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To Cut or Not to Cut... Neonatal Circumcisions

Whether you decide to circumcise your newborn son is a personal decision, influenced by your personal, cultural, and/or religious beliefs. If you have decided to proceed with a circumcision, it is good to know that there are some medical benefits that have been associated with circumcisions, namely:

  • Decreased risk of a urinary tract infection during the first year of life.

  • Decreased risk of contracting sexually transmitted disease in the future, including HIV.

  • Decreased risk of developing cancer of the penis.

However, the benefits are not considered so significant to be universally recommended for all boys.

When is the best time to have my son circumcised?

It is best done within the newborn period, preferably within the first 2-3 weeks of life. Advantages of performing circumcisions early include decreased risk of bleeding, avoidance of general anesthesia (as the procedure only requires local anesthesia in the newborn period), fast healing time of newborns/infants, and most importantly - he will NOT remember it! Beyond 6 weeks, most pediatricians will not perform circumcisions in the office due to the increased risk of bleeding. At that time, these infants will be referred to a pediatric urologist to be circumcised under general anesthesia in the operating room. Because this is generally considered an elective procedure, most urologists will defer circumcisions until age 12 months when babies are better able to tolerate general anesthesia. However, indications for earlier circumcisions may be phimosis (very tight foreskin), causing discomfort and/or interfering with his ability to urinate properly.

What are the potential risks of a circumcision?

Potential risks of the procedure are minimal but include:

  • Bleeding: We strongly recommend that your baby receive the vitamin K injection following delivery - this is usually given automatically to all newborns to prevent both spontaneous and prolonged bleeding.

  • Infection: Despite the location, risk of a penile infection following circumcision is quite low. A baby's urine and stool are not yet colonized by a lot of bacteria in the newborn period, making the area actually quite sterile.

How long do circumcisions usually take?

The procedure takes about 10-15 minutes - it's quick!

Will my baby feel pain?

As mentioned above, a local anesthetic will be administered to numb the area prior to the procedure. It is injected at the base of the penis and can sting a bit but once the anesthetic sets in, he will not feel pain. However, he will still be able to feel tugging, pulling, or pressure which some babies remain sensitive to. The numbness will gradually wear off within 1-2 hours after the procedure. We also typically administer sugar water to the baby during the procedure which generally has a calming effect and can decrease pain.

How long will it take to completely heal? What is involved in the after care?

It will take about 5-7 days for the outer skin layer to grow over the newly exposed glans or the tip of the penis, that becomes exposed after the removal of the foreskin. Because the new skin initially is sticky, we recommend keeping the area lubricated with petroleum jelly until it is completely healed. You are allowed to get the area wet (ex. bath) - it's constantly getting wet anyway! Aerating the area often will help expedite the healing process. We recommend that you "pat" him dry rather than "rubbing" the area during diaper changes until the new skin has completely grown in.

Will my insurance cover the procedure?

Because there are some clear medical benefits associated with circumcisions as discussed above, many insurance companies will cover or partially cover the cost of the procedure. It is always best to confirm with your insurance prior to the circumcision appointment.

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