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A pediatrician's guide to circumcision

baby boy be circumcised, circumcised babies, Circumcision cons, Circumcision pros, Male Circumcision, Medical Ethics, Parenting, San Francisco, how common is circumcision, should you circumcise, Ballot Initiative, Circumcision, Circumcision Ban, Foreskin, Lloyd ShofieldThe practice of male circumcision dates back as far as ancient Egypt when it was performed to improve hygiene and for purification.

Today, approximately 70 percent of all newborn boys in the United States undergo circumcision making it the most common procedure in this population.

In the absence of certain medical conditions or anatomic abnormalities, circumcision during the newborn period is an option you may want to consider for your baby. The decision should be made on the basis of accurate and unbiased information from your physician regarding the medical implications, taking into account your personal, religious and cultural beliefs and traditions.

What happens during circumcision?

Circumcision in the male refers to the surgical removal of the foreskin of the penis. For infant circumcision, different clamps can be used, but the same basic procedure is followed.

First, the amount of foreskin to be removed is estimated and marked before it is opened with a scalpel to reveal the glans underneath. The inner lining of the foreskin is then separated from its attachment to the glans. The device is then placed and remains until blood flow has diminished.

Finally, the foreskin is removed. When performed in the hospital, circumcision is typically performed by a pediatrician, obstetrician, family medicine doctor, surgeon or urologist.

Circumcisions for religious reasons are sometimes done during ceremonies outside of the hospital, by a non-medical person trained in the procedure.

Does it hurt?

Studies have shown that newborns undergoing circumcision exhibit behavioral and physiological signs of stress, such as irritability and increased heart rate and blood pressure.

The stress may be due, in part, to the fact that infants are restrained prior to a circumcision. Still, both the American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) have clear guidelines which recommend using something to control the pain during the procedure.

Pain control measures include oral solutions, like a pacifier dipped in sugar water; topical anesthetics, like numbing creams containing Lidocaine; and/or a local nerve block, such as an injection of Lidocaine to the base of the penis.

But rest assured mom and dad – when performed properly – pain and complications are minimized.

What are the advantages?

Circumcision has been associated with a number of medical benefits for the newborn and later in life.

In general, genital hygiene is easier in the absence of the foreskin. Circumcised males are less likely to develop urinary tract infections (UTI), especially in the first year of life.

In a study of male infants under three months of age with fever, the prevalence of UTI was 2.4 percent in circumcised infants compared to more than 20 percent in the uncircumcised group. In addition, older circumcised males are believed to be at lower risk for penile cancer and sexually transmitted diseases including HIV and herpes virus.
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