Circumcision
Also known as . . . Newborn circumcision
What is it?
Circumcision is a surgical procedure in which the foreskin is removed
from the penis. This procedure has been performed for thousands of years
according to cultural and religious traditions. Previously, approximately
90% of males underwent circumcision in the United States. This percentage
is much smaller in other regions of the world, and has in fact decreased
in this country in recent years. Medical opinions have changed over the
years regarding the medical necessity of circumcision. There is some
evidence that circumcision may reduce the risk of urinary tract
infections. However, at present, there is no clear consensus that
circumcision is medically required in otherwise healthy male newborns. The
procedure is most often performed at the request of the family by
obstetricians, pediatricians, family physicians and pediatric surgeons.
Outpatient Circumcision
In the first few months of life, infants are small enough to undergo
circumcision in the Pediatric Surgery Office with the aid of local
anesthesia. The surgeon will first examine your baby for conditions that
would preclude an office circumcision, or even make circumcision
undesirable. If circumcision is appropriate for your infant, the procedure
will be performed at that day’s office visit. A topical anesthetic cream
is first placed on the foreskin and the skin just above the penis. After
30 minutes, the child is taken to the procedure room. Local anesthesia is
injected through the anesthetized skin to block the nerve endings to the
penis. Excess foreskin is removed using a plastic bell-shaped device (Plastibell)
that protects the penis from injury. The plastic ring stays on the penis
following completion of the circumcision, and acts to prevent bleeding
from the cut edges of the foreskin. It falls off harmlessly in about one
week. No follow-up visit is required, unless the bell fails to fall off
after two weeks.
Patients older than a few months of age or those with
other conditions requiring surgery undergo their circumcisions in the
operating room. In many cases, the Plastibell device is still used;
alternatively, the procedure may be performed with the aid of dissolving
sutures to control bleeding from the cut edge of the foreskin. Only in
rare instances is circumcision performed for medical reasons such as
infection of the foreskin (balanitis) or an unusually narrow opening of
the foreskin (phimosis).
Glossary of Terms
Foreskin: the skin that covers the head of the
penis in uncircumcised males
Phimosis: narrowness of the opening in the
foreskin that prevents the foreskin from being pulled back to expose the
head of the penis. Phimosis is present in most newborns and usually
resolves spontaneously with normal development.
Balanitis: infection of the foreskin of the
penis
Plastibell: the brand name of the device
commonly used for outpatient circumcisions
Gomco clamp: another device used to perform
circumcisions
Physician's Who Treat Anorectal Malformations
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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