MedCity Influencers

The Case for Circumcision

Circumcision involves the surgical removal of the prepuce, or foreskin, that covers the glans, or tip, of the penis. A physician, often the attending OB/GYN, performs the simple surgery the first or second day after birth. Religious or cultural traditions may prompt many parents to arrange for the circumcision of their sons, but research shows that neonatal circumcision has numerous health benefits as well.

Circumcision involves the surgical removal of the prepuce, or foreskin, that covers the glans, or tip, of the penis.  A physician, often the attending OB/GYN, performs the simple surgery the first or second day after birth.  Religious or cultural traditions may prompt many parents to arrange for the circumcision of their sons, but research shows that neonatal circumcision has numerous health benefits as well.

Is It Safe?

The safety of the procedure concerns many parents considering it for their newborns.  The procedure is safe provided the facility and practitioner meet certain criteria.  A qualified and experienced healthcare professional should perform the surgery using sterile technique, on a healthy newborn, with no medical issues that preclude it.  Risks associated with properly executed circumcisions are miniscule – 0.2 % to 0.6%.

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What Are the Benefits?

The majority of pediatricians agree that circumcision provides your baby with a lifetime of health benefits.  Countless research studies, and empirical evidence, show that circumcision prevents urinary tract infections in infants as well as reduces the risk of contracting a sexually transmitted disease (STD) later in life.  Circumcision decreases the risk of males contracting the following diseases:  human immunodeficiency virus (HIV) by up to 60 percent, herpes simplex virus type 2 by up to 34 percent, and human papillomavirus by 35 percent.  Female sexual partners of circumcised males have a 40 percent reduced incidence of bacterial vaginosis and a 48 percent reduction in trichomonas vaginalis infection.

Why Newborns?

The newborn days represent what physicians call the ‘window of opportunity’ for circumcision.  During this period, your son’s system has high levels of endorphins as well as adrenaline and cortisone.  These prepare your son to deal with the stress of the procedure better than at any other time in his life.  Circumcisions performed at an older age open the door for a number of complications and can cost over 10 times more.

How Is It Done?

The physician will apply a local anesthetic to the area.  Methods may include topical anesthetic cream, a ring block, or a dorsal penile nerve block (DPNB). Some physicians recommend allowing the infant to suck on a sugared pacifier to increase endorphin levels and reduce pain. General anesthesia is not advised, except under extenuating circumstances and greatly increases the risks associated with any surgical procedure.  Once the physician applies the local anesthesia, he will use one of three accepted methods to remove the foreskin from the penis:  Mogen clamp, Gomco clamp, or Plastibell.  No evidence exists that favors one of these three methods over the others.

What’s Next?

Afterward, healthcare staff may cover the wound with gauze saturated with petroleum jelly.  Your pediatric physician will provide you with instructions about caring for the area, which you must follow carefully.  Most practitioners recommend cleaning the area several times throughout the day with warm water.  Apply a small amount of petroleum jelly to the area after each diaper change.  If your son’s pediatrician has included the application of antibiotic ointment in the post-surgical instructions, use it instead of the petroleum jelly.  The scab usually heals and falls off within the span of 10 days.

Make an appointment at a local pediatric clinic before you give birth to your son and discuss circumcision benefits and risks with a pediatrician. This will enable you to make this important decision ahead of time.