Circumcision: Why I Choose to Circumcise My Sons

All three of my sons were circumcised. If the baby I’m currently pregnant with is male, he, too, will be. I’ve received some flack over that. It seems anti-circumcision has become a big topic these days. What once was perfectly acceptable will now get you called a mutilator by some. Personally, I’m not pro or against circumcision. I just chose to circumcise. I stand by my decision to have my kids circumcised. This is why.

Studies DO support it.

While lots of people may argue this one, there is a rather lengthy list of studies that support the medical benefits of circumcision. Those include a reduced risk of urinary infections, penile cancer, and sexually transmitted diseases such as HIV. Both the CDC and the American Academy of Pediatrics confirm these findings even though they do not take a firm stance on whether or not parents should circumcise their sons. Please do not try to refute these reputable sources with biased sites.

It is easier to care for.

In my personal opinion, having cared for children who were and were not circumcised, circumcised infants are easier to clean down there. This one is strictly my opinion; of course, as few studies have been done on the subject, but I do feel, hygiene-wise, it’s a cleaner option. I’m sure many have a different view on the subject. If you’re trying to decide, maybe do some baby sitting and get some experience caring for both options.

They won’t feel different.

While circumcision rates have dropped according to the CDC in the last few years, and were only at 54.7% in 2010, the “norm” is still circumcision in my area. The drop is actually suggested to be a result of some states no longer covering circumcisions through public healthcare programs such as Medicaid. Honestly, no matter what sex those may be that are reading this article, what do you picture when you think of a penis? Whatever you saw, that’s probably the cultural norm for you. My husband is circumcised. All my kid’s cousins and friends are circumcised. I don’t want my kids to grow up and feel self-conscious sexually, because they look different. The tables may be opposite for you, but they aren’t for our family.

There aren’t sufficient risks.

The above is not outweighed by the nearly non-existent risks of circumcision. Naturally, the fact that there isn’t a reason not to, does weigh in on my decision to do so. There are just as many minor complications that can arise in an uncircumcised newborn as a circumcised one.

Again, I believe that circumcision is a personal-choice issue for parents where there isn’t necessarily a right or wrong decision. Some would argue the decision should be the child’s, but how many decisions do you make a day for your child that are irreversible? Thousands if not more? The food they eat, the things they learn, the environment they live in, the medical care they receive — that is your job. You are a parent and you make decisions that affect your child’s health and life every single day; to circumcise or not, is just another one of those decisions. Please stop trying to make me feel bad for my decision for my children, as I’ve never looked down on yours.

Uncircumcised Penile Adhesion: Information and Advice for Parents

Many parents who don’t support circumcision believe that uncircumcised children can’t have penile adhesion. While this article is not aimed at supporting circumcision, it is important parents considering it, planning against it, or that have already settled against it and ran into a problem, have accurate information on uncircumcised penile adhesion. Both circumcised and uncircumcised males can suffer from adhesion or an un-retractable foreskin in the later case. You can read about adhesion in circumcised boys here.

Phimosis and adhesions:

Phimosis is a broad term used to describe an inability to retract the foreskin of an uncircumcised penis. While causes vary, the most common include infection, tight foreskin, adhesion that doesn’t naturally release, and scaring from forcible retraction or injury. Though rates of phimosis based on current research vary from about 9 to 27 percent, on average it appears about 10 percent of uncircumcised males suffer from the condition. It should be noted that at an early age, it’s normal for the foreskin to not retract; rates for phismosis are based on patients varying in age from 6 to 18. An adhesion in an uncircumcised male is the same as one in a circumcised male. The foreskin bonds to the glans of the penis to a varying degree. Several studies have found that uncircumcised males have a higher rate of penile problems after the first year of life than those who have been circumcised, though it should be noted most of these studies were done in the ’80s and have not been challenged.

What you need to know as a parent about uncircumcised penile adhesion:

If your baby is uncircumcised, his foreskin should be fused at birth. You shouldn’t forcibly retract it, as this could actually cause penile problems later on. Only clean what you can see until the foreskin easily retracts. If the urine stream is blocked by the foreskin, causing infection, pain, or bubbling, speak with your pediatrician as this is indicative of a problem. 90 percent of all children over the age of 3 have a retractable foreskin, if your child is significantly older than this he may have phimosis or adhesion. Though circumcision is one treatment, there are non-surgical alternatives including manual separation, foreskin stretching, and steroid treatment.

Weighing in on your decision to circumcise:

The rate of penile complications is about the same in both circumcised and uncircumcised males overall. Circumcised infants do tend to have a higher rate of incident in the first year, but uncircumcised males have a higher rate of medical need for complications after that point. While risk of adhesion and complication is a common stone thrown at parents that choose to circumcise, the actual documented studies on the subject don’t logically support this argument. On both sides, most complications are minor and resolve on their own.

Infant Penile Adhesion: What is It, Why Does it Happen, and How to Treat It

With all of our sons, my husband and I decided to circumcise. Within a month of our first baby boy’s circumcision, we noted it just didn’t look quite right. Less of the head of the penis appeared visible than we expected, and when the remaining foreskin was pulled back the edges of the head could not be seen. After further research and a pediatrician visit, we found our son had a penile adhesion.

infant penile adhesions adhesion

What is a penile adhesion?

A penile adhesion occurs when the remaining foreskin after a circumcision reattaches to the glans or head of the penis. Penile adhesions vary in severity and can be located anywhere around the glans. If you gently pull back the skin of a baby’s penis that has a penile adhesion you can see skin sticking to the edge of the head in locations or may not be able to see the edge of the head at all. Remember that a circumcised penis should resemble a mushroom. If it doesn’t, your baby may have an adhesion.

Can penile adhesions be prevented?

In my first son’s case, he was born with an unusual amount of foreskin, so after his circumcision more than usual remained. I was told simply to place Vaseline on the diaper to prevent sticking and allow it to heal. What I was not told is after healing the remaining foreskin should be gently pulled back during diaper changes and baths until 18 months of age to prevent infant penile adhesion. Not only can this process greatly reduce the risk of penile adhesion, but many parents find it to be cleaner. It’s a misconception that a circumcised penis requires no care. Even a circumcised infant will form smegma, or a white substance in the folds of skin around the penis, under the penis itself, and under the remaining foreskin. Choosing not to circumcise will also not prevent the chance of adhesion. Both circumcised and uncircumcised boys suffer adhesion.

It should be noted even with regular retraction of the remaining foreskin infant penile adhesions can still form. With my second baby boy, I was more versed in how to care for an infant circumcision and my baby still developed minor adhesions, yet my third son had no issues.

How are penile adhesions treated?

Expert opinions on how infant penile adhesion should be treated vary. Some feel that the adhesion should be gently pulled free in an office visit to prevent the need for surgery later. Others feel most penile adhesions resolve themselves by the time the baby turns five. Studies currently support the later of the two opinions finding that of the 71 percent of infants that had penile adhesions shortly after birth, only 28 percent still had adhesions by age 5, 8 percent by age nine, and 2 percent beyond this.

It’s recommended that all infant penile adhesions be evaluated by a pediatrician. While some adhesions will indeed resolve themselves, others will not. A medical professional is the best person to make this determination. With my first son, we opted to have the manual retraction. A numbing agent was placed on his penis, and then an hour later his doctor gently pulled the attached skin free. He had some redness for a day or so, but didn’t even cry. The skin did reattach again. It’s not uncommon for a baby that has had a penile adhesion to experience a reoccurrence of penile adhesions. We had the skin unattached a second time, and kept Vaseline between the remaining foreskin and the head this time until redness faded entirely. The adhesion has not returned.

In our second son, the adhesion was less severe. A pediatrician, in this case, recommended either leaving it alone or slow detachment. This should be done at the tail end of a bath. The bath will help soften the tissue. Place one thumb below the adhesion and another on the glans or head of the penis. Then you simply gently push in opposite directions. After a few baths, many adhesions are resolved. You can ask your pediatrician how to do this, and whether or not it is a good idea in your particular case.

In rare cases, penile adhesions exceed the fifth year of life. In these cases, surgery is usually recommended.