Circumcision

Circumcision is a common procedure that removes the foreskin covering the head (glans) of the penis. Often newborn males undergo circumcision shortly after birth. Many babies go through a circumcision within the first week of life. Adults can get a circumcision, too. But it’s less common.

Is it healthier to circumcise or not?

It depends. There are medical pros and cons to circumcision, and several major medical associations recommend offering circumcision as a choice for parents. These groups include the American Urological Association (AUA) and the American Academy of Pediatrics (AAP).

Both organizations state that the benefits are greater than the risks. But they don’t explicitly recommend circumcision — it’s ultimately the parents’ decision. If you have any questions, talk to your child’s healthcare provider.

How common is circumcision?

Circumcision is the most common surgery among males. Over 70% of males in the United States are circumcised. Throughout the rest of the world, the circumcision rate is about 33%.

The highest rates of circumcision are in:

• The U.S.
• The Middle East.
• South Korea.

Circumcision is much less common in Europe, other parts of Asia and South America. Jewish and Muslim people perform circumcision as part of their religions.

At what age do guys get circumcised?

You can get circumcised at any age. But most circumcisions occur within the first week after birth — usually within the first 48 hours — in a hospital. It’s best to perform a circumcision as soon as possible. Delaying the procedure can make it riskier.

In the Jewish faith, a trained religious leader (mohel) performs a circumcision (also called a brit milah or bris) when a baby is 8 days old. Other cultures may perform a circumcision at a later age.

How should I prepare my baby for a circumcision?

In a hospital setting shortly after birth, healthcare providers will prepare your child for circumcision by numbing their penis with an anesthetic (a numbing cream or an injection). They may also recommend giving your child acetaminophen to help with pain relief.

For older children and adults, a provider will review your or your child’s health history and perform a physical examination. Be sure to tell the provider about any prescription or over-the-counter (OTC) medications you or your child is taking, including herbal supplements. Some herbal supplements and OTC medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) and blood thinners (anticoagulants), can increase the risk of bleeding during a circumcision.

You should also tell the provider about any known allergies, including:

• Medication allergies.
• Latex allergies.
• Skin cleaner allergies, like iodine or isopropyl alcohol.

Who performs a circumcision?

The following may perform a circumcision in a hospital:

• Urologist. A urologist is a doctor who specializes in treating and diagnosing conditions that affect the urinary and reproductive systems.
• Obstetrician. An obstetrician is a doctor who specializes in providing care during pregnancy, childbirth and the first few weeks after your child’s birth.
• Pediatrician. A pediatrician is a doctor who specializes in treating infants, children and adolescents.
• Urology and maternal medicine advanced practice providers (APPs). APPs are healthcare providers who aren’t doctors but have training to perform some physician duties, including circumcisions.

In a bris, a mohel performs a circumcision. They may perform the circumcision in a private home, synagogue or hospital setting.

What happens during a circumcision?

Once the anesthetic takes effect, a healthcare provider will:

• Place your baby on their back.
• Gently restrain your baby’s arms and legs so their limbs don’t flail during the procedure.
• Clean the penis.
• Separate the foreskin from the head of the penis.
• Use a scalpel to remove the foreskin.

Newborn circumcision doesn’t require sutures (stitches).

For older children and adults, the circumcision process is the same as it is for babies. But once a provider removes the foreskin, they may use dissolvable stitches or an electric current to burn (cauterize) the area to stop any bleeding and reduce scarring after healing.

What are the different circumcision techniques?

The three major circumcision techniques include:

• Gomco clamp. The Gomco clamp is the most common method of performing a circumcision. The clamp separates the foreskin from the head of the penis. It also protects the head of the penis and helps stop bleeding (hemostasis). The provider then uses a sharp surgical knife (scalpel) to remove (excise) the foreskin.
• Mogen clamp. During this approach, the provider will use clamps that look like scissors or pliers (hemostat) to expose the head of the penis. Once they properly expose the head of the penis, they use a scalpel to remove the foreskin.
• Plastibell device. During a Plastibell approach, the provider places a plastic ring between the foreskin and the head of the penis. Next, they tie a string around the foreskin, which pushes it against the plastic ring. Finally, they use a scalpel to remove the foreskin. The plastic ring stays in place for about a week before it falls off naturally. The Plastibell approach isn’t as common because of an increased risk of infection.

How long does a circumcision take?

A circumcision takes approximately 20 minutes. Often, a bris takes less time.

The surgery takes slightly longer for older children and adults than for infants.

Is circumcision painful?

Like any surgery, circumcision can cause pain. However, pain medications and anesthetics can reduce pain and discomfort during and after the procedure.

What happens after a circumcision?

Most babies don’t need any special care after a circumcision. Be sure to keep the area clean and dry to promote healing.

What are the benefits of circumcision?

Some research suggests that circumcision has many benefits. A circumcised penis is easier to clean and wash, especially in children, and can help aspects of overall penis health.

Other medical benefits of circumcision may include lowering the risks of:

• Foreskin-specific conditions, including the inability to pull the foreskin back (phimosis), inability to pull the foreskin down over the head of the penis (paraphimosis), inflammation of the foreskin and glans (balanitis) and infections.
• Urinary tract infections (UTIs).
• Penile cancer.
• Some sexually transmitted infections (STIs).
• Cervical cancer for female sexual partners.

How successful is a circumcision?

The circumcision success rate is very high. Less than 3% of circumcisions have any complications.

What are the risks or complications of circumcision?

Circumcision is a routine, safe procedure. But, like any surgery, there are some risks. Potential risks may include:

• Anesthesia problems.
• Bleeding.
• Infection.
• Pain.
• Cutting the foreskin too long or too short.
• Irritation at the tip of the penis.
• The opening at the tip of the penis narrows (meatal stenosis).
• Inflammation at the tip of the penis (meatitis).

In rare cases, the foreskin doesn’t heal properly and can adhere to the end of your child’s penis (penile adhesion). If this happens, your child may need a circumcision revision.

Does circumcision reduce sensitivity?

Some people believe that circumcision decreases sexual pleasure and reduces the intensity of orgasms. There’s no proof that circumcision reduces sensitivity.

Does circumcision affect fertility?

No, circumcision also doesn’t affect the ability to have a biological child (fertility).

What happens if you don’t circumcise your child?

There are pros and cons to circumcising your child. But ultimately, it’s your decision. It’s a good idea to consider all of your personal, religious and medical concerns before you make a decision. If you still have questions, talk to a healthcare provider.

Who should not have a circumcision?

Your provider may recommend delaying circumcision or not going through with the procedure at all if your baby:

• Has medical concerns.
• Has physical problems with their penis that may require surgery. Sometimes, surgeons need the foreskin to correct the problem.
• Had a premature birth.

What is the recovery time after a circumcision?

Babies usually recover from a circumcision within 10 days. While the penis heals, it may look swollen and red. You may see a yellow film at the tip.

The circumcision recovery time is longer for adults. In most cases, you’ll recover in two to three weeks, but it may take as long as six weeks.

How do I take care of my baby’s penis after a circumcision?

Your child’s healthcare provider will explain how to take care of your child after a circumcision. In general, you should:

• Gently wash the area with soap and warm water as it heals. Use a sponge or washcloth to clean your child. Avoid a full-body bath for at least two days until after the procedure. Carefully pat the area dry.
• Apply a skincare ointment (Vaseline® or Aquaphor®) to your child’s penis at each diaper change. Be sure to gently clean off any stool (poop) that gets on the affected area.
• Use pain relief that your child’s provider recommends. This may include frequent breastfeeding or medications for infants.
• Avoid toys or holding or placing your child in positions that may cause pain or discomfort in the area. Straddle toys (see-saw, rocking horse or bicycle), jumpers and swings can cause pain and delay healing. Your child should avoid lying on their stomach, and they shouldn’t straddle your arms or legs when you hold them.

When can my child go back to daycare or school?

Your child should be able to go to daycare or school a few days after a circumcision.

In older children and adults, it’s a good idea to take at least a week off school or work.

What should I know if I choose not to circumcise my child?

Talk to your child’s healthcare provider if you choose not to circumcise your child. They’ll explain how to keep your child’s penis clean and healthy.

During the first few years of your child’s life, the foreskin will stay attached to the penis and won’t retract. You shouldn’t force it back. Once your child is old enough, teach them how to clean their penis and foreskin properly.

When should I call a healthcare provider?

Call your child’s healthcare provider if you see signs that your child’s penis isn’t healing well or your child has signs of an infection. These signs may include:

• A fever over 100 degrees Fahrenheit (38 degrees Celsius).
• Frequent bleeding or bleeding that doesn’t stop.
• Chills.
• Pus around their incisions with a foul odor.
• They haven’t started urinating (peeing) again 12 hours after the circumcision.

When can I have sex after circumcision?

Healthcare providers recommend avoiding sexual intercourse and masturbation for at least four to six weeks until your penis completely heals.