Circumcision is the operation of removing the prepuce, or foreskin, of the male. There are three reasons for performing the operation:
2. Because it is medically advisable.
3. Because the parents wish it to be done.
Circumcision for religious reasons is usually performed on or about the eighth day amongst Jews, either by a doctor or by a lay person who has been specially trained to do the operation. If the baby is premature, not gaining weight, is jaundiced or for any medical reason is considered unfit for the operation, then this is postponed until he is fit enough for circumcision to be performed.
Medical indications for circumcision are very few. The foreskin may be very tight with only a tiny pinhole opening at its end so that it is impossible to draw the skin back. Paediatricians in Great Britain are reluctant to advise circumcision without any real medical indication because they do not consider that there is any advantage to be gained and the operation, like any operation, always presents a certain hazard. The arguments that the foreskin is dirty, that it has to be kept clean, that infection can occur underneath it and that circumcision in later life is a most uncomfortable and unpleasant procedure are not considered very substantial by most paediatricians. There are opposing arguments that the foreskin must have been provided for a purpose, that it should be washed and cleaned like any other part of the body, that in childhood a mother should teach her child to retract the foreskin and wash beneath it as a normal part of body hygiene and that if these simple rules are obeyed then infection should not occur in later life.
If circumcision is not necessary for medical or religious reasons it may not be obtainable in the National Health Service. In some countries, especially in the United States, Canada and Australia, circumcision has become almost a routine operation to be performed by the obstetrician at or within a few hours of delivery. It is certainly true that if the operation is going to be performed then it should be performed as soon after delivery as possible or on about the eighth day when the baby has established himself in a feeding routine and is gaining weight satisfactorily. Many doctors believe that operations should not be performed on the third, fourth or fifth days of life because not only is haemorrhage more likely during these days but the general effect of the operation on the baby is upsetting at a time when feeding is being established. Very few doctors or paediatricians in Great Britain would agree with, or even permit, circumcision to be performed at or immediately after birth and therefore the operation, if it is going to be undertaken, has to be deferred until the eighth day or thereabouts.
If you want to have your baby circumcised you must discuss it with the paediatrician or with your own doctor, but do not be surprised if your request does not meet with the approval you had hoped. Some doctors do agree with it and some do not.
If the operation is performed then one of several techniques may be used. It is important to keep a very careful watch during the first few hours after the operation to make certain that the penis is not bleeding. If no dressing has been applied you will be told how to bath the baby and about the special care of the penis. If a dressing has been applied you will probably be told that this should be soaked off in the bath one or two days after the operation. A plastic device may be used to perform the operation and you may find this device tied on to the end of the child’s penis. The device will drop off after three or four days. Whatever type of operation is done the penis is nearly always swollen and slightly inflamed for a few days but if you treat it as you are told everything will gradually settle down satisfactorily. If you are at all worried you should call your doctor or if the operation has been performed in hospital you should telephone the hospital and ask their advice.