Weighing In on Newborn Circumcision
Jan. 10, 2000 (New York) -- Most parents are likely to be reassured by the
results of a new study of more than 300,000 babies that shows complications
from circumcision occur only in approximately one out of every 476 cases. The
study, which appears in the January issue of the journal Pediatrics,
indicates that while this common surgical procedure performed on baby boys just
days after birth is relatively safe, worried parents should be aware that
occasional problems such as bleeding and injury do occur.
"What's important to remember is that the vast majority of children will
derive no benefit, nor will they suffer any harm as a result of
[circumcision]," says lead author Dimitri A. Christakis, MD.
Circumcision is the surgical removal of the foreskin, which covers the head
of the penis. Medically speaking, circumcision is thought to prevent urinary
tract infections as well as cancer of the penis and sexually transmitted
diseases later in life. However, the extent to which circumcision actually
reduces any of these risks has been greatly debated, and some experts believe
that as long as proper hygiene is maintained, the presence of the foreskin does
not increase a man's risk of infections or cancer. Potential risks of
circumcision have been less frequently examined, however.
"For most parents, the decision to circumcise their child is not based
on the medical indications for it, but rather on the religious and cultural or
other discretionary reasons," Christakis tells WebMD. "But for those
parents who seek objective data, we wanted to be able to provide it for
them." Christakis, who is a pediatrician at the University of Washington
Child Health Institute in Seattle, says while many parents may view the
complication rate as acceptably low, others may consider it to be intolerably
high. In addition, some parents may simply be unaware that circumcision
involves any risk of complications.
The Seattle researchers looked at the medical records of almost 135,000 male
infants who underwent circumcision after birth, and nearly 224,000 who did not,
to estimate the potential for complications as well as benefits. They found
that 287 (0.22%) circumcised infants experienced complications such as bleeding
or infection, complications that the authors attributed to the circumcision.
None were considered serious, but they required additional medical attention
The only infectious complication recorded was an infection of the skin and
the tissue just beneath the skin, known as cellulitis, which occurred in two
circumcised as well as two uncircumcised infants and was therefore not
considered to be related to the procedure. Although there have been some
reports of the "flesh-eating disease," necrotizing fascitiis, occurring
in circumcised babies, the study did not find any cases of it.
According to a pediatrician on staff at Rush Presbyterian-St. Luke's
Hospital in Chicago, the complications reported in the study are "extremely
rare in good, reliable hands" and the complication rate "might be an
overstatement." Bill Barrows, MD, who reviewed the study for WebMD, is also
a mohel certified by the Berit Milah Board of Reform Judaism. He performs
approximately 50 circumcisions every year. "In almost 20 years of
experience, I have not seen one infection," he says.