Pros And Cons Of Circumcision

Contents

The circumcision generally heals in 5-7 days.

Circumcision

Circumcision is the surgical removal of the foreskin, which is the skin covering the tip of the penis. It’s common in the United States and parts of Africa and the Middle East but less common in Europe and some countries, according to recent estimates .

The procedure is typically done on a newborn for personal or religious reasons. Circumcision in older children and adults may also be done for the same reasons. Additionally, older children or adults may need circumcision to treat several conditions, including:

balanitis (swelling of the foreskin)
balanoposthitis (inflammation of the tip and foreskin of the penis)
paraphimosis (inability to return a retracted foreskin to its original position)
phimosis (inability to retract the foreskin)

In healthy newborns, there is no medical need for circumcision. However, families may choose to have their sons circumcised for a number of reasons.

One of the most common reasons is religious tradition. The religious laws of both Judaism and Islam require that newborn boys be circumcised. Other reasons to circumcise include:

personal choice
aesthetic preference
resulting lowered risk of some conditions
desire of some fathers to have their sons look like them

In Judaism, the ritual circumcision is called a brit milah and is typically performed as part of a religious ceremony at home or in a synagogue, although it is sometimes performed in a hospital. It is performed by a mohel, who has received religious and surgical training to perform ritual circumcision. The procedure is almost always done when the baby boy is eight days old.

In Islamic culture, the ritual circumcision is called khitan. In some parts of the Islamic world, the procedure is performed as part of a religious ceremony. In other parts, it’s done in a hospital setting. In most Islamic countries, the khitan is performed in infancy, but it may be done when a boy enters puberty.

There are health-related reasons to circumcise newborn males. Most of them aren’t factors until young adulthood, however. Circumcision is a decision best left to parents or to the child himself when he is older. Doctors can help parents better understand the benefits and risks.

Despite rumors to the contrary, circumcision has no effect on a man’s fertility, and there are mixed results from the few studies on how circumcision affects sexual pleasure. Some found no effect, while others found increased sensitivity.

Here are some of the pros and cons of male circumcision.

Pros of circumcision

decreases risk of urinary tract infections in infancy
likely decreases risk of penile cancer, though this cancer is rare and becoming rarer for reasons that appear to be unrelated to circumcision
decreases risk of sexually transmitted diseases, including female-to-male transmission of HIV
decreases risk of cervical cancer and some infections in female partners
prevents balanitis, balanoposthitis, paraphimosis, and phimosis
makes it easier to maintain good genital hygiene

Cons of circumcision

may be seen as disfigurement by some
may cause pain, although safe and effective medications are administered to reduce pain
has few immediate health benefits
may cause rare complications, including cutting the foreskin too long or too short, poor healing, bleeding, or infection

Circumcision is often done while newborns are still in the hospital. Different practitioners are trained to perform circumcision in newborns, including pediatricians and obstetricians. If you choose to have this procedure performed on your newborn, you’ll be asked to sign a consent form.

For older children and adults, the procedure is usually performed in a hospital or surgery center on an outpatient basis. This means that you would go home on the same day. Proper consent is also needed.

Circumcisions are often done by a pediatrician, obstetrician, family medicine doctor, surgeon, or urologist. Circumcisions that are performed for religious reasons are sometimes done by others trained in the procedure.

During the newborn circumcision, your son will lay on his back with his arms and legs secured. An anesthetic is given via injection or cream to numb the penis.

There are several techniques for performing circumcision. The choice of which technique is used depends on the physician’s preference and experience.

The three major methods of circumcision are the Gomco clamp, the Plastibell device , and the Mogen clamp. Each one works by cutting off circulation to the foreskin to prevent bleeding when the doctor cuts the foreskin. The procedure takes about 15 to 30 minutes.

After the procedure, your baby may be fussy. The doctor or nurse will provide instructions for how to decrease any discomfort. Healing time for a newborn’s circumcision is about 7 to 10 days.

It’s normal for the penis to be slightly red or bruised for a few days after the circumcision. You can wash the penis and change the dressings with each diaper change. Keep the diaper slightly loose to help the tip of the penis heal.

Call your child’s doctor if your child has any of the following:

continued fussiness (in babies)
increased pain (in children)
trouble with urination
fever
foul-smelling drainage
increased redness or swelling
persistent bleeding
a plastic ring that doesn’t fall off after two weeks

Recovery in adults

Your doctor will give you specific instructions on how to care for your incision and lessen your pain.

In general, you should return to work and daily activities when you feel comfortable. Avoid strenuous exercise, such as jogging or weight lifting, for the first four weeks of your recovery or until your doctor gives their approval.

Walking is the best way to exercise during your recovery. Try to walk a little more than you usually do each day.

How we reviewed this article:

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healthychildren.org/english/ages-stages/prenatal/decisions-to-make/pages/Circumcision.aspx
Circumcision. (2017).
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Daling JR, et al(2005). Penile cancer: Importance of circumcision, human papillomavirus and smoking in in situ and invasive disease.
ncbi.nlm.nih.gov/pubmed/15825185
Krieger JN, et al. (2008). Adult male circumcision: Effects on sexual function and sexual satisfaction in Kisumu, Kenya.
ncbi.nlm.nih.gov/pubmed/18761593
Male circumcision. (2012). DOI:
10.1542/peds.2012-1990
Mayo Clinic Staff. (2018). Circumcision (male).
mayoclinic.com/health/circumcision/MY01023
Morris BJ, et al. (2016). Estimation of country-specific and global prevalence of male circumcision [Table].
ncbi.nlm.nih.gov/pmc/articles/PMC4772313/table/Tab1/
Newborn male circumcision. (2012).
aap.org/en-us/about-the-aap/aap-press-room/pages/Newborn-Male-Circumcision.aspx
Tsen HF, et al. (2001). Risk factors for penile cancer: Results of a population-based case-control study in Los Angeles County (United States).
ncbi.nlm.nih.gov/pubmed/11405332
Where we stand: Circumcision. (2015).
healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/Where-We-Stand-Circumcision.aspx

Circumcision

Circumcision is the surgical removal of the foreskin, the tissue covering the head (glans) of the penis. It is an ancient practice that has its origin in religious rites. Today, many parents have their sons circumcised for religious or other reasons.

When Is Circumcision Done?

Circumcision is usually performed on the first or second day after birth. (Among the Jewish population, circumcision is done on the eighth day.) The procedure becomes more complicated and riskier in older babies, children, and men.

Circumcision Surgery: What to Expect

During a circumcision, the foreskin is freed from the head of the penis, and the excess foreskin is clipped off.

The procedure begins with medical staff cleaning then numbing the penis, either with a small shot of medicine or a numbing cream. They’ll put a clamp or ring on the penis, and the doctor removes the foreskin. A topical antibiotic ointment or petroleum jelly will then be put on the area, and it’s wrapped with gauze.

Older boys and men may be given medicine to sleep during the procedure, if it’s done in the hospital.

When a newborn is circumcised, the procedure takes about 5-10 minutes. Adult circumcision takes about an hour.

Circumcision Surgery Follow-Up

The circumcision generally heals in 5-7 days.

With an infant, you should wash the penis with only soap and water until it heals. Don’t use diaper wipes. Gently apply petroleum jelly to the area every time you change a diaper and loosely rewrap the gauze bandage if the gauze is still clean or replace gauze with a new piece. Fasten diapers loosely when you change them. The area might look a little red or bruised, and you could see a little yellow fluid in the diaper. If there is excess blood or pus then consult your doctor immediately.

Males circumcised as adults or older boys should take things slowly for 2-3 days. They should rest, do no heavy lifting and take pain meds as prescribed. Then it’s usually OK for them to go back to school or work. They should drink plenty of water and other clear fluids, especially in the first 24 hours after the procedure. They also should ice the area for up to 2 hours the first day, 10-20 minutes at a time. They’ll need to wear loose, comfortable underwear and keep the dressing over the area until the doctor says to take it off.

It’s important that they take the full dose of antibiotics if it is prescribed. Call the doctor right away if something stronger is needed for pain. Don’t take more than one pain medication unless the doctor says it’s OK.

Boys shouldn’t swim or take a bath for at least a week after the procedure. They should avoid bike riding and sitting on toys for at least 3 weeks, and they shouldn’t do strenuous activities like running for 4-6 weeks.

Adults can start being active by walking, going a little longer each day, but should wait 4 to 6 weeks to get back to activities like jogging or weightlifting.

Call the doctor right away if you notice:

Any trouble peeing
A fever
Any bleeding
An unusual smell or discharge at the tip of the penis
Blistering

If there’s a plastic ring instead of a gauze wrap, call the doctor if it stays on longer than 2 weeks.

Is Circumcision Necessary?

The use of circumcision for medical or health reasons is an issue that continues to be debated. The American Academy of Pediatrics (AAP) found that the health benefits of newborn male circumcision (prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV) outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision.

The procedure may be recommended in older boys and men to treat phimosis (the inability to retract the foreskin) or to treat an infection of the penis.

Parents should talk with their doctor about the benefits and risks of the procedure before deciding whether to circumcise a male child. Other factors, such as your culture, religion, and personal preference, will also be involved in your decision.

Circumcision Benefits

There is some evidence that circumcision has health benefits, including:

Less risk of urinary tract infections
A reduced risk of some sexually transmitted diseases in men
Protection against penile cancer and a lower risk of cervical cancer in female sex partners
Prevention of balanitis (inflammation of the glans) and balanoposthitis (inflammation of the glans and foreskin)
Prevention of phimosis (the inability to retract the foreskin) and paraphimosis (the inability to return the foreskin to its original location)

Circumcision also makes it easier to keep the end of the penis clean.

Circumcision Risks

Like any other surgical procedure, there are risks in getting circumcision. But this risk is low. Problems linked to circumcision include:

Pain
Risk of bleeding and infection at the site of the circumcision
Irritation of the glans
Higher chance of meatitis (inflammation of the opening of the penis)
Risk of injury to the penis

Show Sources

American Academy of Pediatrics.

The American Urological Association.

Mayo Clinic: “Circumcision (Male).”

Kids Health: “Circumcision.”

MyHealth.Alberta.Ca: “Circumcision In Older Boys: What To Expect At Home,” “Adult Circumcision: “What To Expect At Home.”

Circumcision Pros and Cons

The difference in reported sexual dysfunction is not statistically significant. The Williamson study consists of young, Midwestern, 98% white mothers. They live in an area of the country with the highest circumcision rate, and 78% of the group had no experience with genitally intact men.

In a more recent survey, women with longer dual experience preferred anatomically complete men overwhelmingly to circumcised men. Without the foreskin to provide a movable sleeve of skin, intercourse with a circumcised penis resulted in decreased vaginal secretions, more vaginal discomfort, harder and deeper thrusting of the partner, less chance of having an orgasm, less frequent orgasms, less frequent multiple orgasms, and shorter duration of coitus.

Circumcision results in a significant loss. The foreskin is an integral, normal part of the penis. It protects the head of the penis and is comprised of unique zones with several kinds of specialized nerves that are important to optimum sexual sensitivity. Investigators found that circumcision removes about one-half of the erogenous tissue on the penile shaft. The foreskin on the average adult male is about 12 square inches of highly erogenous tissue. Men circumcised as adults reported a significant loss of sensitivity.

A description of the complex nerve structure of the penis explains why anesthetics provide incomplete pain relief during circumcision. Cutting off the foreskin removes many fine-touch receptors from the penis and results in thickening and desensitization of the glans outer layer. The complex anatomy and function of the foreskin dictate that circumcision should be avoided or deferred until the person can make an informed decision as an adult.

In a national survey, circumcised men reported they were more likely to engage in masturbation, heterosexual oral sex, and anal sex than genitally intact men. The result suggests that circumcised men seek alternative forms of stimulation to compensate for reduced sensitivity.

A poll of circumcised men described adverse outcomes on men’s health and well-being. Findings showed wide-ranging physical, sexual, and psychological consequences. Some respondents reported prominent scarring and excessive skin loss. Sexual consequences included progressive loss of sensitivity and sexual dysfunction. Emotional distress followed the realization that they were missing a functioning part of their penis. Low-self esteem, resentment, avoidance of intimacy, and depression were also noted. Male satisfaction with circumcision depended on knowledge about circumcision. The more men knew, the more likely they were to be dissatisfied. They wished they had a choice.

Circumcision is traumatic, and the long-term psychological effects of circumcision are similar to the long-term effects of trauma. Using four case examples that were typical among his clients, a practicing psychiatrist presented clinical findings regarding the serious and sometimes disabling long-term somatic, emotional, and psychological consequences of infant circumcision in adult men. These consequences resembled complex post-traumatic stress disorder and emerged during psychotherapy focused on the resolution of perinatal and developmental trauma. Adult symptoms associated with circumcision trauma included shyness, anger, fear, powerlessness, distrust, low self-esteem, relationship difficulties, and sexual shame.

Ethics

Circumcision violates a major principle of medical practice: First, do no harm. According to a journal article, it also violates all seven principles of medical ethics. Some doctors and nurses refuse to perform or assist with circumcisions because of ethical considerations. They have organized to form Doctors Opposing Circumcision and Nurses for the Rights of the Child.

The first intensive exploration of the unrecognized psychological and social aspects of this increasingly controversial American cultural practice. Endorsed by dozens of professionals in psychology, psychiatry, child development, pediatrics, obstetrics, childbirth education, sociology and anthropology.

What You Can Do

Consultation and Counseling – For circumcised men and expectant parents

Educate Yourself – Get books, DVDs, CDs, and more

Volunteer – Help protect the next generation

Help Stop Medicaid Circumcisions – They violate state and federal regulations

Talk About Circumcision – Our tips can turn discomfort into power

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Pros And Cons Of Circumcision