YOUR HEALTH | The conversation surrounding circumcision

A simple surgical procedure where the foreskin is removed, circumcision can be done at any age in any male, but it is most commonly performed in babies.

The paediatric branch of Royal Australasian College of Physicians' position statement says there is no convincing evidence that we should recommend routine circumcision in a normal healthy boy.

Parents usually face the decision over religious, family or cultural tradition reasons.

There is a significant emotive element - people feel strongly in favour or against. One of the arguments against is that at this age the boy cannot be consenting to the procedure.

The argument here is that no one should be receiving a circumcision until they are able to consent to it themselves.

But clearly there is an argument if there is a medical indication for the procedure.

There are very few medical reasons for circumcision to be done on an infant.

However, there are some reasons why it should not be done in every male.

A fairly common condition called hypospadias means that the development of the penis is not quite normal and the opening of the urethra doesn't go right to the tip of the penis.

Repairing this requires the tissue that forms the foreskin, and this cannot be done if the child has had a circumcision.

Also, sometimes a complication that can arise after circumcision where the exposed urethra which was formerly protected by the foreskin will rub against nappies or underwear and lead to a narrowing of the opening (meatal stenosis). This requires further operating.

Having said that, if a parent wants this procedure done they are going to find a way for it to be done and I'd rather it be performed with someone who has the appropriate training and experience and it is performed in a humane, clean and appropriate manner.

Outside of a hospital setting circumcision is usually performed with local or regional anaesthesia, which can be done on younger boys and by other doctors such as general practitioners.

There are some cases where circumcision is recommended for medical indications as circumcision can significantly reduce the risk of infection:

Having said that, UTIs are not life-threatening and can usually be treated with antibiotics.

There is a lot of research about the benefits of circumcision in reducing the risk of transmission of infections and diseases including UTIs, HPV, mycoplasma, genital ulcer disease, and possibly syphilis. There is also good evidence of circumcision reducing (not eliminating) the risk of becoming infected with HIV.

However, it is important to note that much of this evidence comes from heterosexual interactions and in countries where hygiene is poor and barrier contraception is harder to access, and that circumcision is not an effective method of prevention.

You are better off teaching your son about safe sex than simply rely on circumcision to keep him safe from STIs and STDs.