Circumcision
is the removal of the foreskin from the penis. Circumcision was mostly
performed on those of the Jewish faith. An article in a medical journal
in the early 1900's promoted the "cleanliness" of circumcision.

The percent of circumcised males rose from 30% in the 1930's to 90% in the 1970's. Currently, the rate is about 60% in the USA.

Some
theoretical benefits of circumcision include reduction in urinary tract
infections (very rare), some protection against sexually transmitted
diseases, and a lower rate of penile cancer.

The risks of
circumcision include poor cosmetic result, bleeding, infection, removal
of too much foreskin, scarring, and partial amputation of the penis.

There
are two classic devices used in circumcision. The Gomco clamp involves
a bell that protects the tip of the penis. Once the clamp is tightened,
the knife is used to trim the excess foreskin.

The Mogen clamp is
a flat piece of metal that has a slit in it that allows for the passage
of the foreskin. The clamp is then tightened and the excess foreskin is
trimmed.

The choice of instrument is usually based on the preference of the health care provider. 

I
have found that decision of couples choosing circumcision is generally
based on the status of the father. Both of my two children were
circumsized.

Comfort to the infant involves tylenol, sugar water,
and penile anesthesia. I try to reassure parents about the pain of
circumcision by asking them to remember their first memory as a child.

Usually, they are two or three years of age and thus there are no memories for the infant regarding the pain of circumcision.

Have a great week

Joe Edwards III M.D.