In the USA, most males undergo circumcision during their newborn period. Whether you decide to circumcise your son or not, doctors will respect your decision because there is no right or wrong in this area of medicine. There are some potential long-term benefits of circumcision, but some short-term risks are also associated with the procedure.
In my article, I will discuss perceived risks and benefits associated with circumcision and will talk about what medical professional associations say on this topic.
Basic information about circumcision
Male circumcision refers to the removal of the foreskin from the penis. This procedure has been known for many years. It is usually performed by medical professionals but sometimes by healers, priests, and rabbis.
In the USA, if desired by parents, circumcision is performed on healthy newborn babies before their discharge home from the birth hospital.
In the USA, the incidence of circumcision among adult males is estimated to be about 80%. Its frequency varies depending on race and religion. The rate is highest among non-Hispanic White Americans, lower among Black Americans, and the lowest among Mexican Americans.
People request circumcision for different reasons. Some make their decision based on perceived medical benefits. Others want it due to religious, cultural, and social influences.
Circumcision is still considered an elective surgical procedure. Therefore, each family should decide for themselves whether to have it done based on the complete information provided to them by medical providers caring for their son.
Potential benefits of circumcision
Many parents consider potential medical benefits when deciding to have their son circumcised. Let’s talk about the most frequently cited benefits of this procedure.
Reduction in the frequency of urinary tract infections
It is believed that the space between the foreskin and glans of the penis provides a moist environment in which bacteria may grow and spread into the urethra, causing urinary tract infections. This condition affects most frequently children during their infancy and those with anatomical abnormalities of the urinary tract.
One large study that looked at almost 400 000 males up to one year of age showed that circumcised children were nearly 90% less likely to develop urinary tract infections (UTI).
Another research project provided information on the lifetime risk of urinary infections for circumcised and uncircumcised men. The UTI risk in adult males who had the procedure was 8.8% versus 32% for those without it.
One could ask, is this benefit enough to recommend the procedure for all male newborn babies? We have to approach the answer to this question very carefully. Firstly, urinary infections are just an inconvenience without long-term consequences for most people. Secondly, studies cited above are so-called retrospective studies; they are not prospective and randomized research projects that could provide more reliable information.
Without a doubt, decreasing the frequency of urinary infections in children with additional anatomical abnormalities of the urinary tract is much more important. Those children are at risk of developing chronic renal failure, and protecting their kidneys from infections will be extremely useful.
Reduction in risk of certain cancers affecting men and their women partners
Several research studies concluded that circumcision has a weak protective effect on the incidence of penile cancer. Scientists calculated that one would have to perform between 900 and 320 000 circumcisions to avoid one case of penile cancer.
The cancer-protective benefits also extend to men’s women partners. For example, several reports showed that circumcised men were less likely to pass HPV (Human Papilloma Virus) to their partners. As we know, HPV contributes to the development of cervical cancer in women. This benefit may be of lesser importance in developed countries because recently discovered vaccines can protect both males and females from HPV.
Reduction in the incidence of sexually transmitted disorders
We have evidence that circumcision decreases risks of acquisition of HIV (Human Immunodeficiency Virus), HPV (Human Papilloma Virus), herpes simplex type 2 virus and trichomonas. However, the procedure does not change the risk of getting gonorrhea, syphilis, and chlamydia.
One could only speculate what precisely the mechanisms of those positive effects are. Researchers think, it may be because circumcised men’s penis has keratinized epithelium, which is less prone to abrasions and ulcers.
It is easier to keep the penis clean
General genital hygiene is much easier to maintain if a penis is circumcised. That, in turn, leads to a lesser risk of inflammation and infections. For example, the rates of penile inflammation in uncircumcised boys are 14% versus 7.6% for boys who had the procedure.
Risks associated with male circumcision
Every medical procedure carries some risks. It is also true for circumcision. Doctors describe possible complications after the circumcision in 0%-2% of all cases (Reference Article). This rate also varies depending on the surgeon’s own experience, hospital, and country where the procedure occurred.
Let’s look together at possible complications of circumcisions.
Unsatisfactory cosmetic results
Obviously, any surgery that affects external appearance may lead to an unhappy client. For example, in the case of circumcision, removing too much or too little of the skin or post-surgical scarring may lead to an undesirable cosmetic outcome.
Every surgery inherently carries a risk of bleeding. Fortunately, most bleedings following the circumcision are not severe and are easy to stop.
There may be rare situations in which a male baby undergoing circumcision suffers from congenital undiagnosed yet bleeding disorder. In those cases, circumcision may result in severe bleeding and even death. However, the latter outcome is exceptionally infrequent.
Occasionally, post-surgical wounds following the circumcision become infected. If that occurs, treatment with local antibiotics (ointment) or intravenous antibiotics may be necessary. Rarely, additional surgery such as debridement of the dead tissue or aspiration of the abscess may be required.
Narrowing of the urethra
Unprotected by skin urethra may be exposed to wet filled with urine diapers. That, in turn, may irritate the urethra and lead to chemical inflammation and scarring. The scarring may result in narrowing or stenosis of the urethra and subsequent problems with urination. When this complication develops, it can be treated either medically or surgically.
Inexperienced or distracted surgeons may remove too much skin tissue or even damage the glans of the penis. I encountered in my practice a few cases in which babies after their circumcision required further plastic surgeries to correct unpleasant cosmetic appearance. Again, fortunately, those cases are incredibly infrequent.
Circumcision involves excising the foreskin covering the penis. The emphasis here is on an act of “excision” or “cutting.” Despite proper surgical techniques, certain patients may develop scarring, which may be difficult later to treat.
Complications of the anesthesia
It is recommended that circumcisions be performed using some pain control, which local anesthesia achieves in most cases. However, some patients may develop adverse reactions to anesthesia such as allergies, unstable blood pressure, irregular heart rate, or cessation of breathing.
Professional organizations’ opinions about male circumcision
Different local and world organizations expressed their opinion on performing circumcision.
World Health Organization (WHO) has recommended that African countries consider circumcision as a part of their fight against the HIV epidemic.
The American Academy of Pediatrics (AAP), in its 2012 statement, has said that: “the health benefits of newborn male circumcision justify access to this procedure for families who choose it.” However, notably, AAP did not endorse routine circumcision. Instead, the organization emphasized that parents and families need to weigh health benefits, risks, and cultural, religious, and social preferences while making that important decision.
The American College of Obstetricians and Gynecologists (ACOG) generally agreed with the statement from the AAP.
The American Urological Association has similar views to those of AAP. It has stated that: “neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks….and is generally a safe procedure when performed by an experienced operator….”
I hope I was able to provide you with useful information regarding circumcision. Read my article here if you want to learn about other routine procedures and tests performed on all newborn babies in the hospital before they are sent home.
This article is only for general information purposes. It should not be viewed as any medical advice. There is always a chance that information here may be inaccurate. It would be best if you always discussed all health-related matters with your doctor before making any decisions that may affect yours or your family members’ health.