Male circumcision is a
surgery to remove the foreskin, a fold of skin that covers and protects the
rounded tip of the penis. The foreskin provides sensation and lubrication for
the penis. In most cases, circumcision is elective surgery, which means there
isn't a medical reason for it. If it is done, circumcision is usually done soon
after birth. After the foreskin is removed, it can't be put back on again.
If circumcision is done, it's usually done soon after birth. In Canada, over the last several decades the percentage of baby boys circumcised has decreased. The circumcision rate varies from province to province. Circumcision has
both risks and benefits. The decision about whether to have a baby circumcised is usually based on the personal
preference of the parents.
See a picture of the
penis before and after circumcision.
Some older boys and men need circumcision to treat problems with the foreskin of the penis (such as
paraphimosis) or for swelling of the tip of the penis
This topic focuses on the circumcision of newborns.
It's up to you whether you have your baby circumcised or keep your son's penis natural. The Canadian Paediatric Society (CPS) does not recommend circumcision as a routine
procedure for newborn males. When making this policy, the CPS looked at the
possible benefits, risks, and costs of the procedure.1
When you make this
decision, it may help you to think about your personal and cultural
preferences. For example, you may want to consider your religious and family
traditions while you weigh the pros and cons of the surgery. It is your
decision whether to keep your son's penis natural or have your son circumcised.
Circumcision is not just done in newborns. Keep in mind that your son can decide on his own later in life if he wants
a circumcised penis.
Problems from circumcision are not common. If they occur, they are
usually minor. The most common circumcision problems are:
More serious problems are rare. They include damage to the
opening of the urethra, heavy bleeding that requires stitches, severe
infection, and scarring.
Circumcisions usually are done by a
urologist. Circumcisions that are performed for religious reasons are sometimes done by others trained in the procedure. For
your baby's safety, it is best that the person doing the surgery is well trained, uses sterile techniques, and knows
how to manage your baby's pain during and after the surgery.
Frequently Asked Questions
Learning about circumcision:
How it is done:
Care after circumcision:
Health Tools help you make wise health decisions or take action to improve your health.
Circumcision is usually done by a doctor at a clinic,
in the hospital, or at an outpatient surgery centre. During the
circumcision, the groin, penis, and scrotum may appear
reddish brown because of the liquid used to clean the skin before surgery. The
shaft of the penis where the skin was removed will look raw and slightly
Your baby will stay in the hospital or clinic for 2 to 4 hours
after the procedure. His penis will be checked for bleeding, and the
circumcision area may be covered with petroleum jelly and gauze.
You will likely take your baby home
the same day he is circumcised. Some swelling around the penis is normal in the
first few days after the surgery. Some slight bleeding may occur. If this
happens, apply direct but gentle pressure to the area with a clean cloth or
bandage for about 5 to 10 minutes.
After surgery, your baby will
feel some pain. He may be fussy and have trouble sleeping.
If gauze was used, it will probably come off when your baby urinates. Follow your doctor's directions about whether
to put clean gauze on your baby's penis or to leave gauze off. If you need to remove gauze from the penis, use
warm water to soak the gauze and gently loosen it.
yellow film will form over the circumcision site after surgery. This is part of
the normal healing process and should go away in a few days. Although the penis
is beginning to heal, it may look worse a few days after circumcision. The
penis should look like it's getting better about a week after surgery.
Here are some things you can do
to help your baby feel more comfortable:
Ask your doctor about giving your baby
acetaminophen (such as Tylenol) for pain. Call your
doctor anytime your baby seems to be in a lot of pain.
Your son's penis will be
checked during routine
well-baby visits. But it is important to call your
doctor if your baby has problems after
Call your doctor right away if after circumcision:
Plastibell device was used for the circumcision, call
your doctor if the ring has not fallen off after 10 to 12 days.
Doctors who usually perform
circumcisions on infants include:
A urologist or surgeon normally will do circumcisions on
older infants, children, and adults.
Some parents may make the decision about circumcision based on religious and family traditions, personal preferences,
or the social norms of their communities. Often these cultural reasons affect the decision more than the medical
risks and benefits of circumcision.
There may be some health benefits for
circumcised males, but these benefits must be weighed against the risks.
Medical experts agree that these health benefits alone are
not good enough reasons to have circumcision.
The Canadian Paediatric Society (CPS)
does not recommend circumcision as a routine procedure for newborn males. When
making this policy, the CPS looked at the possible benefits, risks, and costs
of the procedure.1
baby's first year of life,
urinary tract infections (UTIs) happen less often in
circumcised boys than in boys who are not circumcised. But UTIs are not common.
No studies support healthy babies having circumcision to prevent UTIs.2, 3, 4
There may be reasons later in life when your son may need a
circumcision. A boy or man may have problems retracting the foreskin or may
have swelling of the foreskin that requires circumcision.
All surgical procedures have risks. Problems
circumcision are not common. Minor problems are
short-term and may include:
Long-term problems can include:
Major problems are very rare but can include:
As a parent, you will decide whether you want to keep
your son's penis natural or want him to be
circumcised. Because circumcision is usually not medically needed, this decision often is a personal one based on your own values and religious or cultural beliefs.
good idea to think about your decision before your baby is born. If you wait,
the excitement and fatigue of the delivery can affect your ability to carefully
consider the benefits and risks of each choice.
Your son's values
Circumcision is not just done in newborns. Keep in mind that your son can
decide on his own later in life if he wants a circumcised penis.
Circumcision and STIs
Some studies have shown that circumcised men are a little
less likely than men who have not been circumcised to get a
sexually transmitted infection (STI), including
HIV. But circumcision should not be done
solely to prevent STIs or HIV.
Any man, especially if he has
high-risk sex, can get STIs or HIV. The best way to
prevent STIs is to teach people about risk factors and the importance of
avoiding high-risk sex.
Some people have concerns that circumcision can decrease sensation in the
penis. Some people also wonder if circumcision disrupts the bonding that occurs
between mother and son during breast-feeding. But there is not a lot of
research about these concerns.
Keeping your son's penis clean may
help prevent infection and other problems. It's important to keep your son's
penis clean whether he has been circumcised or not. When
cleaning a natural (uncircumcised) penis, be careful
not to force the foreskin to retract.
If you choose circumcision
If you decide that you would like to
have your baby circumcised, talk with your doctor. Discuss any concerns you may
have about pain and your preferences for
anesthesia. Ask your doctor about giving your baby
acetaminophen (such as Tylenol) for pain relief after
When is circumcision not done?
Your doctor may not do circumcision if your baby has a medical
condition that makes him more likely to have problems from the surgery, such
The Caring for Kids website was developed by the Canadian Paediatric
Society and provides parents with information about child health and well-being.
The Canadian Paediatric Society (CPS) promotes quality health care
for Canadian children and establishes guidelines for paediatric care. The
organization offers educational materials on a variety of topics, including
information on immunizations, pregnancy, safety issues, and teen health.
The Canadian Urological Association provides information
about a variety of urological conditions in the patient information section on
this website. Some of the pediatric topics are bedwetting, circumcision, and
undescended testicle. Adult topics range from prostate, kidney, and bladder
health to erectile dysfunction and vasectomy.
Fetus and Newborn Committee, Canadian Paediatric
Society (1996; reaffirmed 2002). Neonatal circumcision revisited.
Canadian Medical Association Journal, 154(6):
Singh-Grewal D, et al. (2005). Circumcision for the
prevention of urinary tract infection in boys: A systematic review of
randomised trials and observational studies. Archives of Disease in Childhood, 90(9): 853–858.
Malone P, Steinbrecher H (2007). Clinical review:
Medical aspects of male circumcision. BMJ, 335(7631):
Van Howe RS (2005). Effect of confounding in the
association between circumcision status and urinary tract infection.
Journal of Infection, 51(1): 59–68.
Other Works Consulted
Centers for Disease Control and Prevention (2008). Male circumcision and risk for HIV transmission and other health conditions: Implications for the United States. Available online: http://www.cdc.gov/hiv/resources/factsheets/PDF/circumcision.pdf.
Steadman B, Ellsworth P (2006). To circ or not to
circ: Indications, risks, and alternatives to circumcision in the pediatric
population with phimosis. Urologic Nursing, 26(3):
Towers HM (2006). Circumcision. In FD Burg et al.,
eds. Current Pediatric Therapy, 18th ed., pp. 313–315.
Philadelphia: Saunders Elsevier.
Wiysonge CS, et al. (2011). Male circumcision for prevention of homosexual acquisition of HIV in men. Cochrane Database of Systematic Reviews (6).
May 8, 2013
Adam Husney, MD - Family Medicine
& Andrew Swan, MD, CCFP, FCFP - Family Medicine & John Pope, MD - Pediatrics
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