Pediatrics Group Confirms Benefits of Circumcision
< Aug. 29, 2012 > -- Circumcision can help prevent certain diseases and conditions, but parents should still be able to choose whether their infant boys should have the procedure.
That's the aim of new guidelines issued online this week by the American Academy of Pediatrics (AAP) and endorsed by the American College of Obstetricians and Gynecologists.
Circumcision is the surgical removal of the foreskin of the penis. It's usually done shortly after birth, usually in a hospital by a medical professional. Recent research has found that circumcision can lower the risk for urinary tract infections in infants, and sexually transmitted diseases and penile cancer in adults.
But opponents of circumcision say that the procedure isn't necessary and that it robs men of sexual sensation.
Benefits vs. risks
After evaluating the issue, the AAP concluded that although the benefits outweigh any risks, the benefits weren't enough for the group to recommend circumcision for all infant boys.
"We recognize that the topic cuts across many paradigms in your life -- cultural, religious, ethnic, family tradition, aesthetic," says Andrew Freeman, M.D., a member of the AAP task force that prepared the guidelines. "We're not in a position to make recommendations on those paradigms."
Instead, Dr. Freedman says, circumcision decisions should be left to parents after weighing up-to-date advice from their doctor and their own preferences and beliefs.
Falling out of favor
The popularity of circumcision in the U.S. has declined over the last four decades. In the 1970s and '80s, nearly 80 percent of male infants were circumcised. The rate had dipped to 55 percent by 2010.
With fewer men circumcised, STD cases may shoot up. Over 10 years, those infections could add billions of dollars to U.S. health care costs, a recent study on STDs found.
Risks of the procedure include significant bleeding, which occurs in about one in 500 boys. As for loss of sexual sensation during adulthood because of the loss of nerve endings on the foreskin, Dr. Freedman says it's a poorly studied issue.
Many people say they are upset about a lack of sexual sensation, he says, but "millions of men are perfectly happy. From a scientific standpoint, we really don't have a good handle on it."
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What Care Is Needed After a Circumcision?
Circumcisions done by a qualified doctor rarely have complications. Problems that occur are usually not serious. The most common complications are bleeding and infection. Proper care after circumcision helps reduce the chances of problems.
Your baby's doctor will give you specific instructions on the care of the circumcision. It's important that you keep the area clean. After the procedure:
Your baby may have a gauze dressing with petroleum jelly or an antibiotic cream. You may need to remove this at the first diaper change. Your baby's doctor may recommend applying a new dressing.
The head of the penis may be raw and red looking.
You may find a small amount of blood at first or yellow-colored drainage later. These are part of normal healing.
Your baby may have some discomfort with diaper changes the first few days.
Keep the penis clean with soap and water.
Circumcisions usually heal within one to two weeks.
Your baby may be fussy after circumcision. Cuddling him close and breastfeeding can help comfort him. Most boys don't require special care of the penis after the circumcision is healed.
Always talk with your health care provider to find out more information.
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American Academy of Family Physicians - Circumcision
American Academy of Pediatrics - Circumcision Policy Statement