If you are considering circumcision for your baby boy, read on. We explain what male circumcision is, medical reasons for it, and what it involves.
What is male circumcision?
Male circumcision is the surgical removal of the foreskin. The foreskin is the retractable fold of skin that covers the head of the penis (NHS Choices, 2018). It's a continuation of the skin that covers the whole penis.
There are medical reasons why a boy may need to be circumcised. It could be a last resort treatment for certain conditions.
Circumcision might also be considered for religious or cultural reasons in boys. It’s common practice in Jewish and Islamic communities and occurs in many African communities. Most cultural circumcisions are carried out in young boys.
Is male circumcision for babies common in the UK?
It’s estimated approximately 8.5% of men in the UK are circumcised (BBC, 2012). Over the past few decades the rate of circumcision for baby boys in the UK has significantly decreased (CIRP, 2006). It’s estimated that post-neonatal therapeutic circumcision remains constant at a rate of about 3%.
Circumcision is more usual in certain cultural or religious communities. Men of ethnic minorities (except those of black Caribbean ethnicity) were significantly more likely to be circumcised than those described as white. Most Jewish boys are circumcised (98.7%) and 9.8% of Sikhs, Hindus, and Buddhists are circumcised (CIRP, 2006).
Does the NHS provide male circumcision procedures?
It's rare for circumcision to be recommended for medical reasons in boys. This is because other less invasive and less risky treatments are usually available (NHS Choices, 2018).
Circumcision might be necessary if the foreskin is damaged and won't slide back over the head of the penis. This is very rare before the age of five (NHS Choices, 2018).
If you wish to have your son circumcised without a medical reason, discuss this with your health visitor or GP. Although they might refer you to a private practitioner. Some NHS trusts might consider offering religious or cultural male circumcision, as it is safer than the circumcision being carried out elsewhere.
What would be a medical reason for male circumcision?
The only undisputed medical reasons for circumcision are a tight foreskin that can’t be pulled back, and recurrent foreskin infections.
- When the foreskin is too tight to be pulled back over the head of the penis (phimosis) it can sometimes cause pain when the penis is erect. In rare cases, passing urine might be difficult and immediate treatment may be required (CIRP, 2006a; NHS Choices, 2018). Contact your GP if you’re concerned.
- Phimosis is normal in babies and toddlers for the first two to six years. By the age of about two, the foreskin should start to separate naturally from the penis. Sometimes it takes longer but this isn’t usually a sign of a problem, it will detach later on (NHS Choices, 2015). Never try to force your child’s foreskin back as it might be painful or cause damage.
- Recurrent infection in the penis (balanitis) is when the foreskin and head of the penis become inflamed and infected. It's not usually serious but you should see your GP if you think your son has it (NHS Choices, 2017).
These conditions can often be treated successfully with non-surgical treatments, which will often be tried first before circumcision is considered.
In rare cases the following conditions might require circumcision:
- Paraphimosis – where the foreskin can't be returned to its original position after being pulled back. This causes the head of the penis to become swollen and painful. Immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis (NHS Choices, 2018). Contact your GP if you’re concerned.
- Balanitis xerotica obliterans – a condition that causes phimosis and, in some cases, also affects the head of the penis, which can become scarred and inflamed (NHS Choices, 2018).
- Repeated urinary tract infections (UTIs) – in very rare cases, circumcision may be recommended as a last resort treatment if a boy has repeated UTIs (NHS Choices, 2018).
What happens during a male circumcision?
Circumcision is usually carried out on a day patient basis. Your child will have surgery on the day he goes into hospital. He won't need to stay overnight (NHS Choices, 2018).
They will usually be given a general anaesthetic, so they'll be unconscious throughout the procedure and unable to feel any pain or discomfort (NHS Choices, 2018).
Circumcision is a relatively simple procedure. The foreskin is removed just behind the head of the penis using a scalpel or surgical scissors; any bleeding will be stopped using heat. The remaining edges of skin are stitched together using dissolvable stitches.
It will take up to six weeks for the penis to fully heal (NHS Choices, 2018).
Is circumcision painful?
Your son will be unconscious throughout the procedure and unable to feel any pain or discomfort. He will be allowed home after he's passed urine, which may be slightly uncomfortable at first (NHS Choices, 2018).
The penis will be sore and inflamed for a few days after the operation. Ointment may be prescribed to use for a few days to help the area heal. There's also a small risk of infection after having a circumcision. In most cases, a follow-up appointment won't be necessary (NHS Choices, 2018).
Contact your GP or hospital care team following a circumcision if:
- the penis is bleeding
- the penis is still swollen two weeks after the operation
- passing urine is still painful a few days after the operation.
(NHS Choices, 2018)
What is FGM?
Female genital mutilation (FGM) is when the female genitals are deliberately cut, injured or changed for no medical reason. It is sometimes known as female circumcision or cutting. It's illegal in the UK and is classed as child abuse (NHS Choices, 2016).
FGM is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts. It's very painful and can seriously harm the health of women and girls (NHS Choices, 2016). Help and support is available if you’ve had FGM or you’re worried you’re at risk.
This page was last reviewed in April 2018.
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If you're concerned a girl may be at risk of FGM, contact the NSPCC helpline on 0800 028 3550 or firstname.lastname@example.org.
If you're under pressure to have FGM performed on your daughter, ask your GP, health visitor or other healthcare professional for help, or contact the NSPCC helpline.
If you've had FGM, you can get help from a specialist NHS gynaecologist. You can ask your GP or midwife about this.
CIRP. (2006a) United Kingdom: incidence of male circumcision. Available from: http://www.cirp.org/library/statistics/UK/ [Accessed 1st April 2018]
CIRP; Cathcart P, Nuttall, Van der Meulen J, Emberton M, Kenny SE. (2006) Trends in paediatric circumcision and its complications in England between 1997 and 2003. Available from: http://www.cirp.org/library/procedure/cathcart1/ [Accessed 1st April 2018]
NHS Choices. (2016) Female genital mutilation (FGM). Available from: https://www.nhs.uk/conditions/female-genital-mutilation-fgm/ [Accessed 1st April 2018]
NHS Choices (2018) Available from: https://www.nhs.uk/conditions/circumcision-in-boys/ [Accessed 1st April 2018]
NHS Choices. (2017a) Circumcision operation patient information. Available from: https://www.wwl.nhs.uk/Library/All_New_PI_Docs/Audio_Leaflets/Ward_3/Circumcision/sw3_004_circumcision819v7.pdf [Accessed 1st April 2018]
NHS Choices. (2015) Tight foreskin (phimosis and paraphimosis). Available from: https://www.nhs.uk/conditions/phimosis/ [Accessed 1st April 2018]
NHS Choices. (2017) Balanitis. Available from: https://www.nhs.uk/conditions/balanitis/ [Accessed 1st April 2018]
Jagannath VA, Fedorowicz Z, Sud V, Verma AK, Hajebrahimi S. (2012) Routine neonatal circumcision for the prevention of urinary tract infections in infancy. Cochrane Database of Systematic Reviews. (11):CD009129. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009129.pub2… [Accessed 1st April 2018]