infectiosum • Do not submerge the circumcision site in bathwater until it has healed. PRECAUTIONS • If a circumcision bleeds more than a few drops, call your doctor. • If there are signs of infection (pus, spreading redness, swelling of the penis), see your doctor. • During bathing, any part of the foreskin remaining after healing of the circumcision should be pulled back to expose the base of the glans (the head of the penis) for cleansing. • Babies born with any malformations of the penis should usually not be circumcised. Circumcision is the removal of the cuff of skin (the foreskin) that covers the glans (the head of the penis) in most boy babies. The natural opening in the foreskin is usually large enough to allow urine through (rarely is there no opening at all). It is also important to be able to pull back the foreskin so that the smegma (the waxy material that normally forms under the foreskin) can be removed during bathing. In a condition called phimosis, the opening is not large enough to allow the foreskin to be pulled back to uncover the glans. Although the foreskin can sometimes be stretched by a doctor when the opening is too small to allow the foreskin to be pulled back, circumcision is the usual treatment of phimosis. If the penis is uncircumcised, it sometimes happens that the pulledback foreskin cannot be drawn forward again and may act as a tourniquet, cutting off the blood supply to the glans; this condition, called paraphimosis, is treated by circumcision. Circumcision has been practiced throughout the world for centuries, both for religious and social reasons. It has been commonly performed on newborn infant boys in the United States since World War II. Its advantages are easier cleansing and lessened possibility of paraphimosis. However, contrary to what many people believe, circumcision Tight foreskin In Phimosis, the foreskin cannot be pulled back over the penis. does not protect against cancer of the penis. The disadvantages of circumcision are the slight chance of infection or bleeding after the operation (less than 1 percent), the brief pain of the operation, and the chance of accidental injury to the glans during the operation (a rare occurrence). In recent years many doctors have declared that circumcision is unnecessary surgery. However, many other doctors feel that the advantages outweigh the disadvantages. The decision to circumcise male infants remains with the parents. Parents should ask questions and gather as much information as possible to help them make the decision. INDICATIONS FOR PERFORMING CIRCUMCISION Circumcision is required only when boys are born with no opening in the foreskin, when the opening is too small to allow passage of urine, or when paraphimosis has developed and must be immediately corrected. HOME CARE A circumcision should be covered until healed (two to five days) with a nonstick bandage and gauze coated with petroleum jelly. The area should not be submerged in bathwater until the wound has healed. chicken