what to know before circumcising baby

Circumcision is an operation that involves removing the foreskin, the small skin that covers the glans of the penis. It is practiced for therapeutic or religious reasons. How is the intervention carried out? At what age can it be practiced? What are the postoperative consequences? Here is everything you need to know about infant circumcision.

Circumcision, also called posthectomy, is a widely practiced procedure around the world. It is performed most often for religious or ritual reasons, less for medical reasons. The term comes from the Latin circum (around) and caedere (cut). This operation consists of the partial or total removal of the foreskin.

Why circumcise baby?

Circumcision is generally performed for religious reasons. In the Jewish religion, it is a compulsory ritual for boys. They are circumcised on the 8th day from the day of birth inclusive, before dusk. This rite of passage in Judaism is called the brit milah.
Among Muslims, the name given to circumcision is Al khitân. In the Qur’an, it is considered to be part of fitra (healthy nature). Some Eastern Christian communities also practice it. In Anglo-Saxon countries, circumcision is very widespread and is done mainly for hygienic reasons. A reason which is a received idea in reality because the circumcision would not make it possible to improve the intimate hygiene. Circumcision for hygienic reasons is also not validated by doctors. Unlike a circumcised man, an uncircumcised man just has to retract the penis to wash the inner side of the foreskin with clean water.

More rarely, removal of the fold of skin covering the glans may be indicated for several medical indications:

  • a narrowing of the foreskin that prevents it from shrinking (uncover the glans by pulling on the foreskin). It is phimosis. It is either of congenital origin or of scarring.
  • retraction of the foreskin backwards which prevents it from being brought forward to cover the tip of the penis. It is paraphimosis.
  • a disease of the glans head and / or foreskin.
  • repeated urinary tract infections.

See your pediatrician if your child has one or more of these symptoms before the age of 3 or 4:

  • he has trouble urinating.
  • the erect penis is painful.
  • the penis has redness.
  • the urine stream goes all over the place.

From what age can a baby be circumcised?

The ideal time for circumcision – the most auspicious period – is the one immediately following birth”, Reports an article published in the medical journal Canadian Family Physician. The author of the article, Dr Edgar Schoen explains that newborns cope better with the pain and stress caused by the operation and recover quickly thanks to their high levels of corticosteroids, adrenaline, androgen, thyroxine and endorphins. For the practitioner, circumcision at an older age carries more risks, is more complex and more expensive.

Other practitioners prefer not to perform this operation on children under two years of age because at this age it must be performed under general anesthesia and it involves risks in toddlers. In babies under two months, circumcision for personal reasons (religious or cultural) is performed under local anesthesia.

Note that circumcision for medical reasons is reimbursed by Health Insurance, which is not the case for circumcision for personal reasons.

What does the operation consist of?

A few days before the operation, a preoperative anesthesia consultation is scheduled. The intervention is performed by a urological surgeon and is performed under general, locoregional or local anesthesia. The specialist removes, more or less completely, the foreskin to leave the glans uncovered. During the operation, the frenulum is most often cut and sutured. Stitches are made between the skin of the penis sheath and the glans.
Circumcision techniques differ from country to country. In France, the incision is made quite low, close to the glans. In the United States, it is higher.
The child usually stays in the hospital for one day.

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What are the postoperative consequences?

Analgesics may be prescribed to calm the pain in the operated area, which is usually minimal and temporary. However, discomfort of the glans can persist for several days because following the operation it is now always discovered.

It takes 2 to 4 weeks of healing. During this time, local care should be applied for a few days. The sutures fall spontaneously within 2 to 3 weeks. Baths should be avoided for some time in newly circumcised children (to be determined with the surgeon).

What complications can happen after a circumcision?

Complications from this surgery are rare. Bleeding or bruising can occur after the operation in some cases, requiring local care or even reoperation. Delayed wound healing or scar infection may also be observed. Here again, sometimes prolonged local care allows a return to normal. Among the possible complications, there are also painful, embarrassing or unsightly scars and exceptionally an injury to the glans or urethra.

What are the benefits of circumcision?

  • Several studies have shown that circumcision has a 60 to 70% protective effect against HIV (heterosexual contamination). This prevention against HIV is even officially recognized by the World Health Organization, the United Nations and the National Institutes of Health. Be careful, although circumcision protects to a certain extent, it does not replace the effectiveness of the condom as a means of prevention against HIV.
  • Circumcision would also protect against other sexually transmitted diseases like syphilis, chlamydia and papillomavirus.
  • In infants, circumcision would allow significantly reduce the risk of getting a urinary tract infection (UTI), knowing that serious urinary tract infections such as pyelonephritis predominate in boys during the first 12 months of life. Studies have found that during the first year of life, uncircumcised boys are about 10 times more likely to get a UTI compared to circumcised boys.
  • Finally, circumcision reduce the risk of cancer of the genitals in both men and women whose partner is circumcised.
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