Infant Circumcision

Our clinic has been open and under my direction, since 1995 and runs weekly. I only use the GOMCO technique which has been proven to have the lowest complication rate and in my opinion the best cosmetic results. The procedure is performed with specially trained nursing support at Portsmouth Medical Clinic. You can expect to be at the clinic for ninety minutes in total as there is one hour of post procedure observation. We use four methods of pain control for the procedure that include the dorsal penile nerve block, anaesthetic cream, oral acetaminophen and an oral sucrose solution.

The vast majority of babies are completely content before discharge from the hospital and remain that way.

Consultations are available without a referral at my office to discuss the risks and benefits of circumcision or the procedure itself. It is helpful for parents to come with a list of questions at this visit.

I feel that the optimum timing for circumcision is in the first six weeks of age. However, it is still possible to circumcise an infant outside of this age group depending on the infant's size and gestational age. As a result, it is important to contact our office as soon as possible to tentatively reserve a time, due to the fact that most of the clinics are fully booked.

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The common reasons expressed for circumcision are:
  • Cosmetic appearance
  • To have their son the same as his father or older brother
  • Prevent some complications of not being circumcised
  • Avoid the postoperative discomfort of circumcision at a later point in life
  • Religious reasons
Circumcision: Rates, Risks, and Benefits
Cornelius W. Van Niel, MD reviewing Morris BJ et al. Mayo Clin Proc 2014 May.
National rates are 77% to 81%, and medical benefits outweigh risks.

The 2012 American Academy of Pediatrics (AAP) policy statement on neonatal circumcision notes the procedure's health benefits and recommends that it be covered by health insurance (NEJM JW Pediatr Adolesc Med Sep 19 2012). A 2013 CDC report based on National Health and Nutrition Examination Survey data estimated a small increase (from 79% to 81%) in the prevalence of circumcised males aged 14 to 59 years between the periods 1999Ð2004 and 2005Ð2010. Researchers compared these data with prevalence based on national hospital discharge data, using a correction factor for unrecorded circumcisions performed after discharge. According to their calculations, circumcision prevalence decreased slightly from 83% in the 1960s to 77% in 2010.

A risk-benefit analysis of high-quality studies showed increases among uncircumcised infants and boys in urinary tract infections (up 10-fold in infants, from ~0.1%-~1%), sexually transmitted infections (~1Ð2-fold), and phimosis (100-fold). Risks associated with the procedure itself included local infection in 0.2% and need for surgical revision in 0.1%. The authors estimate that during a lifetime, problems related to having a foreskin will lead 50% of uncircumcised males to seek medical attention.