Thank you for joining me today. This is your pedcast host, Dr. Paul Smolen, also known as Doc Smo. I started this blog for the benefit of my patients …to extend conversations that the office setting just can’t happen due to time constraints. No topic is off the table here which is one of the thing that makes it so much fun to make these posts. From diapers to the diploma as I like to say. Today I want to make my listeners aware of the new Academy of Pediatrics policy statement on newborn circumcision. I plan to wade deep, deep into the diapers today. The AAP’s last word on the subject of male circumcision was in 1999, over a decade ago. Boy, what a difference a decade can make. The pendulum has swung quite a bit since they last weighed in on the subject. So lets get right into it, shall we?
First for the basic facts. A circumcision refers to the surgical removal of about ½ inch of redundant skin that covers the end of the penis in newborn male children. The various procedures that accomplish the removal of this skin are fairly easy to do and rarely lead to complications: the main ones being bleeding or infection. As I say, these problems are very rare. The small cut heals very quickly, usually in a week. Babies often sleep during the procedure because a local anesthetic that is used. The major benefits of circumcision are reducing the chance of a male infant developing a urinary tract infection during the first year of life, eliminating the possibility of getting an infection of the foreskin called balantitis, and reducing the chance that this circumcised child will acquire or pass on the HIV or HPV viruses, or other sexually transmitted diseases when they are older.
Now the cons: opponents argue that doing a circumcision on male infants is cruel and mutilating which has become the basis of the great debate about circumcision in Germany going on right now. Opponents also argue that the child doesn’t get to decide whether he wants this done, does he? They also point out that there are sometimes problems with bleeding and infection when skin is cut not to mention surgical accidents that could occur that can be extremely damaging to a child. And what about pain and suffering… no matter how good the anesthetic is, it will wear off and there will inevitably be some pain somewhere along the way.
So now back to the AAP’s recent policy statement. The authors of this statement are doctors who are experts in many aspects of pediatric medicine. This task force reviewed all the recent evidence pro and con with regards to circumcision and concluded that the benefits (already enumerated) of male circumcision justify the small risks and downsides of the procedure. As I said, this is different than a similar AAP Task Force concluded in 1999. You can imagine that their statement has reignited the great circumcision debate! Emotions run high on both sides and parents ultimately will need to decide this one for themselves. It’s a close call and lots of factors need to be considered. There is no right or wrong answer and parents need to understand this as they weigh the pros and cons. I encourage you to talk to your child’s pediatrician for guidance… they are usually very knowledgeable on the subject.
Again, thanks for joining me. I feel certain that some comments are coming into the blog on this post… if you want to be heard, log onto www.docsmo.com and send your thoughts. We would love to hear your point of view.
This is Dr. Paul Smolen, recording in studio 1E, hoping you score a win, with your decision about your baby’s foreskin.
Until next time.