• Rationale and Comments

    In 2012, the American Academy of Pediatrics Task Force on Circumcision listed hypospadias, congenital chordee, and deficient shaft skin (penoscrotal fusion/webbing, or buried penis) as contraindications to newborn circumcision. For patients with hypospadias, preservation of the prepuce is important for use in future reconstruction. Additionally, abnormal urethral anatomy may predispose the patient to urethral injury during clamp circumcision. Best practice dictates consulting a urologist to help assess these anatomic penile anomalies prior to initiation of circumcision. Newborns with a circumferentially normal foreskin may undergo completion of clamp circumcision without concern for concealed hypospadias. In this situation, if a hypospadias is present, it is usually on the glans of the penis, and clamp circumcision should not increase the risk for future complications if hypospadias repair is needed.

    Sponsoring Organizations

    • American Academy of Pediatrics - Section on Urology


    • American Academy of Pediatrics guidelines


    • Neonatology
    • Urologic


    • American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012;130(3):e756-e785.
    • Lerman SE, Liao JC. Neonatal circumcision. Pediatr Clin North Am. 2001;48(6):1539-1557.
    • Snodgrass WT, Khavari R. Prior circumcision does not complicate repair of hypospadias with an intact prepuce. J Urol. 2006;176(1):296-298.
    • Chalmers D, Wiedel CA, Siparsky GL, et al. Discovery of hypospadias during newborn circumcision should not preclude completion of the procedure. J Pediatr. 2014;164(5):1171-1174.e1.
    • Zamilpa I, Patel A, Booth J, Canon S. To finish the cut or not. Clin Pediatr (Phila). 2017;56(2):157-161.