The benefits and risks of male circumcision

Health Answers

August 29, 2011|By Courtney Humphries

Q. Are there health benefits or risks of male circumcision?

A. The decision to circumcise male babies or not is often based on cultural, religious, ethical, and aesthetic reasons. What about health? Lise Johnson, medical director of the Well Newborn Nurseries at Brigham and Women’s Hospital, says “there are some medical benefits’’ of circumcision, but “the benefits that we know of today are not so compelling that it translates into a recommendation that all boys be circumcised.’’

There are rare health problems that circumcision may prevent or offset. The first is simply the occasional discomfort or swelling caused by irritation of the foreskin, as well as rare instances in which a boy’s foreskin does not loosen up and retract during erection. Johnson says there is also longstanding evidence that boys who are circumcised have fewer urinary tract infections, but these are uncommon in boys. They also have lower rates of penile cancer, a very rare form of cancer.

A more recent case for circumcision has emerged as studies have found that circumcised men in countries where HIV is endemic have lower rates of infection. Some health authorities have called for more widespread circumcision as a public health measure. Whether this benefit is compelling for people with much lower risk of acquiring HIV, however, is subject to debate. On balance, pediatric organizations in the United States agree that while benefits of circumcision exist, they are not significant enough to recommend it for health reasons.

Johnson adds there’s no evidence that circumcision affects later sexual health, or that it has important consequences for hygiene. Uncircumcised boys should be taught to retract the foreskin and wash as part of their normal routine, but “it’s not rocket science,’’ she says.

Circumcision carries a small risk of infection and excess bleeding. A recent review of circumcision studies worldwide found few serious complications, and those reported were often associated with older children, inexperienced providers, and non-sterile conditions. Some parents have concerns about pain, but now pain control is routine in medical settings. Johnson says that babies first get a dose of concentrated sucrose, a sugar with pain-relieving effects in newborns, then are physically soothed while a numbing medication is injected into the penis. Babies get a dose of acetaminophen after the procedure, and can show signs of discomfort for the first few hours, but usually recover within a day.