Circumcision: Pros and Cons for New Parentsby Katlyn Joy | July 30, 2011 7:41 AM
Do you want teddy bears or polka dots in the nursery? Breastfeed or bottle? Labor with a doctor or a doula? Then the ultrasound and the solid prediction of a son. Another big decision looms: to circumcise or not?
Circumcision is the surgical removal of the skin covering the end of the penis, or the foreskin. Typically this is done in the first few days of life in the hospital under a doctor's care. While measures are taken to lessen the pain, it is not a pain-free procedure.
How Is Circumcision Performed?
Approximately an hour before the circumcision is performed a numbing solution is applied to the penis. Right before the procedure, a local anesthetic is injected in the base of the penis. The area of the foreskin and penis is cleaned. A clamp is attached to the penis and the foreskin is cut off with a scalpel. It is a quick process usually taking only a few minutes and often parents are allowed to stay in the room while it is done. However, it's important prior to doing the procedure to find out for certain that anesthesia be used. It was not a common practice until fairly recently, but the AAFP recommends pain relief measures for circumcision. Other than these methods, another helpful practice is to offer a pacifier dipped in sugar water.
Following a circumcision, you will be given directions for caring for the area on your newborn son. This means changing diapers as usual and washing the penis with soap and water. Do not use baby wipes until the penis has completely healed. You will be given an ointment to apply after diaper changes to keep the diaper from sticking to the penis. If a bandage is applied, you may need to change this whenever doing diaper changes for a day or two.
It usually takes a week to a week and a half to fully heal after a circumcision. However, some swelling or blood immediately following the procedure is normal. A yellow crust may be seen a day or two later as well.
Signs that you need to seek medical attention include bleeding or blood in the diaper after a few days, redness that worsens, fever, swelling, foul smelling discharge, pus or oozing, or pus type blisters.
Caring for the Uncircumcised Penis
Wash the penis with soap and water and change diapers as you would normally. No special attention such as the use of cotton swabs or special cleansers or ointments are required. You will be directed not to force back the skin on the penis. When your son is a toddler the skin will pull back easily and you will need to teach your son to pull it back when washing then to pull it back into place to cover the tip.
Pros of Circumcision
- Proponents of circumcision cite medical, religious or cultural factors as reasons to circumcise newborn boys.
- Lowered risk of urinary tract infections. A circumcised boy has a risk of 1 in 1000 for developing a UTI in his first year compared to an uncircumcised boy's 1 in 100 risk.
- Slightly lower risk of developing sexually transmitted infections including HIV and AIDS.
- Lower penile cancer risk.
- No risk of foreskin infections.
- No risk of phimosis, a condition where the foreskin becomes stuck or cannot be pulled back.
- Possibly helps prevent cervical cancer in women.
- Prevents the need for adult circumcision which is a more serious and difficult procedure than when done in the early days of life.
- Cultural or religious reasons. Some people or families have a stronger stance on the importance of circumcision and to be different may carry negative social pressures.
Cons of Circumcision
- No informed consent. While this is a lifetime decision, an infant cannot consent or choose for himself.
- Possible complications of the procedure include minor bleeding, infection, and failure to remove sufficient foreskin requiring another procedure to correct it. While rare, complications including injury to the penis are possible.
- Pain. While circumcision is painful and anesthesia is available, how painful the procedure is remains unknown.
- Urination problems can occur if the tip while uncovered by foreskin becomes irritated and the opening becomes too small as a result.
- Proper hygiene is easily taught and will greatly reduce any instance of increased risk of cancers or STI's.
- About 55 to 65 percent of all newborn boys in the US are circumcised each year.
- The western US has lowest rates or circumcision and the north central regions the highest rates.
- In Asia, Central and South America, and the majority of Europe, circumcision is rarely done.
- At least 1.2 million boys in the US are circumcised each year.
Neither the American Academy of Pediatrics nor the American Academy of Family Physicians recommends routine circumcision to prevent any medical conditions. The AAP neither recommends nor argues against circumcision finding insufficient evidence to support either policy.Article Sources: http://www.nlm.nih.gov/medlineplus/circumcision.html http://www.ucsfhealth.org/education/circumcision_decision/index.html http://health.usnews.com/usnews/health/articles/070801/01circumcision.htm http://www.aafp.org/online/en/home/clinical/clinicalrecs/guidelines/Circumcison.html
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