Table 1.

Issues to consider for timing of male circumcision: neonatal vs. later.

Neonatal circumcision	Circumcision of older boys and men
• Simple.	• More complex.
• Quick (takes several minutes).	• Half an hour or more to perform.
• Cost is lower.	• Much more expensive (often unaffordable).
• Low risk (adverse events 0.4%).	• Moderate risk (adverse events 4–8%).
• Bleeding (uncommon) is minimal and easily stopped.	• Bleeding more common, requiring cautery or other interventions.
• Sutures not needed.	• Sutures or tissue glue needed.
• Convenient for patient.	• Inconvenient (time off school or work).
• Local anaesthesia for age <2 months.	• General anaesthesia for age >2 months to age 9 years. Local anaesthesia for men, although general anaesthesia often preferred by surgeon.
• Healing is fast (<2 weeks).	• Healing takes 6 weeks or more.
• Cosmetic outcome usually good.	• If stitches used stitch marks may be seen.
• No prior anxiety.	• Fear of undergoing an operation.
• Does not disrupt feeding or other day-to-day activities.	• Abstinence from sexual intercourse for the 6-week healing period.
• No embarrassment.	• May be embarrassed.
• Benefits start immediately after healing is complete.	• Benefits delayed. Meantime may suffer from medical problems that he would have been protected against if circumcised earlier.
• Avoids costs for treatment of later medical conditions that circumcision protects against.	• Cost of treatment of these, including both direct and indirect costs.