The American Academy of Pediatrics (AAP) issued a policy statement in 1999 on the use of circumcision. This policy was most recently updated in 2012. The AAP recognizes the following information from studies of both circumcised and uncircumcised males:
- Problems with the penis, such as irritation, can occur with or without circumcision.
- There is no difference in hygiene, as long as proper care is followed.
- There may or may not be any 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 1 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.
- There is a decreased risk of certain sexually transmitted diseases (including HIV) in circumcised males.
- The most current AAP report found that the health benefits to circumcision outweigh the risks. However, these benefits are not significant enough to recommend that all newborn baby boys be
- circumcised. The AAP recommends that parents should be given information on the benefits and risks of newborn circumcision and that parents should decide what is best for their baby.
Initial Management:
What care is needed for an uncircumcised penis?
As the baby grows, the foreskin becomes looser and is able to be retracted (moved back). This may take many months to years. Your baby's doctor will check this as part of your baby's checkups and will show you how to retract the foreskin. This allows cleansing of the area. As a boy grows, he should be taught how to retract the foreskin and clean himself. The foreskin should never be retracted forcibly. Do not allow the foreskin to stay retracted for long periods as this may shut off the blood supply causing pain and possible injury. Sometimes the foreskin becomes stuck in the retracted position and cannot be pulled back down. This is called paraphimosis and is a medical emergency.
In some children, the foreskin cannot be retracted because of a restricted opening, causing a condition called phimosis. This condition may require circumcision later in childhood if it doesn't respond to medical treatment.