Try to make your decision regarding circumcision before the baby is born. Post-labor pain, lack of sleep, plummeting hormone levels, and visiting relatives won’t make it any easier. Here, a few ways to help you make the choice that’s best for your son and your family:
Know the possible health benefits of circumcision:
Reduced risk of urinary tract infections in infants. According to the American Academy of Family Physicians (AAFP) and the AAP, uncircumcised male infants are at a higher risk of urinary tract infections than those who are circumcised. The AAP states that the UTI rate among uncircumcised boys is 1 in 100 and falls to 1 in 1,000 among circumcised boys. Although UTIs are common in children and usually easily resolved, they are also acutely painful and can progress to more serious kidney infections and in some cases lead to renal scarring, which can lead to kidney problems, high blood pressure or even kidney failure later in life. (These severe complications are most often found in infants with undiagnosed urinary tract abnormalities.) Circumcision opponents maintain that proper cleansing of the foreskin can prevent many of these infections. The AAFP agrees.
No risk of foreskin infections, which affects about six percent of uncircumcised boys. This is somewhat obvious: No foreskin, no infection.
Prevention of phimosis, which is when a foreskin can’t be retracted (paraphimosis is when it does retract, but can’t be returned to its usual position). The foreskin is retractable in 90 percent of uncircumcised boys by age three, but 1 percent of all uncircumcised males will still have a nonretractable foreskin at age 17, at which point circumcision may be necessary. Mild cases of phimosis may be treated topically.
Reduced risk of HIV transmission. Recent studies have shown circumcision to reduce the transmission of HIV, the virus that causes AIDS. A review of studies done in Africa, where adult circumcision has been promoted by health organizations to try and stem an epidemic of AIDS, showed that the HIV rate was 44 percent lower in circumcised men. Among men at high risk, such as those being treated at STD clinics, the risk of contracting HIV was 71 percent lower. Virtually every study done worldwide has shown circumcision to have a protective effect against HIV. The risk of contracting HIV was also lower for women with infected partners who were circumcised. While this data is impressive, it mostly comes from studies of adult circumcision in Africa where most HIV is transmitted from male to female, condom use is limited, and sanitary conditions are far different than they are in the United States. So the relevance of these studies to Americans could be questioned.
Reduced risk of other STDs and conditions. Circumcision is also associated with a reduced risk of transmission of human papilloma virus (HPV), some strains of which can cause cervical cancer in female partners or, more rarely, penile cancer in men, as well as genital herpes. In an African study conducted by Johns Hopkins researchers in 2009, circumcision reduced the risk of genital herpes by 28 percent (10.3 percent of uncircumcised men developed genital herpes compared with 7.8 percent of circumcised men) and HPV infection by 35 percent (27.8 percent of uncircumcised men were infected with HPV compared with 18 percent of circumcised men.) On the other hand, parents can now have their sons vaccinated against some strains of HPV before they become sexually active.
Reduced risk of penile cancer, a very rare cancer that affects fewer than 1,400 US men annually. HPV is thought to cause some penile cancers, and about 90 percent of these are squamous cell cancers that occur on the skin, including the foreskin. Phimosis, or tightening of the foreskin is a risk factor for penile cancer. Adult circumcision has not been shown to have the same protective effect as infant circumcision against penile cancer.
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