Circumcision is the removal of the foreskin of the penis. Most boy babies have a cuff of skin (foreskin) that covers the end of the penis (the glans). The natural opening in the foreskin is usually large enough to allow urine through (rarely is there no opening at all). But in a condition called phimosis, the opening is not large enough to allow the foreskin to be pulled back to uncover the glans. It is important to be able to pull back the foreskin so that the normal, waxy material that forms under the foreskin (smegma) can be removed during bathing. When the opening in the foreskin is too small to allow the foreskin to be pulled back, the foreskin can be stretched by a doctor. However, if the penis is uncircumcised, there is some possibility that the pulled back foreskin cannot be drawn forward again and may act as a tourniquet, cutting off the blood supply to the glans (paraphimosis).
Circumcision has been practiced on all continents for centuries, both for religious reasons and as a ritual to reaching manhood. Its advantages are easier cleansing and lessened possibility of paraphimosis. However, contrary to what many people believe, circumcision does not protect the male against cancer of the penis. The disadvantages of circumcision are a slight chance of infection or bleeding after the operation (less than 1 percent); the brief pain of the operation; and rare, accidental injury to the glans during the operation.
In recent years many doctors have declared that circumcision is unnecessary surgery. On the other hand, many other doctors feel that the advantages outweigh the disadvantages. The decision whether or not to circumcise male infants remains with the parents. Parents should ask questions and gather as much information as possible to help them make the decision.
Signs and symptoms
Circumcision is required only when boys are born with no opening in the foreskin, when the opening is too small to allow passage of urine, or when paraphimosis has developed and must be immediately corrected.
Home care
A circumcision should be covered, until healed (two to five days), with a nonstick bandage and gauze coated with petroleum jelly. The area should not be submerged in bath water until the wound has healed.
Precautions
• Any bleeding of the circumcised penis beyond a few drops should be reported to your doctor.
• If there are any signs of infection (pus, spreading redness, swelling of the shaft of the penis), see your doctor.
• Any part of the foreskin left after circumcision should be pulled back to expose the base of the glans, and this area should be cleansed during bathing.
• Boy babies born with malformations of the penis should not be circumcised because the foreskin may be used later during surgery to correct the malformation.
Medical treatment
Your doctor or religious leader will perform the circumcision, using one of a variety of approved techniques. Ask for specific directions for care of the circumcision. In a rare instance of postoperative infection, the doctor will culture the circumcision and blood, and start antibiotics.
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