Circumcision in the United States refers to the removal of foreskin from the glans (head) of the penis. This is a surgical procedure, primarily performed in neo-nates. Developmentally, the foreskin becomes retractable by three years of age. Neonatal circumcision is safe, requiring only locally applied anesthesia. Commonly used devices are the Gomco and Mogen clamps or Plastibell. These methods involve estimation of the amount of foreskin to be removed, freeing the inner layer of the foreskin from its attachment to the glans, and control of bleeding. Circumcision is considered an elective procedure, requiring parental request and written consent. The decision regarding circumcision includes consideration of cultural, religious, and ethnic traditions as well as the medical risks and benefits. Controversy exists as to the relative medical benefits of circumcision because of issues involving urinary tract infections in infants under twelve months old, sexually transmitted diseases (STDs), HIV transmission, and penile cancer.


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