Circumcision: Treatment, Risks, Benefits, and Recovery

Circumcision is the surgical removal of the foreskin, a piece of skin that covers the head, or glans, of the penis. In the United States, nearly two-thirds of newborn boys are circumcised. The procedure is usually done during the week following birth, often within one to two days. However, uncircumcised adolescents and adults sometimes undergo the procedure.

Circumcision is the oldest known surgical procedure. Experts date the practice to nearly 4,500 years ago in Egypt. Circumcision has long been required as part of Jewish law. It is also done for medical and cultural reasons. It’s usually done by a urologist, obstetrician, or pediatrician when performed in a medical setting. It takes 20 minutes or less. As a Jewish ritual, called a bris, it’s done eight days after birth by a mohel, someone specially trained to perform circumcisions.

The American Academy of Pediatrics and the American Urological Association state that the practice of circumcision does have potential health benefits, but it also comes with risks (we’ll get into both below.) Both groups recommend that circumcision be offered to parents as a choice, but neither endorses the routine practice for all boys. Before you decide to have your baby boy circumcised, talk to your newborn’s doctor about the risks and benefits.

What are the potential benefits of circumcision?

• Circumcision lowers the risk of urinary tract infections. UTIs are not common in males, but they occur more often in those who are uncircumcised. During a boy’s first three to six months, his risk of a UTI is ten times higher if he has not been circumcised. When severe, such infections increase the risk of kidney problems later in life.
• Circumcision prevents problems like phimosis. Phimosis causes the foreskin to tighten so that it can’t be pulled back. This can trap urine, which in turn can cause inflammation or infection.
• Some research suggests that circumcision may help lower the risk of HIV and some other sexually transmitted diseases, such as human papillomavirus (HPV). However, circumcised men must still practice safe sex to have adequate protection. Circumcision offers no protection against syphilis or gonorrhea.
• Circumcision may lower the risk of penile cancer. This is a rare cancer, but it’s even less common in men who have been circumcised.
• Another anti-cancer benefit: Women whose male partners have been circumcised may be less likely to develop cervical cancer. Why? Because circumcised men are less likely to be infected with and spread HPV, a known cause of cervical cancer.

What are the risks of circumcision?

It’s rare for problems to occur during or as a result of circumcision. Those that do occur are frequently minor:

• Bleeding may occur but this is nearly always quite mild and easily stopped by applying pressure. It’s rare that it will require more extensive care, such as stitches. Tell your doctor if you have a family history of bleeding disorders. If your baby has a bleeding disorder, bleeding during circumcision could require a blood transfusion or be fatal.
• Infection is another uncommon risk, though they can occur. Infants do not have fully active immune systems so infections can be more serious and need prompt treatment.
• Too much or too little foreskin may be removed. If too much is removed, the problem normally resolves on its own, but it may be distressing for parents immediately after the procedure. When too little foreskin gets removed, it may require a second procedure to fix the problem.

Why do adults get circumcised?

While most males who are circumcised underwent the procedure as newborns, some uncircumcised males choose to get circumcised as an adult. There are a few reasons for this.

Phimosis, as mentioned above, makes it impossible to pull your foreskin back normally. This can develop in adults as well as children. Circumcision may be the only way to treat it.

Some uncircumcised men may opt for the procedure because they want their penis to resemble that of other men, most of whom are circumcised in the U.S. They may be concerned that a sexual partner will find an uncircumcised penis unusual.

How are circumcisions performed?

The baby is placed on his back and gently held in place so that he can’t kick or move his arms during the procedure. His penis is then cleaned and given an anesthetic, which can be a cream or an injection. After these preparations, a plastic clamp or ring may be attached to the baby’s penis to make it easier to cut the foreskin. The person performing the procedure will then use a scalpel to remove the foreskin.

Right after, the baby’s penis will be covered with petroleum jelly or an antibiotic ointment and then wrapped in a gauze bandage. It should fully heal within a week to ten days.

The procedure for adults is similar, though it may take a bit longer and will require stitches. Following an adult circumcision, patients must avoid sexual activities for about a month while the incision heals. For the first two weeks following surgery, heavy exercise is off limits. Otherwise, the sweat and strain could interfere with healing.