Circumcision is a surgical procedure that involves the removal of the foreskin from the tip of the penis. It is one of the most common operations performed globally, but the medical professional who performs it varies significantly based on the timing and location. The choice of physician depends heavily on whether the procedure is performed immediately following birth or later in life for medical or personal reasons. For the vast majority of cases, the procedure is carried out by the primary care team attending to the new baby during the newborn period.
Primary Care Providers for Newborn Circumcision
The primary medical professionals who perform a routine circumcision immediately after birth are typically those already providing maternal and newborn care in the hospital or birthing center. This group includes Pediatricians, Obstetricians/Gynecologists (OBGYNs), and Family Medicine practitioners. These professionals perform the procedure most often within the first 48 hours of life, before the mother and child are discharged home.
Pediatricians specialize in the care of infants and children and are frequently involved in the decision-making process and performing the procedure. OBGYNs, who have managed the mother’s care through pregnancy and delivery, are often skilled in performing the procedure before the baby leaves the hospital. Family Medicine practitioners provide comprehensive care for patients of all ages and are also trained to perform the procedure in the neonatal period.
The procedure is usually performed with a local anesthetic to numb the area. Training in these techniques is integrated into the residency programs for these primary care fields because the procedure is so common. Choosing one of these providers for a newborn circumcision is often a matter of convenience, as they are already on-site and part of the established care team.
Specialized Medical Professionals
When a circumcision is performed on an older child, adolescent, or adult, or if the initial newborn procedure requires correction, the medical professional involved is typically a specialist. Urologists are the primary surgical specialists who manage conditions affecting the male urinary tract and reproductive system. They handle non-newborn circumcisions.
The procedure for an older male is more complex and often requires general anesthesia to ensure patient comfort and safety. Urologists perform these procedures in an outpatient surgical setting or a hospital operating room. They are also consulted when a baby has an anatomical variation, such as hypospadias, which would make a routine circumcision inappropriate, as the foreskin may be needed for future reconstructive surgery.
If an initial circumcision heals with complications, such as a skin bridge or excessive foreskin remaining, a Urologist is the specialist who performs the revision surgery. Their expertise extends to addressing medical conditions like phimosis, where the foreskin cannot be retracted, or balanitis, which is inflammation of the glans penis. In these cases, a circumcision performed by a specialist is considered medically necessary rather than elective.
Factors Influencing Provider Selection
The selection of a circumcision provider is heavily influenced by the timing of the procedure and the reasons for seeking it. If the decision is made to circumcise an infant, parents typically select a primary care provider, such as a Pediatrician or OBGYN, for the procedure to be performed in the hospital setting. This choice is driven by the simplicity and low cost of the procedure during the immediate newborn period.
If the family delays the decision past the first few weeks of life, the options shift away from primary care providers and toward specialized clinics or Urologists. At this later stage, the procedure often requires sedation or general anesthesia and is typically performed in a dedicated surgical setting, which increases both the complexity and the cost. Parents also consider insurance coverage, which may only cover the procedure if a medical condition is present, rather than for purely elective reasons.
Cultural and religious considerations also play a role in provider selection, particularly in the Jewish faith, where the brit milah is performed by a trained religious practitioner called a Mohel. While this is a non-medical procedure, many families who choose this route still consult with a medical doctor to ensure the infant is healthy enough for the procedure. Ultimately, the choice of provider is a balance between convenience, the age of the patient, and the medical or non-medical rationale behind the decision.