Lifespan's A - Z Health Information Library

Circumcision is the surgical removal of the foreskin of the penis. It is often performed in healthy boys for cultural or religious reasons. In the U.S., a new born boy is usually circumcised before he leaves the hospital. Jewish boys, however, are circumcised when they are 8 days old.

A numbing medication (local anesthesia) is usually applied before a circumcision to reduce pain. It might be injected at the base of the penis, in the shaft, or applied as a cream.

There are a variety of ways to perform a circumcision. Most commonly, the foreskin is pushed from the head of the penis and clamped with a metal or plastic ring-like device.

If the ring is metal, the foreskin is cut off and the metal device is removed. The wound heals in 5-7 days.

If the ring is plastic, a piece of suture is tied tightly around the foreskin. This pushes the tissue into a groove in the plastic over the head of the penis. Within 5-7 days, the plastic covering the penis falls free, leaving a completely healed circumcision.

The baby may be given a sweetened pacifier or lollipop during the procedure. Tylenol (acetaminophen) may be given afterward.

In older and adolescent boys, circumcision is usually done under general anesthesia while the child is completely asleep. The foreskin is removed and stitched onto the remaining skin of the penis. Stitches that dissolve (absorbable sutures) are used and will be absorbed within 7 to 10 days. The wound may take up to 3 weeks to heal.

In some faiths, including Judaism and Islam, circumcisions are performed on all baby boys as a religious rite. In other parts of the world, including Europe, Asia, and South and Central America, circumcision is rare in the general population.

The merits of circumcision are currently under debate, and opinions about the need for circumcision in healthy boys vary among physicians. Some place great value on the benefits of an intact foreskin, including a more natural sexual response during adulthood. Rather than routinely recommending circumcision for healthy boys, many physicians allow the parents to make the decision after presenting them with the pros and cons.

There is no compelling medical rationale for the procedure in healthy boys, although some boys have a medical condition requiring circumcision. However, some studies suggest that uncircumcised male infants have an increased risk of urinary tract infections. Other studies show correlations between being uncircumcised and an increased risk of developing penile cancer, certain sexually transmitted diseases including HIV, infections of the penis, and phimosis (tightness of the foreskin that prevents it from retracting). The overall increased risk for these conditions is thought to be relatively small.

Proper hygiene of the penis and safe sexual practices can help prevent phimosis, penile cancer, AIDS, and other sexually transmitted diseases. Proper hygiene is always important, but is thought to be especially important for uncircumcised males.

In 1999 the American Academy of Pediatrics revised their policy statement on circumcision, and this policy is supported by the American Medical Association. A summary of the policy is below:

"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal 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. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided."

• Bleeding
• Infection
• Localized redness
• Injury to the penis

For both newborns and older children, circumcision is considered a very safe procedure.

Healing time for newborns after circumcision usually is about 1 week. Petroleum jelly (Vaseline) should be applied after changing the diaper to protect the healing incision. Some initial swelling and yellow crust formation around the incision is normal.

For older children and adolescents, healing may take up to 3 weeks. In most cases, the child will be discharged from the hospital on the day of the surgery. Home care for older children should include:

• Avoiding vigorous exercise during the healing.
• If the wound bleeds during the first 24 hours after surgery, pressure should be applied with a clean cloth for 10 minutes.
• In older children, use ice packs (20 minutes on, 20 minutes off) for the first 24 hours after surgery to reduce swelling and pain. Bathing or showering is usually allowed. The incision may be gently washed with mild, unscented soap.
• Change the dressing at least once a day and apply an antibiotic ointment. If the dressing gets wet, change it promptly.
• Use prescribed pain medicine as directed. Pain medication should not be needed longer than 4 to 7 days. In infants, use only acetaminophen, if needed.

Call your pediatrician or surgeon if:

• Fresh bleeding occurs
• The entire penis looks red and swollen
• Pus drains from the incision
• Pain becomes severe or lasts for longer than expected