What is a circumcision?A circumcision is an operation that removes some of the skin that covers the penis, also known as the foreskin. Neonatal circumcision is generally done when a boy is between 1 and 10 days old, but can be done at a later date as well.
What are the benefits of circumcision?
- Decreases the rate of urinary tract infections and penile infections
- Decrease swelling of the opening at the tip of the penis: Indicated in cases of phimosis (where the foreskin cannot be pulled back) or paraphimosis (where the foreskin can be pulled back but not advanced back over the penis)
- Lower risk of penile cancer, HIV, and STD’s
What are the risks of circumcision?
- Bleeding or infection from the operation
- Risk of anesthesia
- Damage to the penis or urethra
- Either excess or inadequate foreskin removal
- Scarring of the urethral opening, called meatal stenosis
- Scarring of the foreskin to the penis, causing adhesions that may require revision of the circumcision
- If your child is found to have an abnormal urethral opening at surgery, the circumcision may not be possible. Sometimes this cannot be identified until the operation
Preparing for Surgery:
- Surgery is generally done on an outpatient basis. You should plan to be present in the hospital for approximately 3 hours on the day of surgery.
- An anesthesiologist (a physician who specializes in pain relief) gives your child general anesthesia, which puts him asleep.
- The technique of circumcision may vary, with use of a clamp or other device, or sometimes incision and stitches. Your surgeon will review the planned technique with you prior to the procedure.
- Local anesthesia may also be used.
- Generally, in newborns at home, the operation is delayed until age 6 months to reduce the risks of general anesthesia.
- Lab work is not needed unless your child has other medical conditions.
- If you have a family history of a bleeding disorder or your child has had abnormal bleeding please inform your surgeon prior to the operation.
Caring for a Circumcised Penis:Following circumcision, it is important to keep the area as clean as possible. Gently clean with warm water and do not use diaper wipes during the initial healing period. You should place petroleum jelly on the baby's penis or on the front of the diaper for 3 to 5 days to ease any potential discomfort caused by friction against the diaper. Most children will not need anything stronger than Tylenol for pain relief.
It usually takes between 7 to 10 days for a penis to heal. Initially the tip may appear slightly swollen and red and you may notice a small amount of blood on the diaper. You also may notice a slight yellow discharge or crust after a couple of day, which is normal. Any sutures that are used are absorbable and do not need to be removed. For older children, several weeks of abstinence from sports or strenuous activities may be necessary.
When to Call your Healthcare Provider:
- persistent bleeding or blood on diaper (more than quarter-sized)
- increasing redness
- fever greater than 101.5
- other signs of infection, such as worsening swelling or discharge, or the presence of pus-filled blisters
- not urinating normally within 12 hours after the circumcision
- any other questions or concerns