Circumcision of male newborns is an operation performed since the beginning of recorded history. The removal of the foreskin has its roots in religion cultural heritage. Once recommended for all males, it may not be necessary for all. Some conditions require circumcision for treatment. A narrowing at the tip (phimosis), infections (posthitis), or irritation are easily remedied with the procedre. Circumcision is recommended for boys with any underlying kidney abnormality or if he suffers from urinary tract infections (UTI’s).

Uncircumcised penis care

Do not pull back on the foreskin to expose the tip of the penis (glans penis). The foreskin will eventually separate from the tip of the penis. In future years, erections and old skin particles between the inner foreskin and the glans naturally complete the process by age 5 or 6. Is should not be necessary for daily hygiene until he reaches puberty.

Why circumcise?

Medical reasons may require circumcision. Vesicoureteral reflux, kidney or bladder infections, posthitis (inflamed foreskin), or true phimosis (a narrowing of the foreskin). Parents for family, cultural, or religious reasons may request circumcision. The procedure is usually done shortly after birth. It may be delayed if the newborn infant is too ill, or if the infant has an abnormality of the penis such as hypospadias or chordee. The foreskin is left in place for use in later reconstructive surgery.

In older infants and children general anesthesia is preferable and would require a hospital stay.

Circumcised penis care

Vaseline is applied to the diaper with each change. Starting 24 hours after the circumcision, the skin should be pushed back each day to prevent adhesions.

Circumcision: is a surgical procedure that is not essential to a child’s health. Parents must weigh the benefits and risks.

Benefits of circumcision

A lower risk of urinary tract infections (UTIs). A circumcised infant boy has about a 1 in 1,000 chance of developing a UTI in the first year of life; an uncircumcised infant boy has about a 1 in 100 chance of developing a UTI in the first year of life.

A lower risk of getting cancer of the penis. However, this type of cancer is very rare in both circumcised and uncircumcised males.

A slightly lower risk of getting sexually transmitted diseases (STDs).  Includes HIV, the AIDS virus.

Prevention of foreskin infections.

Prevention of phimosis.  A condition in uncircumcised males that makes foreskin retraction impossible.

Easier genital hygiene.

Risks of circumcision

Complications from circumcision are rare and usually minor. They may include bleeding, infection, cutting the foreskin too short or too long, and improper healing.

The belief that the foreskin is necessary to protect the tip of the penis. When removed, the tip of the penis may become irritated and cause the opening of the penis to become too small. Rarely, this can cause urination problems that may need to be surgically corrected.

Some people believe that circumcision makes the tip of the penis less sensitive, causing a decrease in sexual pleasure later in life. This has not been proven by any medical or psychological study.

Almost all uncircumcised boys can be taught proper hygiene that can lower their chances of getting infections, cancer of the penis, and sexually transmitted diseases.

Hernias And Hydrocele

As a child develops in the womb, testicles grow near the kidneys in the abdomen.  During the last three months of pregnancy, the testicles move toward their normal place in the scrotum.  To begin their descent, a muscle ring in each side of the groin opens to allow their travel.  The lining of the abdomen accompanies the testicles to line the scrotum and may carry fluid with it. This causes the scrotum to appear enlarged.  Usually this channel closes in most boys and the fluid is absorbed.  This is called a noncommunicating hydrocele.  If it remains open, or reopens, the fluid causes a sac and remains around the testicle(s) in the scrotum.  This is called a communicating hydrocele.  If it opens (or reopens) widely, a part of the intestine can descend through this channel toward the scrotum, ending up as an inguinal hernia.

Injury or inflammation within the scrotum can also produce a hydrocele.  Usually this resolves itself within a few months.  If it remains, medical attention may be required.  Hernias can also develop from straining during bowel movements, coughing, sneezing, heavy lifting or obesity.  These cause pressure on the intestines and can push a section of intestine through a weak spot in the abdomen.

Surgery is recommended for a hydrocele if it is still present in one-year-olds.  Surgery may be required before one year if the scrotum continues to enlarge from fluid build-up.  If the hydrocele is uncomplicated, a simple incision is made to the scrotum so the sac and fluid can be removed.  If it is complicated, such as accompanied by a hernia, a small incision to the groin is made to treat both conditions at the same time.

Hernias should be treated as soon as they are identified.They do not go away on their own. Hernias require suturing (or sewing) of the channel and repair of the muscle ring by a urological surgeon.