This is one of the more controversial topics in Pediatrics today. The American Academy of Pediatrics, in their most recent Circumcision Policy Statement, concluded that 'data are not sufficient to recommend routine neonatal circumcision' and that 'parents should determine what is in the best interest of the child'. Since the statement didn't really come out for or against circumcision, it left many parents still asking the question, 'Should I have my son circumcised?'

It may help to look at some of the reasons that parents use to have their sons circumcised. One common reason is because 'everyone else is circumcised'. This is really not true at all. Worldwide, only about 10% of males are circumcised, and even in the United States, circumcision rates have declined from 80% in 1980 to 64% in 1995. The incidence of circumcision in the United States today is probably even less. Many online polls1 show an incidence of about 50%. Current data shows that the incidence of circumcision also depends on where you live in the US, with a high of 81% in the Midwest to a low of 36% in the West.

Parents sometimes want their son circumcised because they think that the uncircumcised penis is too hard to take care of and keep clean. This is not true. The uncircumcised or intact penis is relatively easy to take care of. In fact, until the foreskin begins to retract, no special care is required. Once the foreskin does retract, you, or your child once he is old enough, can just gently retract the foreskin, clean the head of the penis with soap and water, rinse, and then pull the foreskin back over the head of the penis.

Another reason is that there 'are medical benefits for being circumcised', including a lower risk of urinary tract infections, penile cancer and sexually transmitted diseases. Most studies do show that uncircumcised male infants have about a 10 fold increase in UTIs, but the overall risk of an uncircumcised male infant getting a UTI is relatively low, only about 1%. Penile cancer is also more common in uncircumcised men, but this type of cancer is very rare anyway. And there is also a "small correlation between the uncircumcised male and risk for STDs".1

While these medical conditions seem to support circumcision, the American Academy of Pediatrics states that "almost all uncircumcised boys can be taught proper hygiene that can lower their chances of getting infections, cancer of the penis, and sexually transmitted diseases".2

Other conditions that only occur in uncircumcised males and which can sometimes require a later circumcision include infections of the foreskin, phimosis (inability to retract the foreskin) and paraphimosis (inability to pull the foreskin back over the head of the penis after it has been retracted).

It is also important to look at the reasons not to have a circumcision, including the risk of bleeding, pain from the procedure, infection, and injury to the head of the penis, and penile sensation deficits. Children who are circumcised are also at increased risk of meatitis, or inflammation of the urethral opening.

In the end, one of the major reasons that many parents want to circumcise their child is because they want their son to look like their father, who is circumcised. Does it matter if a father is circumcised, but his children aren't? This is one area where some research is needed. There are many situations where a father and son aren't both circumcised. Premature infants are often too sick to be circumcised, and with all of the other medical issues that come up, circumcision is often not thought about. Step-fathers and adoptive parents also may not be 'the same' as their children. Does it make a difference to these children? A formal study that shows no difference would probably help to decrease the incidence of circumcisions even further.

With all that is known about the minimal medical benefits and the possible risks of circumcision, whether or not to have your son circumcised should be more of a cultural (ritual circumcision by the Jewish religion and Muslims, etc) than a medical question.
A better question would be 'Does my new baby boy need a circumcision?' The answer to that one is much easier. No, he doesn't need a circumcision.

If you wish to have your son circumcised this is your choice. The circumcision procedure is usually done 48 hours or more after the birth. What this means to you is that the procedure will usually be done after your discharge form the hospital. The physician that I recommend to do the procedure is Dr. Don Peacock. He is a very experienced pediatrician who has done many of these procedures safely. They are done at B.C. Children’s hospital is the Medical Day unit which is on the second floor. Your son will be given a local anesthetic before the circumcision so that he will be comfortable during the procedure. You may choose to be present in the room during the procedure although most of my patients, especially the mothers prefer to go and sit downstairs at Starbucks while things are happening. The procedure takes approximately 15 minutes to perform and before you go home the nurse will give you instructions on how to take care of the dressings and how to change diapers. Dr. Peacock will arrange a follow up visit with you.

There is a cost for this procedure, as it is not covered by MSP. The cost to the hospital is $150.00 and the cost for Dr. Peacock’s services is $ 200.00.

If you wish to have the circumcision done please let me know and I will be happy to arrange this for you or you can call Dr. Peacock directly at 604-875-1118 and tell him that I am referring you to him for a circumcision procedure.

References:

1 Lerman, Steven E, MD, Neonatal Circumcision: The Pediatric Clinics of North America: Vol 48 No 6 December 2001
2 American Academy of Pediatrics. Circumcision Information For Parents