Should my son undergo circumcision?
Dear doctor, Is it advisable to have my 6-year-old son undergo circumcision? I know that it is a religious requirement for some people but in our case, we are considering it purely for health and hygiene purposes? Are there benefits and is my son too old for the procedure? Melissa Lee, Klang
Dear Melissa,
THERE are many cultural and religious practices for circumcision. Circumcision for religious or cultural reasons can happen at different ages.
In Malaysia, some boys are circumcised at birth and some later on as a passage into manhood, at around 10 years of age.
So, circumcision can be done at any age and it can be done under local or general anaesthesia.
With local anaesthesia, the child will need to stay still for the procedure, easier done on newborn babies and on a slightly older child who understands what’s being done to him and is cooperative.
Circumcision with general anaesthesia is best avoided for the very young (under 6 months old) but suitable for procedures at any age after that.
To be purely medical, there are reasons for and against circumcision.
In terms of hygiene, 90 per cent of boys at the age of 6 are able to retract their foreskin and therefore, able to wash under their foreskin while in the shower or bath. This should be sufficient to remove the oily secretion which collects under the foreskin as a white cheesy substance called smegma, the cause of localised infections.
In addition, your boy should be retracting his foreskin when passing urine and drying the head of his penis with a tissue before returning the foreskin back over. This will avoid the irritation caused by the urine on the skin and head of penis, making it itchy.
In situations where boys get recurrent infections due to a tight foreskin which is not retractable, it is advisable to see a doctor. There may be a need for circumcision here.
For a completely normal retractable foreskin, with good personal hygiene, there are no medical indications for circumcision at this age.
In terms of sexual function, as an adult, the recommendation from the World Health Organisation is that circumcision can reduce the risk of contracting and transmitting sexually transmitted diseases.