A baby boy amazed while his doctor is checking his heartbeat with a stethoscope.

What Is a Circumcision?

Circumcision is a surgical procedure that removes the foreskin surrounding the glans (head) of the penis.

It is typical for the foreskin to be attached to the head of the penis initially and then gradually separate as the child ages. Many parents choose to circumcise their child in the newborn period, often within the eight-week period following birth.  After that period, a child normally must wait until they are at least 6 months old and be put under general anesthesia to have a circumcision performed. As a result, if a parent wants to circumcise their son it is important that they act quickly after birth to avoid the need for general anesthesia. Not all children require a circumcision.

How Do You Know If a Circumcision Is Right for Your Baby?

A member of our pediatric team will examine your son to determine if there are any abnormalities present, such as inadequate foreskin, curvature, or abnormal placement of the meatus.  Should they identify potential risks with the procedure, then a circumcision under a brief general anesthetic when the child is older may be recommended.

The American Academy of Pediatrics (AAP) issued a statement in 2005, reporting information from studies of both circumcised and uncircumcised males and found the following:

  • Problems with the penis such as irritation can occur with or without circumcision.
  • There should be no difference in hygiene if proper care is followed.
  • There may or may not be difference in sexual sensation or practices in adult men.
  • There is an increased risk of urinary tract infection in uncircumcised males, especially in babies younger than 1 year of age. However, the risk for urinary tract infections in all boys is less than one percent.
  • Newborn circumcision does provide some protection from cancer of the penis. However, the overall risk of penis cancer is very low in developed countries, such as the United States.

The AAP notes some health benefits related to circumcisions, but these reasons are not sufficient to mandate circumcision nationwide. The AAP advises that the physician should inform parents of the benefits and risks of the circumcision and allow the parent to decide.

Occasionally, a circumcision will become medically necessary to treat a medical problem.

Should you decide to proceed with circumcision, you can trust that The Newborn Circumcision Center team has the experience and skill that your child deserves.

What Occurs During the Procedure?

Circumcision is an outpatient procedure that involves the removal of the foreskin from the penis. This is done using a surgical knife.  The goal is to leave the correct amount of skin on the shaft of the penis so that the head of the penis is exposed (Many well-fed babies have a fat pad which engulfs the base of the penis. In these cases, the foreskin may partially or even completely cover the glans of the penis which is retracted in the fat pad. This will usually correct itself as your son’s penis grows and the baby fat disappears.)

After the foreskin is removed, the edges of the skin are placed together using dissolvable suture or surgical glue.  The sutures, if present, will dissolve on their own after one to two weeks. Local anesthetic is used to minimize discomfort. The entire procedure normally takes less than thirty minutes.

Where Is the Circumcision Performed?

Traditionally, circumcision is performed in the hospital setting but often requires physicians to return for the procedure at a later time which may cause additional delay and unnecessary hospital stays for babies and mothers. Thanks to The Newborn Circumcision Center, the procedure can be performed in the physician office setting.

The will take place in the Newborn Circumcision Center’s state-of-the-art facility in Roswell. The providers will use injected and topical anesthetic agents as an alternative to general anesthesia to keep the patient comfortable during the procedure. After the circumcision, the baby will be reunited with the family in a private room where the child will be observed for a period of time before being discharged.

What Indications Are Present for Circumcision?

Although a circumcision is not strictly necessary for most boys, circumcisions do offer some benefits. Boys under the age of one year old are at an increased risk for urinary tract infections. Boys with other urologic issues, such as vesicoureteral reflux or urinary obstruction, are at higher risk for urinary tract infections including infections to the kidney that may have long-term implications on the health of the kidney. Circumcision may also help prevent sexually transmitted infections (STIs) and invasive penile cancer later in life.

Possible risks associated with circumcision that may include scarring, bleeding, or infection are generally considered mild. According to the American Academy of Pediatrics (AAP), the benefits associated with having a baby circumcised outweigh any of the possible complication risks.
There are some conditions that may require a circumcision if medical management with the use of a topical steroid fails. These include:

  1. Inability to retract the foreskin (phimosis) with significant scarring of the foreskin.
  2. Ballooning or bulging of the foreskin during urination causing voiding dysfunction.
  3. Recurrent urinary tract infections or infections of the foreskin.

What Occurs After the Circumcision?

After circumcision is performed, we will examine the patient and provide specific instructions on how to care for the child post-procedure.

Antibiotic ointment and gauze can sometimes be used, and Acetaminophen (Tylenol) may be recommended to help a baby deal with pain that may occur after the circumcision. This is generally not needed.

Are There Situations When Circumcision Should Not Be Considered?

A pediatric urologist may recommend delaying circumcision if a baby has other medical conditions, such as heart or lung issues, that take precedence and require immediate attention, bleeding disorders, or congenital abnormality of the penis, including curvature, incomplete formation of the foreskin, or abnormal location of the urethral opening.

How to Diaper Your Newborn After Circumcision

Despite how commonly it is performed, understand that circumcision is surgery and thus has inherent risks, including infection. Any time foreign matter or objects come in contact with the penis before it heals, there is a risk of infection. Further, improper diapering can be very uncomfortable for the recently circumcised child. After circumcision, it’s important to take particular care when diapering your baby and follow the step-by-step guide from your urologist. Here are some common tips on how to diaper your baby, but bear in mind that your doctor may have other instructions particular to your child’s needs. Learn more about diapering your newborn after circumcision

Why Do Newborns Need a Vitamin K Shot for Circumcision?

A vitamin K shot shortly after birth in newborns has become commonplace to prevent a serious condition known as vitamin K deficiency bleeding or VKDB. Though rare, VKDB can be devastating, causing significant and life-threatening bleeding. When the bleeding occurs in the brain, the child’s life may be at risk, and the possibility of longer-term health problems and neurological deficits increases dramatically. Learn more about Vitamin K shots

What About a Partial Circumcision?

Partial and complete circumcisions are both safe in the hands of a qualified and experienced circumcision specialist. However, partial circumcisions come with a relatively high rate of complications, so we do not perform them. The decision to circumcise should be made in consultation with your trusted medical professionals and aligned with your values, beliefs, and health goals. Learn more about partial vs complete circumcision.

Does Circumcision Reduce Penile Sensitivity?

While we always look to educate parents about the benefits and risks of circumcision, we encounter plenty of parents who have performed extra research on whether they should have their newborn circumcised. On the one hand, doing this research uncovers many opinions and experiences. On the other, there is plenty of misinformation floating around that should not factor into such an important decision. One of the more hotly debated topics involving circumcision revolves around penile sensitivity and, ultimately, sexual enjoyment later in life. There are conflicting opinions and even studies about whether removing the foreskin affects the individual’s ability to enjoy sex or sexual activity later in life. These studies have tried to compare sensitivity and pleasure between those who have and those who haven’t had a circumcision. Learn more about whether circumcision reduces penile sensitivity.

Is Circumcision Painful for a Newborn?

At first glance, the idea of removing the foreskin from a baby’s penis soon after they are born can seem incredibly painful. Some cultural and religious customs require it, but for most other patients, circumcision of their newborn is an elective procedure that has benefits but also concerns that parents should address with their pediatric urologic surgeon and circumcision specialist. Learn more about how circumcision can be painful for a newborn.

What is Phimosis, and Does Circumcision Help?

When patients are not circumcised, the foreskin covers the entire glans, or head, of the penis. Usually, when pulling back on the foreskin, it should retract quickly, showing the entirety of the glans. This should be the case for both children and adults when the penis is in its flaccid or erect state. Phimosis is a condition in which the foreskin is tight, or the skin wraps tightly around the penile shaft, almost like a rubber band has been placed around it. In addition to potentially causing balanitis, an infection under the foreskin, phimosis can also be caused by balanitis and the swelling that often accompanies these infections. Learn more about Phimosis.