Circumcision in boys

Male circumcision is the surgical removal of the foreskin.

The foreskin is the roll of skin that covers the end of the penis.

Why circumcision is carried out in boys

Circumcision in boys may be carried out for:

• medical reasons – for example, as a treatment of last resort for conditions such as a tight foreskin (phimosis) or recurrent infection of the foreskin and head of the penis (balanitis)
• religious or cultural reasons – it's a common practice in Jewish and Islamic communities, and it's also practised by many African communities; most cultural circumcisions are carried out in young boys

The information on this page focuses on circumcision in boys for medical reasons.

Read more about circumcision in adult men for medical reasons.

How the foreskin develops

It's normal for a baby boy's foreskin not to pull back (retract) for the first few years of life.

Around the age of 3 – or later, in some cases – the foreskin should start to separate naturally from the head of the penis (glans). Full separation occurs in most boys by the age of 5 years.

For some boys, the foreskin can take longer to separate, but this doesn't mean there's a problem, it will usually just detach at a later stage.

As the foreskin starts to separate from the head of the penis, you may see the foreskin "ballooning out" when your son passes urine. This can occasionally lead to infection (balanitis), but this ballooning usually settles down with time.

Never try to force your son's foreskin back, as it may be painful and damage the foreskin.

Medical reasons for a boy to have a circumcision

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 a tight foreskin and, in some cases, also affects the head of the penis, which can become scarred and inflamed

The procedure

Circumcision is usually carried out on a day patient basis. This means your child will be admitted to hospital on the same day he has surgery and won't need to stay overnight.

He won't be able to eat or drink before having surgery – you'll receive detailed information about this in a letter.

After being admitted to hospital, your child will be seen by the surgeon who will carry out the procedure. They'll explain the operation in more detail, discuss any concerns and answer any questions you have.

They'll also ask you to sign a consent form, giving your permission for the operation.

The anaesthetist will also visit your child before the operation. Your son will usually have a general anaesthetic, so he'll be asleep throughout the procedure and unable to feel any pain or discomfort.

Circumcision is a relatively simple procedure. The foreskin is removed just behind the head of the penis using a scalpel or surgical scissors.

Any bleeding can be stopped using heat (cauterised). The remaining edges of skin are stitched together using dissolvable stitches. It will take up to 6 weeks for your son's penis to fully heal.

Recovering after male circumcision

After the operation, a dressing will be put over the penis to protect the wound. It may be removed before your child goes home, or it may be left. If it is left it should fall off itself within 24 hours.

He will be allowed home after he's passed urine, which may be slightly uncomfortable at first.

The penis will be sore and inflamed for a few days after the operation. Ointment may be prescribed to use for a few days to help the area heal. 

Your child will also need regular pain relief for at least 3 days. They can take paracetamol or ibuprofen following the instructions on the packet.

Your child will be able to have a bath the day after the operation. He should avoid riding a bicycle or other toys you sit on until any swelling has gone down.

It may be more comfortable to wear loose clothing – or no clothing at all – on his bottom half for a few days after the operation. Passing urine in the bath or shower may also be more comfortable.

He should be able to return to school or nursery about a week after the operation. Make sure you tell the school or nursery about the operation.

In most cases, a follow-up appointment won't be necessary.

However, you should contact your GP or hospital care team if:

• your child's penis is bleeding
• your child's penis is still swollen 2 weeks after the operation
• passing urine is still painful a few days after the operation

Risks of male circumcision

The risks associated with circumcisions when carried out by qualified and experienced doctors are small.

The main risk is reduced sensation or a permanent change in the sensitivity of the head of your child's penis. This is one of the reasons why circumsion is only recommended for medical reasons.

But it shouldn't affect your child's ability to have a fulfilling sex life in the future.

There is a small risk is bleeding, both during and after the operation. The surgeon will seal off any bleeding during the procedure, and the dressing applied afterwards will absorb any further bleeding.

However, seek medical advice if your child's penis continues to bleed after they return home.