What's the Right Circumcision Decision?

To snip or not to snip? It's a question that every son's parents must ask themselves. In recent years more and more parents are opting against circumcision. In 2006, 56 percent of boys in the United States were circumcised, and those numbers varied dramatically by region, with 34 percent in the western states and 78 percent in the north central states.

Should your son be circumcised? Questions to ask before you make the call.

Whether it's a religious, cultural or medical decision, parents should consider and discuss the choice with their physician first, says Dr. Douglas Diekema, a professor of pediatrics at the University of Washington and member of the American Academy of Pediatrics task force on circumcision.

"I'm not someone who would push parents strongly in one direction or another on this issue," Diekema says, "but what I would say is that in addition to weighing the pros and cons, parents should also consider that this is a decision, given what those risks and benefits are, that maybe should be left to their child to make when their child turns 18. And it's true that some of the potential benefits of circumcision either disappear or are less great if you wait that long, but it's also true then that the decision is being made by the person who will be most impacted by it."

The American Academy of Pediatrics holds that there's not sufficient evidence of benefit to justify a recommendation of routine newborn circumcision. That stance was determined about 10 years ago, and the current task force is convening to reevaluate and reexamine that decision. Diekema expects that their latest stance will be announced this month.

Need help weighing the pros and cons of circumcision?

Diekema outlined the following as risks and benefits to consider when it comes to the circumcision decision:

Benefits

- "We know there's a reduction in the likelihood of contracting a urinary tract infection in the first couple of months of life. … But most babies are never going to get a UTI, whether they're circumcised or not, so you're talking about sort of a small number who would be positively impacted.

-"It does look like males who have been circumcised have a lower incidence of penile cancer, which is a really rare cancer. The estimate is you probably have to do 600 to 900 circumcisions to prevent one case of penile cancer."

-"Just the presence of the foreskin can result in problems that we see occasionally in emergency rooms and doctors offices, where the foreskin gets pulled over the penis and forms a tight ring and decreases blood flow to the penis and can end up causing a real problem if it's not fixed."

-"The foreskin can get infected."

-"There also appears to be a reduced risk to transmitting the human papillomavirus (HPV) to female sexual partners if you're circumcised as opposed to uncircumcised."

Risks

-"As far as risks go, they're pretty small. Most of them can be reduced to minimal numbers if the circumcision is done by somebody who's experienced and trained in doing the procedure, and does it in a safe and sterile environment. Complication rates go way up if you're talking about having a non-medical person performing this in a non-sterile environment."

-"The most common complication is bleeding. But it's usually pretty mild, just a little pressure stops it and it's rare for a child to require a transfusion or to need sutures to stop that."

-"Infections can occur. We're talking about a rate of less than 1 percent and we're talking mild, the sort of infections that respond to topical antibiotics."

Diekema emphasizes that there's no right or wrong decision when it comes to circumcision. It's up to the individual, or the individual's parents to decide. "Every parent's going to weigh the risks and benefits differently," he says. "And the risks are pretty small and the benefits are relatively modest for most kids, for each individual child. So I get nervous about people who feel that there's only one right way on this issue, that there's never any reason to circumcise a child. They're ignoring some important data. But those who also say I don't see why every child shouldn't be circumcised are not being fair to potential risks and other considerations."

Want another doctor's opinion? Read another take on the issue.

By Kate Silver for Parents.com