Circumcision

Circumcision

What is circumcision?

Circumcision is the surgical removal of the layer of skin, called the foreskin, that covers the glans (head) of the penis.

When is circumcision performed?

Circumcision on newborns may be performed after 24 hours of birth. Circumcision can also be performed on older children and would require general anesthesia. However, recovery may take longer when circumcision is done on an older child.
How is circumcision performed?

• The physician will carefully examine your baby to make sure that your baby is in good health to undergo the procedure. The penis will be examined for any abnormalities. If there was any abnormality, circumcision may be postponed.
• The circumcision procedure takes only a few minutes. Two main types of local anesthetic are used to make the procedure less painful for the baby including:
• A topical cream to be applied on the penis which requires at least
40 – 60 minutes to take its full effect.
• An injectable anesthetic before the procedure which gives a longer period of anesthesia.
• Acetaminophen (Paracetamol) could also be prescribed by the physician to reduce discomfort during the procedure and for several hours afterwards. Moreover, giving a pacifier dipped in sugar water and swaddling a baby can help reduce stress and discomfort.

The circumcision procedure typically involves the following steps:

• The penis and foreskin are cleaned.
• A special device called Plastibell is attached to the penis and the foreskin is removed.
• After the procedure, Ointment Fucidin is applied over the wound.

Post circumcision care

• Wound care: Gently clean the wound with warm water. We suggest using diaper wipes only for his buttocks, but for the penis use a wash cloth or dry wipes.
• Pain relievers: Pain relievers are often not needed, and are perhaps best avoided with newborns.
• Antiseptic ointment: Every time you change the diaper for the next 7 days after the procedure, or until the Plastibell falls off and all the granulation tissue is gone, apply antiseptic cream over the glans (head) of the penis.
• Shower: You may give a quick shower to the baby 24 hours after the procedure.
  Don’t worry if a moist, yellow coating (granulation tissue) develops over the glans (head) of the penis. These are a type of scab and are completely normal.

Are there any risks associated with circumcision?

Possible complications (2% only) may include bleeding, infection, and scarring. In rare cases, too much of the foreskin or not enough foreskin is removed. An additional surgery sometimes is needed to correct these problems.

When to consult your doctor?
If you notice any of the following problems, please consult your doctor:

• Persistent bleeding
• Increasing redness
• Fever > 38⁰ C
• 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
• Plastibell does not fall off 10 days or if it slides up to the body of penis