Family Health: Having a son? What is the data on infant male circumcision?

You are expecting a baby boy? Congratulations! Soon you will be faced with the decision of whether or not to circumcise your son.

On both sides of the argument you have probably heard outspoken proponents, and I’m sure family and friends have made their opinions known. Yet the decision will ultimately be up to you. So what should you do? After reading this article you will be able to make an informed decision based off the most current data, and feel good about that decision.

History of the AAP position on male circumcision

Let’s start with a little history: from 1979 to 2010 the rate of newborn circumcision decreased from 64.5 percent to 58.3 percent. The explanation for this decline can most readily be associated with the 1999 official recommendation by the American Academy of Pediatrics, or AAP, that there was insufficient evidence to recommend the procedure. Shortly thereafter, many states chose to remove the procedure from Medicaid coverage and other commercial insurers followed suit. In 2012, the AAP issued a new statement saying that the health benefits of circumcision outweigh the risks, but they will not be recommending it universally. So as a parent, what does this mean? Let’s take a closer look at the benefits of which they speak.

Benefits of male circumcision

  • Beginning with hygiene, the removal of foreskin allows for easier access to the head of the penis. In uncircumcised boys, it is crucial that the space between the foreskin and the tip of the penis be cleaned regularly and parents be educated about proper practices in doing so. Neglecting to care for the uncircumcised penis increases the likelihood of balantitis or phimosis, which is when the foreskin becomes infected and too tight to be pulled back over the head of the penis, possibly requiring surgical intervention.
  • The data well establishes that circumcised boys are less likely to acquire urinary tract infections, or UTIs, particularly in the first year of life. UTIs in the pediatric population can be particularly damaging, with the possibility of permanently scarred kidneys. What’s more, infection can spread outside the urinary tract, causing life-threatening complications. Studies show that the risk of UTI is nearly 10 times lower in circumcised boys.
  • We find data in support of circumcision when considering the acquisition of sexually transmitted disease and the prevention of penile and cervical cancer. Clinical trials from the 2000’s found that male circumcision significantly decreases the risk of HIV, HPV and herpes. Additionally, the data supports that circumcision in conjunction with safe sex habits decreases the risk of acquiring cervical and penile cancer.
  • Finally, many parents question whether or not circumcision decreases penile sensitivity. In 2015 a paper in the Journal of Urology addressed this topic and concluded that penile sensitivity did not differ when comparing either group.

The bottom line

The bottom line? As a parent the decision regarding circumcision ultimately comes down to what feels comfortable for you and what you believe to be best for your son. Thoughtfully and carefully considering the current facts is necessary to feel confident in your choice. For a decision as paramount as this, you should not hesitate to discuss with your family medicine or pediatric provider.