Definition of Circumcision:

Circumcision is the surgical removal of the foreskin of the penis.

Description:

The health care provider will usually numb the penis with local anesthesia before the procedure starts. The numbing medicine may 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 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 are used to close the wound. They will be absorbed by the body within 7 to 10 days. The wound may take up to 3 weeks to heal.

Why the Procedure Is Performed:

Ciurcumcision is often performed in healthy boys for cultural or religious reasons. In the United States, a newborn boy is usually circumcised before he leaves the hospital. Jewish boys, however, are circumcised when they are 8 days old.

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 have been debated. Opinions about the need for circumcision in healthy boys vary among health care providers. Some believe there is great value to having an intact foreskin, such as allowing for a more natural sexual response during adulthood.

Rather than routinely recommending circumcision for healthy boys, many health care providers 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.

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."