We feel parents should be well informed and respected for whichever choice they make.

This section addresses the scientific evidence regarding circumcision.

In August 2012, The American Academy of Pediatrics revised its guidelines. The new policy states that “health benefits of newborn male circumcision outweigh the risks… Specific benefits from male circumcision were identified for the prevention of urinary tract infections, acquisition of HIV, transmission of some sexually transmitted infections, and penile cancer. Male circumcision does not appear to adversely affect penile sexual function/ sensitivity or sexual satisfaction.

The Canadian Paediatric Society issued its most recent guidance on infant male circumcision in 2015, and it was reaffirmed in 2018. Their current position is that “Because the medical risk:benefit ratio of routine newborn male circumcision is closely balanced when current research is reviewed, it is challenging to make definitive recommendations for the entire male newborn population in Canada…Current evidence indicates that there are potential health benefits associated with male circumcision, particularly in high-risk populations…Health care professionals should provide parents with the most up-to-date, unbiased and personalized medical information available so that they can weigh the specific risks and benefits of circumcising their son in the context of familial, religious and cultural beliefs.”

Top Benefits

  • Less local infection
  • Less UTI’s
  • Lower risk of STI’s
  • Easier hygiene

Minimal Risk of:

  • Bleeding
  • Infection
  • Suboptimal cosmetic outcome
  • Trauma to the penis

Benefits

Scientific research has found several advantages to infant circumcision. These include but are not limited to:

 

  • Less urinary tract infections, especially in the first year of life (12 times less)
  • Less local infection of the forekin (posthitis) or the head of the penis (balanitis) (50% less)
  • Reduction in the risk of sexually transmitted infections including:
    • HIV (60% less)
    • Herpes (31% less)
    • HPV or Human Papilloma Virus (33% less)
      (HPV is the cause of genital warts in men and women, and cervical cancer in women)
    • Syphilis
  • Reduction in sexually transmitted infections in female partners of circumcised men (Bacterial Vaginosis decreased 40%, Trichomonis decreased 48%)
  • Eliminates phimosis, an often painful inability of the foreskin to pull back over the penis.
  • Easier hygiene
  • Virtually eliminates risk of cancer of the penis
  • Tied to lower prostate cancer risk
  • Some studies suggest less sexual dysfunction later in life
  • Avoidance of need to circumcise later in life when risks are higher (10 times), costs are higher and pain is higher (some estimate between 6% and 10% of boys will require circumcision in their lifetime due to medical reasons)
  • See our page on important medical research

Risks

Any surgical procedure involves some risk.  Please read the following and make sure you have your questions answered prior to proceeding.

 

The overall risk of complication from this procedure is between 0.2% (2/1000) and 0.6% (6/1000).

 

More specifically:
  • Risk of bleeding- most often there is little to no bleeding.
  • Sometimes (1 time in 100) a small amount of bleeding can happen and it can be stopped with gently applied pressure by the doctor or by yourself. More rarely (1 time in 4000) there can be excessive bleeding that will require stitches. In very rare circumstances (1 time in 20,000), a blood transfusion may be required (never happened in this practice).
  • Risk of Infection – most often there is no infection after this procedure. Rarely (1 time in 1000) there can be an infection that requires the application of topical antibiotics to the penis for several days. More rarely (1 time in 4000) the baby may be required to have antibiotics given either by mouth or intravenously (never happened in this practice).
  • Suboptimal cosmetic outcome- most often the circumcision is a cosmetic success. Occasionally either too much or too little skin is removed. Rarely, this can require a second surgery for a better outcome (never happened in this practice).
  • Trauma to the Penis (never happened in this practice)- most often there is no trauma to the penis. Rarely, the penis itself can be damaged by the procedure, requiring urgent surgical consultation at the hospital. Damage can be done to the urethra (the hole where urine comes out), the glans (the head of the penis), or the shaft of the penis.
  • Death (never happened in this practice)-In very rare cases, death has been caused by circumcision, usually due to undiagnosed medical or bleeding problems in the baby. Between 1954 and 1989, fifty million circumcisions were performed in the USA. Three deaths were reported due to circumcision. Two babies had undiagnosed bleeding disorders and one was a premature infant weighing only 1.9kg. Surgical complications can, of course, also be a cause of damage resulting in death.
A Baby should NOT have a circumcision prior to discussion with Dr. Green if
  • There is a family history of bleeding disorder
  • The baby is premature (under 37 weeks at birth)
  • There is a congenital abnormality of the penis (the anatomy of the penis is not normal)
  • There is a medical disorder in the newborn (ex. hypothyroid, heart disease, infectious disease)