If you’re expecting a boy, then it’s inevitable that you’ll face the question of whether to circumcise him or not. Ultimately, it comes down to what you think is best for your child, but it’s still extremely important to be informed about the process before you face the final decision. Today, circumcision is becoming more controversial and can be a dividing topic, even between you and your partner, so your maternal fetal medicine specialist can ensure you have the information you need to make the right decision for your child.
Circumcision is a surgical procedure in which the foreskin is incised from the penis. The foreskin is a sheath of skin that serves a natural protective function and is made up of a vast number of nerves. At birth, the foreskin is fused to the glans of the penis where it will eventually loosen during puberty so that it can easily glide and retract. Circumcision is traditionally performed on infants within a few days of birth, but it’s possible for men to opt for circumcision for many different reasons later in life.
Circumcision rates in the United States vary according to geographic area, socioeconomic status, religious affiliation, insurance coverage, hospital type, and racial and ethnic group. The overall prevalence is estimated to be about 80 percent for males aged 14 to 59 years, with most of these procedures performed as newborns. Circumcision rates outside of the United States vary widely, from less than 5 percent to over 90 percent of males. Less than 30% of boys worldwide are circumcised. As a whole, circumcision rates in the United States have been shown to be declining.
The most recent review on male circumcision was published by the American Board of Pediatrics (AAP) in 2012. In their review, the AAP states that the procedure appears to be safe has some health benefits that appear to outweigh the risks of the procedure and that circumcision should be available for families who choose it. But the AAP also states that “the benefits of male circumcision are not great enough to recommend universal newborn circumcision.” Circumcision has been associated with benefits including lower rates of urinary tract infection (UTI) in the first year of life, as well as lower rates of penile cancer, penile inflammation, penile dermatoses, and sexually transmitted infections. In addition, studies have shown that women that are partners of men that are circumcised are less likely to contract the human papilloma virus (HPV) and are therefore less likely to develop cervical dysplasia and cervical cancer.
Other reasons for performing circumcision may be related to religious or cultural beliefs and some medical reasons like a congenital abnormality of the foreskin or penis which may require a circumcision as part of the repair. As circumcision rates are declining nationally, the justification that boys should be circumcised in order to look like their peers may become less common.
The most common argument against circumcision it is a surgical procedure and that as is the case with any surgery, there is a potential risk for complications including bleeding, infection or damage to the penis. In two studies that included a total of over 200,000 circumcisions performed in US hospitals, the rate of complications during the first month after the procedure was approximately 0.2 percent (2 in one thousand). The overwhelming majority of the complications that have been reported are minor and have resulted in no long term sequelae. In the past circumcision was routinely performed without providing pain relief. Today both safe and effective methods of pain control now exist and are provided to all infants undergoing the procedure. Our practice always uses pain relief prior to performing circumcision with either a dorsal nerve block or a ring block or a topical numbing cream EMLA.
Circumcision can be a difficult choice with many different factors to consider. After receiving written consent, our obstetricians can perform circumcisions prior to your discharge. To learn more about the pros and cons and discuss your concerns with your obstetrician, contact our New York City office by calling or filling out our online form.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!