been performed ritually and surgically ever since. Traditions vary widely about this procedure. In this country, over 65% of newborns are circumcised. In many Asian countries, however, the incidence is below 20%. The American Academy of Pediatrics (AAP) has issued policy statements on the benefits and dangers of circumcision:
Why do parents choose to circumcise?
- Medical benefits
- A slightly lower risk of urinary tract infections (UTIs). An uncircumcised boy has a 1:100 chance of developing a UTI in the first year of life. A circumcised boy has a 1:1000 chance or 1/10th the likelihood of developing a UTI.
- A lower incidence of cancer of the penis. However, this is a very rare type of cancer to begin with.
- A slightly lower risk of getting a sexually transmitted disease including HIV.
- No foreskin infections. We see about 5 per year in our practice.
- Prevention of phimosis, which is a tight foreskin that cannot be pulled back
- Easier genital hygiene
- Social reasons
- When all the men in the family have been circumcised, many parents circumcise their own child.
- Religious or cultural reasons
- Many Jews and Moslems circumcise their children in keeping with their tradition that Isaac and Ishmael were circumcised.Why do parents choose not to circumcise? Many parents fear of the risks, which are minimal but may include bleeding and infection. There is also a belief that circumcision is an unnecessary surgical intervention since the medical benefits are minor. And finally, proper education of genital hygiene for a young male can be very helpful in limiting the risk of infections.
Is there a recommendation?
No, the American Academy of Pediatrics has taken a neutral position on circumcision. The medical benefits are considered mild. The position of most pediatric providers is that if you are leaning towards circumcision, the medical data may be enough to push you over towards circumcising. If you are dead set against the procedure, the medical data is not strong enough to push you in the opposite direction.