To be or not to be.... circumcised

... that is the question if you have a baby boy.

This debate has been running the gamut for a very long time. In the U.S. it seems to go in and out of vogue and the health professionals have wavered in their opinions. For a time they felt it resulted in less disease and infection, then after a time they said it makes no difference. Now the pendulum seems to be going back the other way just a bit but for the most part it is considered a personal decision. In some countries circumcision is quite rare, but in the U.S. it is quite common. If you're looking at this issue, here is some helpful information.

Most recent report

(LifeScript Health News - Apr. 5, 2009) Male circumcision can reduce men’s risk of contracting human papillomavirus (HPV) and herpes, according to a new study published in the New England Journal of Medicine. Circumcision has already been shown to prevent heterosexual transmission of HIV infection in men.

Researchers from Makerere University in Uganda and Johns Hopkins University tracked more than 3,300 Ugandan men for two years. The study showed that adult male circumcision reduced the risk of contracting herpes by 25%; the risk of HPV decreased by 35%. The cause is uncertain, but researchers believe that when the foreskin retracts during sex, the penis is exposed to infection. The foreskin can also provide a moist area for viruses to thrive.

According to the Centers of Disease Control and Prevention, more than 45 million Americans age 12 and older have herpes simplex Type 1, the type that causes genital lesions. About 20 million Americans are infected with HPV, which causes cervical cancer in women.

See also March of Dimes Blog post here.

What do do and when to do it

At this point, each family needs to decide for themselves what is best, but in 1999 when the American Academy of Pediatrics made the statement that the medical advantages were not convincing enough to recommend routine circumcision, insurance plans took advantage of it, and many refused to cover the costs. So, this is one thing you may want to check into, though we understand the procedure is not very expensive if it is done while the baby is still in the nursery.

Many doctors now use a local anesthetic for the procedure which seems to minimize pain. Sometimes the nurses also administer a small amount of a glucose solution which also seems to lessen pain. Usually the procedure is done within a few days of birth, but if you decide later to have it done, you should do it within the first month of life or it is considered a surgery requiring another hospitalization and increased costs.

Some doctors prefer not to do the procedure themselves for personal reasons (and so far in this country they can refuse based on their own preferences). If yours doesn't do it, and you want your baby to be circumcised, your baby's doctor will refer you to a colleague and there will be no delay in having it done. Now is the time to study up on the issue and talk to your pediatrician so you have the facts before you get to the hospital.

More information to help you decide

In weighing the pros and cons, you may wish to go to the Mayo Clinic site to research the subject. This site will also teach you how to care for the circumcised penis while it heals as well as the uncircumcised (intact) penis for hygiene.