The strict criteria for publicly-funded circumcisions has seen fewer procedures carried out in the Waikato.

Over the last four-and-a-half years, 403 males received a publicly funded circumcision, with more than half of those patients aged five years and under.

Waikato Hospital Services executive director Brett Paradine said policy does not allow paediatric surgeons to perform circumcisions for religious or cultural reasons.

"We are confident as we can be without a manual search of all records, that the circumcisions that have been done have been done for clear medical indications, often as a necessary part of other surgery."

K'aute Pasifika nurse Maiotele Lowen said circumcision is common among the Samoan community but it was more of a religious practice as opposed to a cultural practice.

"Parents have all the information and now make their own choice. Not many people do it but I do know that sometimes they send their children back home to the islands," she said.

"Usually for Samoan people the [basis] for getting circumcisions are usually religious. Not many people ask about it [in Hamilton], but we have had inquiries about where you can get it done."

Lowen said because circumcisions for religious or cultural purposes are not available through the public health system, it has put a lot of people off getting the procedure done.

"It costs like $300-$400 now (under local anaesthesia) and you have to go private so I think it has put a lot of people off."

Waikato DHB paediatric surgeon Askar Kukkady said there is a high threshold that must be met before a circumcision is performed.

"We would carry out circumcisions for those children who have repeated episodes of infection of the foreskin and difficulties in passing urine caused by a very narrow opening in the foreskin that has not responded to application of local steroids, [among other conditions]."

Paradine said the number of children that present to Waikato Hospital with a complication following circumcision carried out in the community is very low.

"The occasional case does present but these are rare and there are insufficient numbers for any meaningful trends or conclusions to be drawn," he said.

"We identify only 22 emergency department presentations for both children and adults in the four-and-a-half years from January 2011-June 30 2015."

The circumcisions conducted by the DHB generally require a theatre and anaesthetic and the cost is estimated to range from around $1245 to over $2000, said Paradine.