What Is Circumcision?

Circumcisions can reduce the risk for several diseases, including HIV.

Circumcision is a surgical procedure to remove the penile foreskin — the retractable fold of skin that covers the tip of the penis (glans penis).

Circumcision of newborns is fairly common in the United States, though it appears to be on the decline.

In 1979, about 65 percent of newborn boys were circumcised, but only 58 percent were circumcised in 2010, according to the Centers for Disease Control and Prevention (CDC).

Worldwide, about 30 percent of males are circumcised, according to the World Health Organization (WHO).

Circumcision Surgery

Circumcision is performed under local anesthesia.

The three most commonly used circumcision procedures in the United States are the Gomco clamp, Plastibell device, and Mogen clamp, according to a 2012 report in the journal Pediatrics.

During the Gomco clamp method, a doctor will place the bell of the clamp over the glans and pull the foreskin over the bell. He will then situate the circular base of the metal clamp around the penis where the foreskin will be cut, and tighten it.

Five minutes later, after blood clotting has occurred, he will cut the foreskin off with a scalpel.

The Plastibell device method involves inserting a plastic ring on to the glans and covering it with the foreskin.

The doctor will then place a ligature or suture around the foreskin, crushing it into the groove of the Plastibell.

The device stays on the penis for several days until the foreskin tissue dies and falls off, along with the Plastibell.

The Mogen clamp is a metal device with two flat blades separated by a small slit.

During a circumcision, doctors place it above the glans and lock it shut around stretched foreskin, which they remove with a scalpel above the clamp.

Complications

Complications are rare and occur in only a small number of circumcisions, according to the Pediatrics report.

Depending on the procedure, they can include:

• Bleeding
• Infection
• Redundant foreskin, in which the foreskin completely covers the glans when not erect
• Phimosis, or trapped penis, in which the foreskin is too tight to retract from the glans
• Urinary retention, the inability to fully empty the bladder

Circumcision Recommendations

The American Academy of Pediatrics, in its 2012 Pediatrics report, considers the benefits of newborn circumcision to outweigh the potential harms.

These sentiments are echoed by the CDC, which issued draft guidelines in 2014 that endorsed newborn circumcision.

Specifically, circumcision decreases a man's risk of contracting HIV from vaginal sex (but not from anal sex).

It also reduces the risk of genital herpes, certain strains of human papillomavirus (HPV), penile cancer, and urinary tract infections (UTI) during infancy.

However, anti-circumcision advocates argue newborns shouldn't be given the procedure, in part because the infants cannot give their own consent.