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Pros and Cons of Circumcision

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q: We are about to have a child. If it is a boy, we are debating on circumcision. I'm not sure I want it done to him. My wife says yes. Lately in the news its been said that there's no link to diseases, cancer, or ill effect other than the unsightliness of the foreskin. I would like your professional opinion.

A: The decision about whether or not to circumcise is truly a personal one, once you have weighed all the medical evidence. One of the reasons why there is so much debate about circumcision is because in the 1980s there were some studies done that showed some potential medical benefit from circumcision. These studies showed that there was an increased risk of urinary tract infections in infant males who were not circumcised.

Other studies have confirmed this. However, the amount of difference was not always as great. A recent summary report from the American Academy of Pediatrics estimates that between 7 and 14 of 1,000 uncircumcised males will develop a urinary tract infection in their first year of life, versus 1 to 2 of 1,000 circumcised males. As you can see there is a difference, but even with this difference, the overall risk is still very low.

There is also a slightly higher rate of cancer of the penis in uncircumcised males, however penile cancer is extremely rare (9 to 10 cases in 1 million men in a year).

There are potential risks to circumcision, though the most common complications are minor ones (excessive bleeding, minor infection). The other concern is that in the past most newborn circumcisions were done without any anesthesia, and now many studies have reported that newborns have significant pain and stress with the procedure. Current recommendations are that some type of local anesthesia be used for all newborn circumcisions.

So while there seems to be some potential medical benefit from circumcision, there is not enough information to recommend that it be done routinely. As a parent, you should take into account your own cultural, religious, and ethnic traditions as well as these medical factors, to make your decision. You should speak with your wife's obstetrician, as well as your intended pediatrician, if you want more detailed information.

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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.

Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

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