Potential Benefits:

There are many reasons why families choose to circumcise their sons. Some choose circumcision for religious reasons, others for hygiene and others because males in the family are circumcised. Some of the reported benefits are:

 

• Decreased Phimosis:

  • Phimosis is a tight, nonretractable foreskin affecting 1-4% of uncircumcised boys. Most cases can be treated with topical steroids though 0.8-1.6% of children will need a circumcision, in some cases emergently.

 

• Decreased Urinary Tract Infections (UTI):

  • Approximately 2.7% of boys less than 1 year of age will develop a UTI. Uncircumcised baby boys have ~10 times higher chance of UTI compared to circumcised boys in the first year of life.

 

• Decreased Sexually Transmitted Infections (STI):

  • Circumcision has been shown to decrease the risk of HIV, herpes and Human Papilloma Virus (HPV, the virus associated with cervical and penile cancer) to males and their partners in Africa with an unknown effect in North America. There is no proven effect on chlamydia and gonorrhea rates.

 

• Decreased local infections:

  • Uncircumcised boys are at risk of local skin infections of the penis and glans (balanitis, posthitis, balanoposthitis). These occur in 3-11% of men in their lifetime. Due to easier hygiene, these risks are greatly reduced if boys are circumcised.

 

• Less risk of later circumcision:

  • The risks of circumcision in older boys and men are greater than when done early in infancy (10x higher) and more costly. There are also risks associated with general anesthesia, which is more often required in older boys and men.

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Potential Risks:

Less than 1% of children having circumcision will have a complication. It is important to be aware of the potential risks when making your decision. In many situations the actual risk is not fully known due to the rarity of complications.

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Risks are greatest in the following populations and therefore it is not advised to do an office-based circumcision:

• There is a family history of bleeding disorder

• The baby did not receive vitamin K after birth

• The baby is premature (under 37 weeks at birth)

• There is a congenital abnormality of the penis (the anatomy of the penis is not normal)

• There is a medical disorder in the newborn (ex. hypothyroid, heart disease, infectious disease)

 

• Bleeding:

  • It is normal for some bleeding to occur after circumcision with most cases being evident and managed right after the procedure in the clinic with pressure or topical agents. Significant bleeding may occur in 1/1000-4000 cases. In very rare circumstances these require a blood transfusion. If you are concerned about bleeding please go to your nearest emergency department.

 

• Infection:

  • Infections after circumcision occur in less than 1/1000 circumcisions. These are best prevented with good hygiene. In some cases oral or intravenous antibiotics may be required.

 

• Poor Healing/Trauma to the penis:

  • Adhesions are common after circumcision (~25%). Most self-resolve or require skin creams.

  • In some cases there may be redundant foreskin or asymmetries. These look more prominent in smaller children and are often outgrown. In rare cases a second procedure is needed.

  • Trauma to the penis is rare and may require urgent surgical consultation. Damage can be done to the urethra (the hole where urine comes out), the glans (the head of the penis), or the shaft of the penis.

 

• Death:

  • This is very rare (<3/>50 million) and often due to an undiagnosed bleeding disorder.

 

What about sexual function?

There is no clear evidence that circumcision affects sexual function. There are reports of both increased and decreased sexual satisfaction in circumcised males.