Circumcision

Circumcision is a surgical procedure to remove the foreskin of the penis. Up until the early 1970s the procedure was routinely carried out for new-born boys, usually within a few days after birth. Today, the procedure is performed less commonly in New Zealand (estimated at less than 10% of boys), mostly for social, cultural or religious reasons.

It is generally agreed among medical professionals that, except in a few instances, there is no medical reason for routine circumcision. Those exceptions include conditions such as balanitis (where there is repeated inflammation of the head of the penis) and phimosis (where there is tightness of the foreskin, usually due to recurrent infection of the foreskin).

The Royal Australasian College of Physicians position on infant male circumcision, published in 2010, is as follows:

"After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However, it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons."

The procedure

To reduce the risks and discomfort to the child, circumcision is usually performed under a general anaesthetic after about six months of age.

A typical surgical technique involves making an incision around the area of the foreskin where it joins the skin that covers the shaft of the penis. The foreskin is then carefully pulled away from the tip of the penis and is cut away down to the level of the initial incision. The skin covering the shaft of the penis is then sewn back underneath the head of the penis.

Another technique for circumcising young babies is the attachment of a plastic ring under the foreskin. This is tied into place and works by restricting blood flow to the foreskin. The ring and the foreskin fall off after a few days. This technique is performed using a local anaesthetic.

The penis may have a dressing applied after the operation. It is important to keep the area clean and an antibiotic cream may be prescribed in order to prevent infection. Pain relief medication such as paracetamol and/or anaesthetic ointments may be used for any pain and discomfort after the operation.

As with any surgery there are possible complications that should be discussed with the surgeon.

Uncircumcised penis hygiene

Hygiene for the uncircumcised penis is important and it should be cleaned just as any other part of the body is cleaned. At birth, and for some years into childhood, the foreskin is firmly attached to the head of the penis. While this is the case it is extremely important not to retract the foreskin during cleaning as this can damage it.

When the boy's foreskin becomes retractable, it can be gently retracted and the surface underneath cleaned during the daily bath or shower. The foreskin should be slipped back in place over the head of the penis after cleaning and rinsing.

References

KidsHealth (2018). Circumcision (Web Page). Christchurch: Paediatric Society of New Zealand. Auckland: Starship Foundation. https://www.kidshealth.org.nz/circumcision [Accessed: 31/03/20]
KidsHealth (2017). How to care for your child's foreskin (Web Page). Christchurch: Paediatric Society of New Zealand. Auckland: Starship Foundation. https://www.kidshealth.org.nz/how-care-your-childs-foreskin [Accessed: 31/03/20]
Royal Australasian College of Physicians – Paediatrics and Child Health Division (2010). Circumcision of infant males (Policy Statement). Sydney, NSW: Royal Australasian College of Physicians. https://www.racp.edu.au/docs/default-source/advocacy-library/circumcision-of-infant-males.pdf
Royal Australasian College of Physicians – Paediatrics and Child Health Division (2014). Circumcision: A guide for parents (Brochure). Sydney, NSW: Royal Australasian College of Physicians. https://www.racp.edu.au/docs/default-source/advocacy-library/circumcision-brochure.pdf
O'Toole, M.T. (Ed.) (2017). Circumcision. Mosby's Dictionary of Medicine, Nursing & Health Professionals (10th ed.). St Louis, MI: Elsevier.

Last Reviewed – April 2020

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