Logan Reid
Circumcision is the surgical removal of the foreskin from the penis. It is not a medically necessary procedure, and parents may choose to have their infant sons circumcised for religious, cultural, or health reasons. Circumcisions are usually performed by a urologist, pediatrician, family doctor, or obstetrician in a hospital setting, though they can also be carried out at home.
| Characteristics | Values |
|---|---|
| What is circumcision? | Surgical removal of the foreskin from the penis |
| Who performs it? | Obstetrician, pediatrician, urologist, mohel, family doctor, APPs |
| Where is it performed? | Hospital, private home, synagogue, operating room |
| When is it performed? | Within the first 10 days of a baby's life, often within the first 48 hours, or within the first month |
| Why is it performed? | Health benefits, religious practices, cultural practices |
| What are the risks? | Bleeding, infection, scarring, irritation, inflammation, reduced sensitivity, adhesions |
| What are the benefits? | Lower risk of some diseases (e.g. UTIs, penile cancer, STIs), improved hygiene |
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What You'll Learn
Who performs circumcisions in hospitals?
Circumcision is a surgical procedure to remove the skin covering the end of the penis, called the foreskin. It is typically performed on newborns and is usually carried out by an obstetrician in the hospital. In some cases, the procedure may be performed by a pediatrician, or a physician who specializes in treating children.
In some hospitals, such as the Children's Hospital of Philadelphia, the obstetrician or pediatrician may request that the child be evaluated by a pediatric urologist prior to the circumcision. Pediatric urologists are doctors who specialize in treating and diagnosing conditions affecting the urinary and reproductive systems. They are skilled in performing circumcision on newborns and can provide specialized care in this area.
In addition to doctors, hospitals may also have advanced practice providers (APPs) who are trained to perform circumcisions. These individuals are not doctors but have received training to carry out certain medical duties, including circumcisions. APPs may work under the supervision of urologists or pediatric urologists to provide care to patients.
It is important to note that circumcision is an elective procedure and is not required by law or hospital policy. Parents have the choice to decide whether or not to have their son circumcised, weighing the potential health benefits and risks associated with the procedure. The procedure can be performed in a hospital setting or in a non-medical setting for religious or cultural reasons, as long as the person performing the circumcision is well-trained and qualified to do so.
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When is circumcision performed in hospitals?
Circumcision is the surgical removal of the foreskin from the penis. It is not a medically necessary procedure, and parents may choose to have their sons circumcised for religious, cultural, or health reasons. The American Academy of Pediatrics (AAP) has found that the health benefits of circumcision in newborn boys outweigh the risks of the procedure, but that the benefits are not great enough to recommend that all newborn boys be circumcised.
Circumcision can be performed at any age, but it is most commonly done within the first month of a baby's life, and most often within the first 10 days, and even within the first 48 hours. It is usually performed by an obstetrician, pediatrician, or family doctor in a hospital, though it may also be performed by a urologist, a doctor specializing in treating and diagnosing conditions affecting the urinary and reproductive systems. In some cases, it may be performed by a maternal medicine advanced practice provider (APP), a healthcare provider who is not a doctor but has training to perform some physician duties.
The procedure typically involves cleaning the penis and foreskin, attaching a special clamp to the penis to stop bleeding, cutting and removing the foreskin, and then placing gauze or a small dressing with petroleum jelly over the wound to protect it from rubbing against the diaper. In some cases, dissolvable stitches or an electric current may be used to stop bleeding and reduce scarring.
In terms of timing, circumcision may be performed before or after the mother and baby leave the hospital. It is typically only performed if the baby is healthy, and may be postponed if the baby has a medical condition. For older children and adults, a provider will review their health history and perform a physical examination before the procedure.
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Benefits and risks of circumcision
Circumcision is the surgical removal of the foreskin from the penis. It is one of the most common surgeries performed worldwide, with a rate of up to 80% in the United States and about 38% globally. It is often carried out in hospitals by obstetricians, paediatricians, or urologists, and can be performed on newborns, older children, and adults.
Benefits of Circumcision
Circumcision is associated with several potential health benefits, including:
- Lower risk of urinary tract infections (UTIs) during the first year of life. However, it is important to note that the risk of UTIs in uncircumcised infants is also relatively low, at around 1%.
- Reduced risk of penile cancer, although this type of cancer is already rare.
- Prevention of foreskin infections and phimosis, a condition where the foreskin cannot be retracted.
- Lower risk of certain sexually transmitted infections (STIs), such as HIV. However, circumcision is much less effective against STIs commonly found in the United States, and the reduction in HIV risk is minimal.
- Decreased risk of inflammation of the head of the penis (balanitis) and inflammation of the foreskin and head of the penis (balanoposthitis).
- Cultural or religious reasons: Circumcision is a long-standing tradition in some cultures and religions, including Christianity, Islam, and Judaism.
Risks of Circumcision
As with any surgical procedure, circumcision carries certain risks, including:
- Bleeding: This can be a concern, especially if the individual is taking certain herbal supplements, over-the-counter medications, or blood thinners.
- Infection: The risk of infection is present in any surgical procedure.
- Scarring: Scarring may occur, which can be a concern for some individuals.
- Removal of too much or too little foreskin: In rare cases, complications may arise if too much or insufficient foreskin is removed.
- Pain: Circumcision can cause discomfort, and pain management may be necessary.
- Impact on sexual function and sensitivity: Some people worry that circumcision may affect sexual function, sensitivity, or satisfaction. However, doctors maintain that it has no effect on sexual function or fertility.
The decision to undergo circumcision is a personal one, and individuals should carefully consider the potential benefits and risks before making an informed choice. Experts generally agree that while there are minimal benefits and risks associated with the procedure, they are not significant enough to mandate or prohibit it.
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Religious and cultural aspects
Circumcision is one of the world's most common and oldest surgical procedures, with a long history of cultural and religious significance. It is deeply rooted in various faiths and societies worldwide, often serving as a rite of passage or a symbol of religious devotion.
Judaism
In Judaism, circumcision holds immense importance and is considered one of the most sacred commandments. According to the Torah, a covenant was established between God and Abraham, symbolised by circumcision for all Jewish males. Traditionally, male infants are circumcised on their eighth day of life, unless there are medical reasons not to. Circumcision is near-universally practised among Jews and is seen as a way to ease penile hygiene in hot, sandy climates and as a form of blood sacrifice.
Islam
Islam is the largest religious group that practises male circumcision, known as "tahera" or purification. It is considered one of the rules of cleanliness, pertaining to "Fitrah" or the innate disposition and natural character of humans. While some Muslim scholars deem it obligatory, others view it as a highly recommended practice. The procedure is recommended to be performed at an early age.
Christianity
Male circumcision is practised in some African and Eastern Christian denominations, including the Nomiya church in Kenya, which requires circumcision for membership. However, the Roman Catholic Church has stated that male circumcision is unnecessary, and some Christian churches in South Africa oppose it, deeming it a pagan ritual.
Other Cultures and Religions
Male circumcision is also prevalent in various cultures worldwide, including sub-Saharan Africa, Aboriginal Australasians, the Aztecs and Mayans in the Americas, the Philippines, Eastern Indonesia, Fiji, and the Polynesian islands. It often serves as a rite of passage into manhood, marking a boy's transition into adulthood and enhancing his social cohesion, self-identity, and spirituality. Additionally, circumcision is practised in the Druze faith and among members of the Coptic Church, the Ethiopian Orthodox Church, and the Eritrean Orthodox Tewahedo Church.
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Alternatives to hospital circumcision
Circumcision is the surgical removal of the foreskin from the penis. It is usually performed by an obstetrician in a hospital, but there are several alternatives to having the procedure done in a hospital setting.
One alternative is to have the procedure done by a urologist, who is a doctor specialising in treating and diagnosing conditions affecting the urinary and reproductive systems. This can be done in a hospital, but urologists can also perform the procedure outside of a hospital environment. In some cases, a urologist may recommend that the circumcision takes place in a hospital, to ensure access to the necessary equipment and support staff.
Another alternative is to have the procedure done by a maternal medicine advanced practice provider (APP). APPs are healthcare providers who are not doctors but have training to perform some physician duties, including circumcisions. APPs can perform circumcisions in a hospital, but they may also offer this procedure in other settings, such as a private home or a synagogue, depending on the circumstances and the patient's preferences.
In a religious context, a mohel may perform a circumcision as part of a bris ceremony. This can take place in a hospital, but it is more common for this to occur in a private home or a synagogue.
It is important to note that circumcision is an elective procedure and is not required by law or hospital policy. The choice of whether or not to have a circumcision, and where to have it performed, is a personal decision that should be made after consulting with a healthcare professional.
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Frequently asked questions
Circumcision is a surgical procedure that involves the removal of the foreskin from the head of the penis.
Circumcisions can be performed in hospitals by a urologist, obstetrician, pediatrician, family doctor, or advanced practice providers (APPs). They can also be performed at home, in a synagogue, or in a private setting for religious reasons.
Circumcision is not required by law or hospital policy and is usually performed on newborn males. However, it can be done at any age.
Some parents choose to circumcise their newborn sons due to the health benefits, such as a decreased risk of urinary tract infections, sexually transmitted infections, and penile cancer. Circumcision can also make it easier to maintain penile hygiene, reducing the risk of infection from bacteria.
Circumcision carries the common risks associated with surgery, including bleeding, infection, and scarring. In rare cases, too much or too little of the foreskin may be removed, requiring a revision. Some believe that circumcision may also reduce sensitivity in the penis, decreasing sexual pleasure later in life.
