If you have a son who was born in the United States, there is a 77 percent chance he was circumcised.

There are a variety of religious, cultural and even medical reasons why parents choose circumcision. While the risks associated the procedure are quite low (two to five cases per 1,000), there are numerous complications that can arise.

Although the most common problems are infection and excessive bleeding, there are some instances that require a second procedure to correct the problem.

"Acute complication is pretty infrequent," said Dr. Christine Beiler, a pediatrician with Roseville Pediatrics. "Usually if we have to redo a circumcision, it's because the parents aren't pleased with it cosmetically, but in some instances it is truly medically necessary."

Male circumcision involves the surgical removal of the foreskin from the penis. Cosmetic concerns arise when too much or too little skin is removed. In the rarest of cases, circumcisions can inhibit proper function of the penis. Sometimes, complications may not present themselves until the child is potty training or entering puberty.

According to an article posted in January on www.uptodate.com, surgical complications from circumcision include injury to the glans (tip) or urethra, removal of excess skin, inadequate removal of skin, benign cysts and abnormal scarring that may result in adhesions or penile curvature.

"If there is an adhesion or skin bridge, parents usually don't notice it until the child is potty training," Beiler said. "The stream doesn't go the way it's expected when they urinate."

Another warning sign is when the child is producing a small stream of urine with prolonged voiding. While signs of this condition may not be cosmetically visible, it is important to have the child checked if symptoms occur.

Children who are entering puberty and have a bending of the penis during an erection may also require additional surgery. "Complications such as this have to be corrected in a surgical environment with anesthesia," said Beiler. "It's a bit of a procedure."

Additionally if a child is overweight, the penis may be hidden by what's known as a fat pad, which can prevent proper healing following a circumcision. Parents of overweight children are typically discouraged from circumcision because of the tendency for the penis to become buried.

In an article published by The Scientific World Journal in September 2011, there is one documented case of death directly associated with circumcision. Reported by the Ontario Pediatric Death Review Committee in 2007, the death involved improper use of surgical equipment, resulting in insufficient blood flow that caused a buildup of bacteria in the bloodstream.

According to other international studies, there have also been indirect cases of death from tetanus due to circumcisions being performed under non-sterile conditions.

And studies also have shown that complications from circumcision risks are lowest during the first week of a child's life. Waiting as little as three weeks can result in a 30 percent increase in complications from excessive bleeding.

While there are numerous complications from circumcision, the rate of these incidences is so small that the benefits typically outweigh the risks.

"The American Academy of Pediatrics says there are not enough benefits to endorse circumcisions," Beiler said. "However, some studies show there is an increase in penal cancer, urinary tract infections and transmission of sexually transmitted diseases in men who are not circumcised."

While more than seven in 10 males are circumcised in the U.S., that percentage counts adults who were born when the procedure was performed much more as a matter of course — according to circs.org. For example, a survey indicated about 90 percent of men born in 1965 are circumcised.

The percentage is much lower for boys born in recent years. Individual rates depend on the region of the U.S. and whether the procedure is covered by their insurance, but the National Center for Health Statistics puts the infant circumcision rate at slightly less than 60 percent nationwide.

Worldwide, according to the World Health Organization, circumcision rates are at one-third of adult males; other studies report the rate may be as high as 42 percent. Some nations, like Finland, are near 0 percent.

"There is a higher percentage of circumcision in this region," Beiler said. "Certainly, parents who are concerned about the appearance have to weigh the cost/benefit ratio."