ABSTRACT
Development of the external genitalia is a complex process in the male, which predisposes to many congenital anomalies. Masculinization of the external genitalia occurs in normal human embryos between 8 and 12 weeks of gestation. The endodermal urethral plate canalizes and the inner genital folds fuse to create the male anterior urethra and corpus spongiosum, while the fused outer genital folds make the scrotum. The neonatal male penis is a focus of considerable parental anxiety and attention. The foreskin in a premature infant may appear relatively deficient, but by term, it protrudes beyond the glans. Neonatal circumcision is one of the commonest operations in the United States and Israel, although in other Western countries, the frequency is much lower. Circumcision should prevent phimosis, paraphimosis, and balanitis, although good population studies proving this are hard to find. Neonatal circumcision should only be performed with adequate analgesia, using a ring penile block, local anesthetic cream, or a dorsal penile nerve block.
