Benefits and Risks
The American Academy of Pediatrics (AAP) takes a fairly neutral stance, acknowledging the probable medical benefits of circumcision but stopping short of universally recommending it. An updated statement is expected for 2012, but as of press time, the group had not announced it. "The surgery risks remain the same as when the last statement was written 12 years ago, but from the new research we have, it is clear that circumcision does provide protective health benefits, particularly with regard to HIV and HPV [the human papillomavirus]," says Douglas Diekema, M.D., a member of the AAP's circumcision task force. Circumcision's ability to reduce the risk of contracting HPV, the most common sexually transmitted disease (STD), can in turn protect against genital warts as well as cervical cancer in women (men pass on the infection).
It's difficult enough for most moms to picture their tiny newborn saying Mama, much less growing up to have an active sex life, so prevention of STDs is almost too abstract to contemplate. But the results of three randomized clinical trials of adult men in Africa were sufficient for the World Health Organization to endorse male circumcision as an effective way to reduce the risk for HIV acquired through heterosexual sex in regions with heterosexual epidemics, high HIV rates, and few circumcised men.
As for a more immediate benefit, the AAP reports that circumcised boys have a lower chance of getting a potentially serious urinary tract infection during their first year than uncircumcised boys do (1 in 1,000 vs. 1 in 100).
Those who are against circumcision bring up the question of sexual pleasure, pointing out that there are thousands of nerve endings on the foreskin that will be excised. It's impossible to study the difference in sexual sensation for men who were circumcised at birth, but Dr. Diekema notes that the few studies done with African men who were circumcised as adults show that some find intercourse better afterward, some describe it as worse, and the vast majority say it is pretty much the same as before.
Regarding the risks of the surgery itself, if circumcision is performed by an experienced physician in a sterile environment, they should be low. One to 3 percent of circumcisions will result in minor complications, such as extra bleeding or infection, which topical antibiotics can clear up. More serious complications, such as removal of too much skin or other damage to the penis requiring follow-up surgery, are rare, estimated at less than 1 percent. Still, many families who choose to forgo circumcision say they simply can't imagine putting their child through a painful procedure when he can live a healthy life without it.
And yes, the surgery will hurt. "Newborns do feel pain," Dr. Gray says. Prior to the incision, all infants should be given anesthesia, either a topical cream or an injection. With proper care and infant Tylenol, your son's penis should heal comfortably in a few days to a week.