Pediatric Circumcision

Circumcision is one of the oldest operations performed. Sometimes it is done because a specific problem with the foreskin (prepuce) exists, and other times it is done for family, cultural, or religious reasons. Although routine circumcision was once advocated for all newborn males, the current feeling is that it is not necessary for all baby boys. Most boys will do fine later in life if their foreskins are not removed. A few may eventually need circumcision because of narrowing at the tip (phimosis), infections (posthitis), or irritation. The foreskin may be a source for urinary tract infections, and circumcision may be a good idea in boys with any underlying kidney abnormality.

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How Do You Care for the Uncircumcised Penis?

Care of the uncircumcised infant is easy. We do not recommend pulling back on the foreskin to expose the tip of the penis (glans penis). As the boy gets older, the natural processes of erections and accumulation of old skin remnants between the inner foreskin and glans cause the foreskin to eventually separate from the tip of the penis. By age 5-6 years the foreskin should pull back easily, but it is not until puberty that it is necessary for boys to pull the foreskin back daily to clean the penis.

Circumcision may be indicated for certain medical reasons: vesicoureteral reflux, kidney or bladder infections, posthitis (inflammation of the foreskin), or true phimosis (narrowing of the foreskin). Parents for family, cultural, or religious reasons may request circumcision. Although circumcision is often done shortly after birth, the procedure may be delayed for certain reasons:

• the newborn infant may be too ill, in which case an elective circumcision when the infant is well can be arranged
• the infant may have an abnormality of the penis such as hypospadias or chordee, in which case the foreskin should be left in place for use in later reconstructive surgery

In very young babies circumcision can be performed in the clinic with local anesthesia and a clamp. In older infants and children general anesthesia is preferable.

We suggest antibiotic ointment or Vaseline be applied to the glans with every diaper change after circumcision. We like to see the patient 2-4 weeks after circumcision.

UT Pediatric Urology
UT Physicians Professional Building
6410 Fannin St. Suite 950
Houston, Texas 77030
Phone: (832) 325-7234