Everything you need to know about male circumcision

Believe it or not, male circumcision (circumcision of the penis) is the most common surgery in human history.¹ But how much do you actually know about it?

Here, we look at the basics behind the procedure.

Male circumcision is a preventative-health operation where the foreskin is cut away from the penis, permanently exposing the head of the penis.

While the procedure has continued throughout history, it has significantly decreased in popularity in recent years.

Until around 70 years ago, 85% of newborns with penises were circumcised. By the 1970s, that rate dropped to 50%.² Nowadays, only 10 to 20% are circumcised.³

Penile circumcision is usually performed on babies and young children, but the procedure can be done at any age. Local or general anaesthetic is usually required, depending on age.

Circumcision isn’t performed in Australian public hospitals unless it’s to treat a condition like regular urinary tract infections or foreskin problems.

But parents can request a non-medical circumcision through a private clinic.

The current health advice is that there’s no medical reason for routine circumcision in newborns.⁴

However, there are numerous reasons a parent or individual may decide on the procedure.

When the procedure is performed for a non-medical reason, it’s called a ‘non-therapeutic circumcision’.

Only a small number of males or people with a penis will need circumcision for medical reasons. This may be a result of a condition like:

• phimosis. This occurs when a foreskin is too tight, making it difficult to pull over the head of the penis. The procedure involves making one or 2 small cuts in the foreskin to help it stretch
• paraphimosis. This condition occurs when a retracted narrow or inflamed foreskin gets stuck at the head of the penis. It usually requires urgent medical attention
• recurrent balanoposthitis. This is a generalised inflammation of the foreskin or head of the penis that may occur as a complication of a bacterial or fungal infection.

A penile circumcision may also be performed for family or religious reasons.

As well as addressing the previously mentioned conditions, circumcision may reduce the risk of the following:

• Urinary tract infections. A penile circumcision reduces the chance of getting this infection, especially in infancy.⁵ The procedure may be recommended for those who have recurrent urinary tract infections or other kidney problems.
• Penile cancer. While this cancer is rare, there may be a reduced risk among people whose penis is circumcised.⁶
• Cervical cancer. People with an uncircumcised penis may be more likely to acquire and transmit the human papillomavirus, which is responsible for most cervical cancers.⁷ However, cervical cancer rates are declining in Australia due to effective screening and vaccination programs.
• Penile inflammation and dermatoses. These skin disorders are less common in people who have been circumcised, but can develop in either case. For uncircumcised people, retracting the foreskin while bathing can reduce problems with inflammation.
• Sexually transmitted infections. Although circumcision may slightly reduce the risk of transmission, it does not protect against sexually transmitted infections and should not replace safe sex practices.

There is a small chance (less than 5%) that circumcision may lead to a complication.⁴

These can include:

• pain and distress. A circumcision can be painful, and pain control should be offered to anyone undergoing the procedure. Post-operative pain, swelling and bruising are common
• cosmetic concerns. Too much or too little skin removal may present problems. Likewise, abnormal scar tissue may develop following a circumcision
• buried penis. This occurs when the penis is buried under scar tissue at the site of incision. It may occur if too much or too little skin is removed
• sexual dissatisfaction. Some people report reduced sensitivity at the end of their penis when the foreskin is removed⁸
• surgical complications. There’s a small risk of minor complications, like bleeding and wound infection, following a procedure. In rarer cases, more serious complications may occur, including meningitis (a type of brain infection) or septicaemia (a bloodstream infection).

For some, the issue of non-consent among circumcised children is problematic.

Some people grow up to resent the fact that they didn’t have a say on their circumcision, with some utilising foreskin restoration procedures.⁹

Penile circumcision is a controversial topic and a deeply personal decision, with medical, ethical, cultural and social considerations.

While there may be some medical benefits, most Australian experts agree that the overall risks usually outweigh them.²

Like all medical procedures, it’s important to consider the physical and psychological implications that follow a circumcision, particularly when it concerns another person.

You can talk to your GP or paediatrician throughout the decision-making process.