Circumcision In Children

It's rare for circumcision to be recommended for medical reasons in boys. This is because other less invasive and less risky treatments are usually available.

The following conditions affect the penis and, in rare cases, may require a circumcision:

• tight foreskin (phimosis) where the foreskin is too tight to be pulled back over the head of the penis; this can sometimes cause pain when the penis is erect and, in rare cases, passing urine may be difficult
• recurrent infection (balanitis) where the foreskin and head of the penis become inflamed and infected
• paraphimosis where the foreskin can't be returned to its original position after being pulled back, causing the head of the penis to become swollen and painful; immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis
• balanitis xerotica obliterans a condition that causes phimosis and, in some cases, also affects the head of the penis, which can become scarred and inflamed
• repeated urinary tract infections (UTIs) in very rare cases, circumcision may be recommended as a treatment of last resort if a boy has repeated UTIs

These conditions can often be treated successfully with non-surgical treatments, which will often be tried first before circumcision is considered.

Mild cases of phimosis can be treated with topical steroids to help soften the skin and make it easier for the foreskin to retract.

However, circumcision may be necessary if the foreskin is damaged and won't slide back over the head of the penis. This is very rare before the age offive.

In paraphimosis, a healthcare professional may rub a local anaesthetic gel on to the head of the penis (glans) to help reduce pain and inflammation. They may then apply pressure to the glans while pushing the foreskin forward.

In severe cases of paraphimosis, local anaesthetic gel can be applied and a small slit made in the foreskin to help relieve the pressure.

Balanitis and balanitis xerotica obliterans can sometimes be successfully treated using corticosteroid ointment, gel or cream , antibiotic creams or antifungal creams .

Most UTIs are mild and can be treated with antibiotics.However, repeated UTIs can occasionally cause kidney damage.

For example, if a boy has a birth defect that causes urine to leak back up into the kidney, bacteria can spread from the foreskin, through the urine, and infect the kidney. Circumcision may be recommended in these cases.