Family Health Guide

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Circumcision Risks

Know the possible risks of circumcision:

Meatitis, an inflammation of the urethral opening (or meatal stenosis, a narrowing of the opening), which might otherwise be protected by the foreskin. Meatitis is the most common complication of circumcision in infancy, but changing your circumcised son’s diaper often can greatly reduce this risk.

Infection. Neonatal circumcision is considered low-risk, but “low risk” does not mean “no risk”. Large studies of neonatal circumcision in the U.S. have shown hospital inpatient complication rates of between .2 and 2 percent, with most complications being minor bleeding and minor infection. Keep in mind, however, that although most reported infections are minor, any infection in a neonate can be dangerous because of their undeveloped immune system. Life-threatening infections such as meningitis, gangrene and sepsis, a blood infection, have been linked to circumcisions.

Injury to the penis or glans. With sharp instruments and human tissue, injury is always a possibility and, to parents, a big concern. Historically there have been rare instances of amputation or partial amputation of the glans or penis, but this is a freak occurrence. In fact, a 2010 British review of more than 16 studies on infant circumcision worldwide found a zero percent rate of serious complications. More common is a partial circumcision, where some foreskin is left, which can cause irritation, phimosis, and problems that may require revision surgery later.

Consider hygiene. Circumcision makes it easier to clean the penis, although it is not difficult to learn to clean under the foreskin. If an uncircumcised penis isn’t properly cleaned, smegma can accumulate under the foreskin and cause infection or adhesions. According to the AAP, it is proper hygiene that is critical to an infant’s health, not his circumcision status.

Learn the truth about circumcision and sexual satisfaction. The internet is full of websites claiming that the nerve endings on the foreskin are essential for sexual satisfaction. Research on this is limited, but there is no evidence at all that it’s true. The few studies conducted on adult men after circumcision found either no change or an improvement in satisfaction. Hundreds of millions of American men have been circumcised, so an epidemic of men who didn’t enjoy sex would have been pretty hard to miss.

Recognize your personal preference. Some families feel it is important for a son to look like his father or older brothers, or to feel comfortable in the high school locker room. This factor could lead you in either direction depending on your ethnic heritage, religion, and where you live.

Debate the ethical issues. Critics of circumcision say it’s wrong to make a decision for an infant boy to remove a part of him, no matter how small, and subject him to risk, no matter how small, when the surgery is unnecessary.  Also, circumcision can be performed at any age (the risks become greater after infancy, however, and the surgery requires general anesthesia and a longer recovery). Proponents feel that it’s unethical not to circumcise when the procedure could help prevent a deadly infection like HIV later in life.

Have a heart-to-heart with your partner. He may be focused on how his son will feel in the middle school locker room, while you might be more concerned with medical evidence. Hear each other out and give yourselves time to come to a decision if you disagree at first.

Bring it up at your pre-natal pediatrician appointment. Your doctor should be up on the latest studies and the AAP policy, as well as pain and infection control. He can also give you some firsthand information on problems or complications that he’s seen in both circumcised and uncircumcised boys.

Discuss it with a representative of your faith. If you are thinking of circumcision for religious or traditional reasons, do some reading to find out why the tradition is important and schedule a meeting with your rabbi, priest, pastor, or imam. Find out how you can have a meaningful religious experience while minimizing pain and infection risk for your baby.