Key Takeaways

  • Circumcision is the surgical removal of the foreskin covering the tip (glans) of the penis. In most cases, doctors perform this procedure shortly after a child’s birth.
  • People have circumcisions for religious, cultural, or medical reasons, such as treating balanitis, balanoposthitis, paraphimosis, or phimosis.
  • Circumcision may carry small health benefits, such as easier hygiene. However, performing genital surgery on newborns without agency or consent raises ethical questions.

Circumcision is the surgical removal of the foreskin, which is the skin covering the tip of the penis (glans). It is one of the most common surgical procedures globally.

In this article, we detail the reasons people have circumcisions, the pros and cons, procedure preparation, risks, and recovery.

Circumcisions are typically performed for health, cultural, or religious reasons. The procedure is especially prevalent in the United States and among Jewish or Muslim populations.

Cultural reasons

In healthy newborns, there is no medical need for circumcision. However, families may choose to have their child circumcised for a number of reasons.

One of the most common reasons is religious tradition. The religious laws of both Judaism and Islam require that newborn boys be circumcised.

In Judaism, the ritual circumcision is called a brit milah and is typically performed as part of a religious ceremony at home or in a synagogue, although it is sometimes performed in a hospital. The procedure is almost always done when the baby boy is eight days old.

In Islamic culture, the ritual circumcision is called khitan. In some parts of the Islamic world, the procedure is performed as part of a religious ceremony. In other parts, it’s done in a hospital setting. In most Islamic countries, the khitan is performed in infancy, but it may be done when a boy enters puberty.

Parental preference

In other instances, a circumcision is a societal or cultural preference, rather than a religious necessity. These preferences may be due to:

  • parental choice
  • aesthetic preference
  • hygiene concerns

Medical reasons

Additionally, older children or adults may need circumcision to treat several conditions, including:

  • balanitis, a swelling of the head of the penis
  • balanoposthitis, inflammation of the tip and foreskin of the penis
  • paraphimosis, inability to return a retracted foreskin to its original position
  • phimosis, inability to retract the foreskin

There are instances where circumcision is a medical necessity, such as with paraphimosis. In other cases, it is essential to be aware of the pros and cons of male circumcision.

Pros of circumcision

  • It may decrease the risk of urinary tract infections in infancy.
  • Circumcision helps prevent balanitis, balanoposthitis, and phimosis.
  • The removal of a foreskin makes it easier to maintain good genital hygiene.
  • Decreases the risk of sexually transmitted diseases, including the human papillomavirus (HPV).

Cons of circumcision

  • In infant cases, there is an ethical consideration for performing non-medical genital surgery without the patient consenting to it. Circumcision is an irreversible procedure, and removing a person’s autonomy over this decision poses questions.
  • Studies show that circumcision increases the risk of penile problems in the first 5 years of life.
  • Surgery carries a risk of complications, including cutting the foreskin too long or too short, poor healing, bleeding, or infection.
  • Circumcision reduces the sensitivity of the glans.

In cases of religious or cultural reasoning, doctors typically perform the operation on males shortly after birth, or within the first year of life.

Doctors often perform circumcisions while newborns are still in the hospital. Caregivers are required to sign a consent form before the procedure, and they should understand the medical and ethical considerations of their choice fully before doing so.

For older children and adults, circumcision is an outpatient procedure, so a person will arrive at a primary care facility and leave the same day.

Doctors perform the procedure in a hospital or surgery center on an outpatient basis. This means that you would go home on the same day. If a person elects for heavy anesthesia, doctors may require them to fast before the procedure.

It is important to have travel arranged for after the operation, as it will be unsafe to transport oneself.

Anesthesia

The form and extent of anesthesia will vary between cases.

For infants, doctors may recommend a combination of oral, topical, and injectable anesthesia to numb the area.

For children and young adults, a general anesthetic is a recommended option. Adults can work with their primary care provider to determine the best option, be it general or local anesthesia.

There are several techniques for performing circumcision. The three major methods of circumcision are:

  • Gomco clamp
  • Mogen clamp
  • Plastibell device

Each one works by cutting off the circulation to the foreskin to prevent bleeding, at which point the medical professional will cut around the foreskin just below the head of the penis. After removing the foreskin, they may use dissolvable stitches to close the wound. These will typically dissolve within 2 to 6 weeks.

Doctors may choose not to use stitches and dress the wound for healing without them.

After the procedure, your baby may be fussy. The doctor or nurse will provide instructions for how to decrease any discomfort. Healing time for a newborn’s circumcision is about 7 to 10 days.

It’s normal for the penis to be slightly discolored or bruised for a few days after the circumcision. You can wash the penis and change the dressings with each diaper change.

Keep the diaper slightly loose to help the tip of the penis heal. Using a protective ointment can also help prevent the penis from sticking to diapers and other clothing.

Call your child’s doctor if your child has any of the following:

  • continued fussiness (in babies)
  • increased pain (in children)
  • trouble with urination
  • fever
  • foul-smelling drainage
  • increased redness or swelling
  • persistent bleeding
  • a plastic ring that doesn’t fall off after two weeks

Recovery in adults

Your doctor will give you specific instructions on how to care for your incision and lessen your pain.

In general, you should return to work and daily activities when you feel comfortable. Avoid strenuous exercise, such as jogging or weightlifting, for the first four weeks of your recovery or until your doctor gives their approval.

Walking is the best way to exercise during your recovery. Try to walk a little more than you usually do each day.

You should also typically avoid sexual activity for six weeks after the procedure. Follow the instructions from your doctor about sexual activity.

Call your doctor if you have any of the following:

  • increased pain
  • trouble urinating
  • bleeding
  • signs of infection, including fever, increased skin discoloration, swelling, or drainage

Circumcision is one of the most common surgical practices globally. It involves the removal of a person’s foreskin, the layer of skin cover the tip (glans) of the penis. Circumcision carries few health benefits and is typically performed for aesthetic, cultural, or religious reasons.

Most circumcision procedures occur on newborns while they are in the hospital post-birth. As such, critics raise ethical concerns about performing irreversible genital surgery on infants without their consent. Additionally, circumcision poses surgical risks, such as bleeding or infection, and may reduce glans sensitivity.