Neonatal circumcision: Risks and benefits
- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr., MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
- Section Editors
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
- John G Bartlett, MD
John G Bartlett, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — HIV; Pulmonary Infections
- Professor Emeritus
- Johns Hopkins University School of Medicine
- Duncan Wilcox, MD
Duncan Wilcox, MD
- Section Editor — Pediatric Urology
- Professor of Urology, The Ponzio Family Chair in Pediatric Urology
- University of Colorado
Circumcision in the male refers to the surgical removal of the prepuce (ie, foreskin) of the penis. The procedure is centuries old and continues to be performed for a variety of religious, cultural, and medical reasons.
Parents of newborn males often have questions about circumcision: Is it necessary? What are its benefits? What are its risks? In addition to these medical issues, other factors that influence parental decision-making include the father's circumcision status, opinions of family members and friends, a desire for conformity in their son's appearance, and the belief that the circumcised penis is easier to keep clean [1-3].
The risks and benefits of circumcision will be reviewed here, with the focus on circumcision of neonates. Procedures for neonatal circumcision are discussed separately. (See "Techniques for neonatal circumcision".)
Normal penile development and anatomy — (See "Techniques for neonatal circumcision", section on 'Development and anatomy'.)
Prevalence and epidemiology — The United States is the only country in the developed world where the majority of male infants are circumcised for nonreligious reasons. Circumcision rates in the United States vary according to geographic area, socioeconomic status, religious affiliation, insurance coverage, hospital type, and racial and ethnic group. The overall prevalence is estimated to be about 80 percent for males aged 14 to 59 years, with most of these procedures performed in newborns . Circumcision rates are highest in the Midwestern states (74 percent), followed by the Northeastern states (67 percent) and Southern states (61 percent), and are lowest in the Western states (30 percent) . The rate is higher in non-Hispanic whites (91 percent) than in non-Hispanic blacks (76 percent) and Mexican Americans (44 percent) .
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- Normal penile development and anatomy
- Prevalence and epidemiology
- POTENTIAL BENEFITS
- Reduction in urinary tract infection
- - Infants with congenital uropathy
- Reduction in risk of some cancers
- - Penile cancer
- - Cervical cancer in partners
- Reduction in penile inflammation and retractile disorders
- Reduction in HIV and other sexually transmitted infections
- Easier hygiene
- POTENTIAL DISADVANTAGES
- Procedure related complications
- Sexual dissatisfaction
- OPINIONS OF ORGANIZATIONS AND GROUPS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS