Circumcision: Should I Keep My Son's Penis Natural?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Circumcision: Should I Keep My Son's Penis Natural?

1

Get the
Facts

2

Compare
Options

3

Your
Feelings

4

Your
Decision

5

Quiz
Yourself

6

Your Summary

Get the facts

Your options

Keep your son's penis natural.
Have your son circumcised.

Key points to remember

Circumcision is surgery. It causes pain during and after the procedure. After the foreskin is removed, it can't be put back on again. Like all surgeries, circumcision has risks. Major problems, such as scarring of the penis, are rare. Minor risks include bleeding and infection.
Some parents choose circumcision based on religious or cultural reasons.
Health benefits of circumcision include being less likely to get urinary tract infections (UTIs) or sexually transmitted infections (STIs).
Circumcision is not just done in newborns. Keep in mind that your son may have his own feelings about circumcision and can decide later in life if he wants a circumcised penis.
No matter whether your son is circumcised or his penis stays natural, his penis needs to be kept clean to help prevent infections and other problems.

FAQs

What is circumcision?

Male circumcision is a surgery to remove the foreskin, the natural covering of the penis. The foreskin provides sensation and lubrication for the penis. After the foreskin is removed, it can't be put back on again.

If it is done, circumcision is usually done soon after birth.

When should a baby not be circumcised?

If you don't want your baby to be circumcised, he shouldn't be circumcised. Circumcision is a decision you make because you want it for your baby.

Circumcision may not be safe if your baby is sick or weak, has a problem with his penis, or has a family history of bleeding problems.

What can you expect after circumcision?

Some swelling and slight bleeding are normal after circumcision. Your baby may be fussy and have trouble sleeping for the first few days. He may feel some pain for a few days when he urinates. For about 2 weeks, he may feel some pain whenever urine or stool touches the tip of the penis.

Your baby will probably start to feel better within 3 to 4 days after circumcision. Even though he may feel better, his penis may look worse. The penis will usually look better about 7 to 10 days after circumcision.

It's important to keep your son's penis clean whether he has been circumcised or not. Keeping your young son's penis clean may help prevent infections and other problems.

What are the risks of circumcision?

Problems from circumcision aren't common. If they occur, they are usually short-term, such as minor bleeding or infection. Other possible problems include pain and irritation of the tip of the penis.

Long-term problems are even more uncommon, but they can include damage to the opening of the urethra, heavy bleeding, severe infection, or scarring.

Are there benefits to circumcision?

Circumcision has some health benefits. For example:

In the first year of life, urinary tract infections (UTIs) happen less often in circumcised boys than in boys who are not circumcised. But UTIs are not common.
Some studies have shown that circumcised men are a little less likely than men who have not been circumcised to get or spread a sexually transmitted infection (STI), including HIV.

Your personal preference, religion, cultural belief, or ethnic background may affect your decision. The Canadian Paediatric Society (CPS) does not recommend circumcision as a routine procedure for all newborn males, but there may be benefits for some.^{footnote 1} But it's up to you whether you have your baby circumcised.

What do numbers tell us about benefits and risks of circumcision?

Examples of outcomes with and without circumcision*
Problems that can occur	Circumcised baby boys	Natural baby boys
Urinary tract infection within first 15 months	None	2 out of 100
Tightening of the foreskin (phimosis) within first 15 months	None	3 to 4 out of 100
Heavy bleeding after the procedure	0 to 30 out of 100	None

*Based on the best available evidence for these outcomes (evidence quality: borderline to inconclusive for infection and phimosis, borderline for heavy bleeding)

Benefits

The quality of the evidence about the benefits of circumcision is not strong. It is borderline to inconclusive.

Take a group of 100 baby boys. Circumcision may reduce their risk of having a urinary tract infection (UTI) within the first 15 months of life.

Of 100 circumcised baby boys, none of them may have a UTI.
Of 100 baby boys who are not circumcised, 2 may have a UTI. This means that the other 98 may not.

Circumcision also may reduce the risk of phimosis, which happens when the foreskin becomes too tight to be pulled back and causes swelling or other problems. (This can be corrected easily in most cases.)

Of 100 baby boys who are circumcised, none of them will have this problem, because the foreskin has been removed.
Of 100 baby boys who are not circumcised, 3 to 4 may have tightening of the foreskin within the first 15 months of life. This means that 96 to 97 may not.

Risks

The quality of the evidence about the risks of circumcision is borderline.

One risk of circumcision is that the procedure may cause bleeding heavy enough to require medical care. Out of 100 baby boys who are circumcised, 0 to 30 may have bleeding that is serious enough to need medical care. This means that 70 to 100 may not.

Understanding the evidence

Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it.

The information shown here is based on the best available evidence.^{footnote 2, footnote 3, footnote 4, footnote 5, footnote 6, footnote 7, footnote 8, footnote 9} The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive.

Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.

What if you decide to keep your son's penis natural?

Your child was born with a natural penis, and it is fine to keep it that way.

When cleaning your son's natural penis, be careful not to force the foreskin to retract. As your son gets older, teach him how to wash and care for his penis.

There may be reasons later in life when your son may need a circumcision. A boy or man may have problems retracting the foreskin or may have swelling of the foreskin that requires circumcision. But these problems are rare.

Circumcision is not just done in newborns. Keep in mind that your son can decide on his own later in life if he wants a circumcised penis.

Compare your options

Compare


What is usually involved?
What are the benefits?
What are the risks and side effects?

Have your son circumcised Have your son circumcised

For a baby in his first month, medicine may be used to numb the penis during circumcision. Your baby will probably be awake for the procedure.
For circumcision done after the first month, your baby may need general anesthesia.
You can take your baby home the same day he is circumcised.
Your baby may have pain during and after surgery. The pain usually lasts 3 or 4 days but can continue for up to 2 weeks.
Your baby may not sleep well and will be fussy for a few days after surgery. His penis should heal in 7 to 10 days.

Circumcised men are a little less likely than men who have not been circumcised to get or spread a sexually transmitted infection (STI), including HIV.
In the first year of life, urinary tract infections (UTIs) happen less often in boys who are circumcised. But UTIs are rare.

Minor problems include bleeding, infection, pain, and irritation of the tip of the penis.
Long-term problems, which are rare, include:
- Damage to the opening of the urethra.
- Scarring.
Short-term problems that are serious but also rare include:
- Heavy bleeding.
- Severe infection.

Keep your son's penis natural Keep your son's penis natural

No surgery is needed. Your son's penis stays natural.

Your baby avoids the pain and risks of surgery.
Your son can decide on his own later in life if he wants a circumcised penis.

In the first year of life, your son may have a slightly higher risk of urinary tract infections (UTIs). But UTIs are rare.
Some studies have shown that circumcised men are a little less likely than men who have not been circumcised to get or spread a sexually transmitted infection (STI), including HIV.

Any man, especially if he has high-risk sex, can get STIs or HIV. The best way to prevent STIs is to teach people about risk factors and the importance of avoiding high-risk sex.

Personal stories about circumcision

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I had my three sons circumcised. None of them ever had a problem from the surgery. I know it hurt, but it didn't last long and they all healed quickly. It was important to me to follow our religious customs.

Robert, age 42

When I was young, my father taught me how to keep my penis clean, and I have never had any problems. Most boys in my gym classes were circumcised, but I never felt that I was strange or different because I wasn't. When my son is born, we will not have him circumcised.

Aidan, age 25

When our son William was born, we didn't have any reason to have him circumcised. We discussed it with our doctor and decided not to have the surgery. When William is older, he can decide for himself if he wants to have the procedure.

Elise, age 49

When our first son was born, we had him circumcised. All the men in my family are circumcised. But the procedure was painful and very stressful for him, so when our second son was born, we decided to leave him uncircumcised. We decided to spare him that pain. Both our sons are healthy and happy. Neither seems to care that their penises do not look exactly alike. I feel we made the right decision.

Jeff, age 29

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose circumcision

Reasons to keep my son's penis natural

My religious beliefs make circumcision the best choice for my son.

My religious beliefs are not a factor in my decision.

More important

Equally important

More important

Most of the men in my family are circumcised, and I want my son to be circumcised like them.

Most of the men in my family are not circumcised, and I want my son to have a natural penis like them.

More important

Equally important

More important

The risks of surgery for my baby don't bother me.

I'm worried about the risks of surgery and how I would feel if something went wrong.

More important

Equally important

More important

I'm worried that my son won't fit in when he is older if he isn't circumcised.

Many boys are not circumcised. I'm not worried about my son fitting in.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Choosing circumcision

Keeping my son's penis natural

Leaning toward

Undecided

Leaning toward

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Print Summary

Credits and References

Credits

Author	Healthwise Staff
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Thomas M. Bailey MD - Family Medicine
Primary Medical Reviewer	Kathleen Romito MD - Family Medicine
Primary Medical Reviewer	Martin J. Gabica MD - Family Medicine
Primary Medical Reviewer	John Pope MD - Pediatrics

References

Citations

Sorokan ST, et al. (2015). Newborn male circumcision. Paediatrics and Child Health, 20(6): 311–315. http://www.cps.ca/documents/position/circumcision. Accessed September 17, 2015.
Craig JC, et al. (1996). Effect of circumcision on incidence of urinary tract infection in preschool boys. Journal of Pediatrics, 128(1): 23–27.
Fergusson DM, et al. (1988). Neonatal circumcision and penile problems: An 8-year longitudinal study. Pediatrics, 81(4): 537–541.
Perera CL, et al. (2010). Safety and efficacy of nontherapeutic male circumcision: A systematic review. Annals of Family Medicine, 8(1): 64–72.
Ridings H, et al. (2007). Male neonatal circumcision: An evidence-based review. Journal of the American Academy of Physician Assistants, 20(2): 32–34, 36.
Schoen EJ, et al. (2000). Newborn circumcision decreases incidence and costs of urinary tract infections during the first year of life. Pediatrics, 105(4, Part 1): 789–793.
Simforoosh N, et al. (2012). Neonatal circumcision reduces the incidence of asymptomatic urinary tract infection: A large prospective study with long-term follow up using Plastibell. Journal of Pediatric Urology, 8(3): 320–323.
Tiemstra JD (1999). Factors affecting the circumcision decision. Journal of the American Board of Family Practice, 12(1): 16–20.
Weiss HA, et al. (2010). Complications of circumcision in male neonates, infants and children: A systematic review. BMC Urology, 10: 2.

Circumcision: Should I Keep My Son's Penis Natural?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Keep your son's penis natural.
Have your son circumcised.

Key points to remember

Circumcision is surgery. It causes pain during and after the procedure. After the foreskin is removed, it can't be put back on again. Like all surgeries, circumcision has risks. Major problems, such as scarring of the penis, are rare. Minor risks include bleeding and infection.
Some parents choose circumcision based on religious or cultural reasons.
Health benefits of circumcision include being less likely to get urinary tract infections (UTIs) or sexually transmitted infections (STIs).
Circumcision is not just done in newborns. Keep in mind that your son may have his own feelings about circumcision and can decide later in life if he wants a circumcised penis.
No matter whether your son is circumcised or his penis stays natural, his penis needs to be kept clean to help prevent infections and other problems.

FAQs

What is circumcision?

If it is done, circumcision is usually done soon after birth.

When should a baby not be circumcised?

If you don't want your baby to be circumcised, he shouldn't be circumcised. Circumcision is a decision you make because you want it for your baby.

Circumcision may not be safe if your baby is sick or weak, has a problem with his penis, or has a family history of bleeding problems.

What can you expect after circumcision?

It's important to keep your son's penis clean whether he has been circumcised or not. Keeping your young son's penis clean may help prevent infections and other problems.

What are the risks of circumcision?

Problems from circumcision aren't common. If they occur, they are usually short-term, such as minor bleeding or infection. Other possible problems include pain and irritation of the tip of the penis.

Long-term problems are even more uncommon, but they can include damage to the opening of the urethra, heavy bleeding, severe infection, or scarring.

Are there benefits to circumcision?

Circumcision has some health benefits. For example:

In the first year of life, urinary tract infections (UTIs) happen less often in circumcised boys than in boys who are not circumcised. But UTIs are not common.
Some studies have shown that circumcised men are a little less likely than men who have not been circumcised to get or spread a sexually transmitted infection (STI), including HIV.

Your personal preference, religion, cultural belief, or ethnic background may affect your decision. The Canadian Paediatric Society (CPS) does not recommend circumcision as a routine procedure for all newborn males, but there may be benefits for some.¹ But it's up to you whether you have your baby circumcised.

What do numbers tell us about benefits and risks of circumcision?

Examples of outcomes with and without circumcision*
Problems that can occur	Circumcised baby boys	Natural baby boys
Urinary tract infection within first 15 months	None	2 out of 100
Tightening of the foreskin (phimosis) within first 15 months	None	3 to 4 out of 100
Heavy bleeding after the procedure	0 to 30 out of 100	None

*Based on the best available evidence for these outcomes (evidence quality: borderline to inconclusive for infection and phimosis, borderline for heavy bleeding)

Benefits

The quality of the evidence about the benefits of circumcision is not strong. It is borderline to inconclusive.

Take a group of 100 baby boys. Circumcision may reduce their risk of having a urinary tract infection (UTI) within the first 15 months of life.

Of 100 circumcised baby boys, none of them may have a UTI.
Of 100 baby boys who are not circumcised, 2 may have a UTI. This means that the other 98 may not.

Of 100 baby boys who are circumcised, none of them will have this problem, because the foreskin has been removed.
Of 100 baby boys who are not circumcised, 3 to 4 may have tightening of the foreskin within the first 15 months of life. This means that 96 to 97 may not.

Risks

The quality of the evidence about the risks of circumcision is borderline.

Understanding the evidence

The information shown here is based on the best available evidence.^{2, 3, 4, 5, 6, 7, 8, 9} The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive.

What if you decide to keep your son's penis natural?

Your child was born with a natural penis, and it is fine to keep it that way.

When cleaning your son's natural penis, be careful not to force the foreskin to retract. As your son gets older, teach him how to wash and care for his penis.

Circumcision is not just done in newborns. Keep in mind that your son can decide on his own later in life if he wants a circumcised penis.

2. Compare your options

	Have your son circumcised	Keep your son's penis natural
What is usually involved?	For a baby in his first month, medicine may be used to numb the penis during circumcision. Your baby will probably be awake for the procedure. For circumcision done after the first month, your baby may need general anesthesia. You can take your baby home the same day he is circumcised. Your baby may have pain during and after surgery. The pain usually lasts 3 or 4 days but can continue for up to 2 weeks. Your baby may not sleep well and will be fussy for a few days after surgery. His penis should heal in 7 to 10 days.	No surgery is needed. Your son's penis stays natural.
What are the benefits?	Circumcised men are a little less likely than men who have not been circumcised to get or spread a sexually transmitted infection (STI), including HIV. In the first year of life, urinary tract infections (UTIs) happen less often in boys who are circumcised. But UTIs are rare.	Your baby avoids the pain and risks of surgery. Your son can decide on his own later in life if he wants a circumcised penis.
What are the risks and side effects?	Minor problems include bleeding, infection, pain, and irritation of the tip of the penis. Long-term problems, which are rare, include: Damage to the opening of the urethra. Scarring. Short-term problems that are serious but also rare include: Heavy bleeding. Severe infection.	In the first year of life, your son may have a slightly higher risk of urinary tract infections (UTIs). But UTIs are rare. Some studies have shown that circumcised men are a little less likely than men who have not been circumcised to get or spread a sexually transmitted infection (STI), including HIV. Any man, especially if he has high-risk sex, can get STIs or HIV. The best way to prevent STIs is to teach people about risk factors and the importance of avoiding high-risk sex.

Personal stories

Personal stories about circumcision

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I had my three sons circumcised. None of them ever had a problem from the surgery. I know it hurt, but it didn't last long and they all healed quickly. It was important to me to follow our religious customs."

— Robert, age 42

"When I was young, my father taught me how to keep my penis clean, and I have never had any problems. Most boys in my gym classes were circumcised, but I never felt that I was strange or different because I wasn't. When my son is born, we will not have him circumcised."

— Aidan, age 25

"When our son William was born, we didn't have any reason to have him circumcised. We discussed it with our doctor and decided not to have the surgery. When William is older, he can decide for himself if he wants to have the procedure."

— Elise, age 49

"When our first son was born, we had him circumcised. All the men in my family are circumcised. But the procedure was painful and very stressful for him, so when our second son was born, we decided to leave him uncircumcised. We decided to spare him that pain. Both our sons are healthy and happy. Neither seems to care that their penises do not look exactly alike. I feel we made the right decision."

— Jeff, age 29

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose circumcision

Reasons to keep my son's penis natural

My religious beliefs make circumcision the best choice for my son.

My religious beliefs are not a factor in my decision.

More important

Equally important

More important

Most of the men in my family are circumcised, and I want my son to be circumcised like them.

Most of the men in my family are not circumcised, and I want my son to have a natural penis like them.

More important

Equally important

More important

The risks of surgery for my baby don't bother me.

I'm worried about the risks of surgery and how I would feel if something went wrong.

More important

Equally important

More important

I'm worried that my son won't fit in when he is older if he isn't circumcised.

Many boys are not circumcised. I'm not worried about my son fitting in.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Choosing circumcision

Keeping my son's penis natural

Leaning toward

Undecided

Leaning toward

Credits

By	Healthwise Staff
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Thomas M. Bailey MD - Family Medicine
Primary Medical Reviewer	Kathleen Romito MD - Family Medicine
Primary Medical Reviewer	Martin J. Gabica MD - Family Medicine
Primary Medical Reviewer	John Pope MD - Pediatrics

References

Citations

Sorokan ST, et al. (2015). Newborn male circumcision. Paediatrics and Child Health, 20(6): 311–315. http://www.cps.ca/documents/position/circumcision. Accessed September 17, 2015.
Craig JC, et al. (1996). Effect of circumcision on incidence of urinary tract infection in preschool boys. Journal of Pediatrics, 128(1): 23–27.
Fergusson DM, et al. (1988). Neonatal circumcision and penile problems: An 8-year longitudinal study. Pediatrics, 81(4): 537–541.
Perera CL, et al. (2010). Safety and efficacy of nontherapeutic male circumcision: A systematic review. Annals of Family Medicine, 8(1): 64–72.
Ridings H, et al. (2007). Male neonatal circumcision: An evidence-based review. Journal of the American Academy of Physician Assistants, 20(2): 32–34, 36.
Schoen EJ, et al. (2000). Newborn circumcision decreases incidence and costs of urinary tract infections during the first year of life. Pediatrics, 105(4, Part 1): 789–793.
Simforoosh N, et al. (2012). Neonatal circumcision reduces the incidence of asymptomatic urinary tract infection: A large prospective study with long-term follow up using Plastibell. Journal of Pediatric Urology, 8(3): 320–323.
Tiemstra JD (1999). Factors affecting the circumcision decision. Journal of the American Board of Family Practice, 12(1): 16–20.
Weiss HA, et al. (2010). Complications of circumcision in male neonates, infants and children: A systematic review. BMC Urology, 10: 2.

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