ASK THE DOCTOR: Circumcision common for American boys
By Dr. JIM MITTERANDO
The Patriot LedgerQ. I am pregnant and expecting a baby boy. Can you discuss the pros and cons of circumcision?
A. Circumcision is a common operation performed on newborn boys to remove the foreskin that covers the tip of the penis.
In the United States, about 70 percent to 80 percent of boys are circumcised, whereas, in Europe the majority of boys are not circumcised. These days, newborn boys are circumcised mostly for cultural, religious or personal reasons - not for medical reasons.
Jews and Muslims have traditionally had their boys circumcised a week after birth. In the United States, most boys are circumcised for social reasons - either the father is circumcised or the parents are concerned that an uncircumcised boy may feel ‘‘different’’ or awkward in the locker room or with sexual experiences later in life.
Circumcision is a very personal choice with no right answer. The decision whether or not to circumcise a newborn son is important for parents, since it is usually the first big decision that they must make regarding their child.
Circumcision’s benefits are minimal. Circumcised males have a lower risk of urinary tract infection and cancer of the penis; both of these problems are rare and do not justify circumcision on a medical basis.
As many as 5 percent to 10 percent of uncircumcised males may require circumcision later in life because the skin around the tip of the penis may become tight and uncomfortable (called phimosis). Circumcised males may have a slight decreased chance of getting some sexually transmitted diseases but still need to practice safe sex.
As with any surgery, there are risks - though circumcision is a fairly safe procedure. Complications occur in one in 200 to one in 500 circumcised newborn males - most often minor, including bleeding and infection. Occasionally a child will need a second circumcision if not enough foreskin was removed the first time.
If you choose to have your baby circumcised ask your doctor about pain control. The penis can be numbed with a lidocaine injection (similar to what the dentist injects to numb the mouth).
It is important to discuss these issues with your healthcare provider before you deliver your baby so that you have time talk about it and make a decision. It is tough to make a decision shortly after delivering a child with all the emotions and activities that you will be experiencing.
Q. How do I care for my baby’s penis if it is circumcised?
A. Vaseline jelly is applied to a gauze pad that is placed on the penis to prevent it from sticking to the diaper. This is performed with every diaper change during the first three or four days. After that time, no further special care is needed and simply wash the area when bathing.
Q. How do I care for my baby’s penis if I choose not to have him circumcised?
A. Simply keeping the penis clean with soap and water during bathing helps reduce the risk of problems or infections.
In older boys and adult men, the foreskin slides back and forth over the penis, allowing the area underneath to be cleaned. The foreskin doesn’t retract in boys for a few years. Don’t try to force the foreskin to retract, because this can damage the penis and cause problems.
After the baby is 1 year old, you can gently try to pull back the foreskin while you are bathing him. If the foreskin moves easily, wash the end of the penis and carefully place the foreskin back over the end of the penis. If you cannot pull the foreskin back, don’t worry. This is perfectly normal and you can try again in a few months. As your child grows, the foreskin will gradually become retractable. The foreskin is retractable in 80 percent of 3-year-old boys and 99 percent of 17-year-olds.
Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.
Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.
Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.
Copyright 2002 The Patriot Ledger
Transmitted Tuesday, October 22, 2002