If you have a little boy on the way, you have probably thought about whether to have the foreskin on your son’s penis removed, or leave it intact. With both “pros” and “cons” to consider, some new parents may be confused about this decision. In the end, it’s a family’s personal choice. However, here are some things to consider.

Dr. George Steinhardt, a urologist at Helen DeVos Children’s Hospital in Grand Rapids, Michigan, says the biggest reasons American parents choose to circumcise their boys are still religious and cultural. “I think it’s done primarily for cultural reasons,” he explains.

photo by Proud to Introduce

The Medical Perspective
Medical professionals today debate whether or not the procedure is medically necessary. Dr. Mark Reiss, a retired physician and executive vice president of the nonprofit organization, Doctors Opposing Circumcision, believes that there is no medical reason to circumcise.  “The penis is meant to be covered by the foreskin. The normal state is intact. The U.S. is the only country in the world that performs routine circumcisions.”

Yet, other experts point that there are valid reasons to consider the procedure. Among them are the following:

Infections: Dr. Anthony Chin, a Los Angeles-based obstetrician, points out that circumcision does make it easier to keep the penis clean, and decreases the chances of infection.  “Let’s face it, boys aren’t the cleanest of genders,” he points out!  Today, however, we have antibiotics to treat infections, making them less dangerous than they were in the past. “Before antibiotics, people got really sick, but now in the post antibiotic era, circumcisions are not ‘medically’ necessary anymore.”

Kindney Problems: “We see a lot of babies with kidney problems,” notes Steinhardt. “For those boys, I would recommend that a circumcision be done. It protects against the possibility of an infection.”  In particular, when his patients are diagnosed with fetal hydronephrosis, or dilated kidneys (which is more common in boys than girls) he almost always believes that circumcision is necessary to alleviate the risk of infection and other complications.

Sexually Transmitted Disease: Steinhardt believes that circumcision may have other serious benefits. “There’s valid scientific evidence that HIV is more likely in a man with foreskin than in a man without foreskin.” Steinhardt also says that you rarely see cancer of the penis in a man who has been circumcised.  However, other experts say there is not evidence that circumcision prevents any STD’s or cancers.

Appearance
Chin notes that circumcisions are basically for cosmetic purposes now, saying that sometimes an uncircumcised child decides to have the procedure done later in life.  In the US, women seem to prefer a circumcized penis, and there are plenty of teenagers who get  circumcised for cosmetic reasons.

Ease
A 5-minute procedure as an infant is easier than the same procedure on an adolescent or adult.  Barbara Dehn, RN, MS, NP, a practicing nurse who teaches at Stanford University, says if you opt to circumcise, do it soon after birth. “The key with circumcision,” she says, “is that if you decide to do it, don’t wait too long. Even when they’re 3, that’s probably too late, since the experience will be too traumatic for them.”

Pain Control
Those who oppose circumcision often call it as a barbaric procedure that leaves infants in terrible pain.  The issue of pain and cruelty is often one of parents’ biggest concerns. Will he feel the incision? Will there be a long, difficult recovery? Will there be complications?

The claim that circumcision causes tremendous pain is simply not true, says Steinhardt. “In general, it’s a pretty harmless procedure. It’s well tolerated, it’s done with great care, and complications are rare and few and far between.”  Plus, with proper pain control, many babies just sleep right through the procedure. “You can have confidence that it can be done safely.” If you are concerned, have a conversation with whoever will be doing the procedure, whether the pediatrician, OB/GYN, or mohel, about what measures can be taken for pain control. A local anesthetic can be used to ensure a painless circumcision.

For more info:

TheCradle: Circumcision: What you need to know

Dr. Sears: Frequently Asked Questions about Circumcision