Circumcision

Parents and guardians of male infants are faced with the decision of whether or not to circumcise their infant. For some families, this is an easy decision based on culture,

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tradition, or specific preferences. Others, however, might not have strong opinions and might look to the family physician for information on the risks and benefits of this procedure. Epidemiologic studies have shown some potential medical benefits to circumcision, but real risks are associated with the surgery itself. Parents and guardians should be given full information on the risks and benefits before making a decision (AAP Circumcision Policy Statement, 1999).

The circumcised penis can take 7 to 10 days to heal. Parents should gently clean the penis with each diaper change, being careful not to be too aggressive and reopen the wounded glans. Any new or significant bleeding from the penis should be reported to the family physician. Bleeding from the circumcision site occurs in about 0.1% of cases and often can be treated in an office setting with local pressure, chemical cautery (silver nitrate), or sutures (AAP, 1999).

The uncircumcised penis does not require any particular care. Many parents may be anxious to retract the foreskin and clean between the glans and the foreskin. Early retraction, however, is unnecessary and can lead to paraphimosis. The foreskin should not be retracted until it can be retracted easily, without any force and without causing pain to the child. This can take 3 to 5 years, and at that time parents can teach the boy to clean under the foreskin daily (Thureen et al., 2005).

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