What is circumcision ?

Circumcision is the surgical removal of the foreskin, which is the skin covering  the tip of the penis. It is usually done a week or two after birth of the baby boy. Circumcision can be  difficult and involves a lot of cultural, religious and personal considerations.

Why is circumcision done ?

Parents circumcise their sons for religious and cultural reasons. Some also do it because of family culture and others do it as personal hygiene or preventive health. In some cases , circumcision may be necessary due to medical reasons such as the foreskin being too tight to pull back over the glans.

What are the benefits ?

Some of the benefits of this procedure include :

• decreases the risk of urinary tract infection
• reduces risk of  penile cancer in adult men
• reduces the risk of sexually transmitted diseases STDs
• makes hygiene easier because it is simpler to wash the penis

The American Academy of Pediatrics (AAP)  however does not recommend circumcision as a routine for all male newborns.  They believe this should be the decision of the parents.

What are the risks of circumcision ?

As with any surgical procedure , there are some risks associated with circumcision however this is minimal.  It can result in bleeding and infection and occasionally the adverse reaction to anesthesia.

Other serious complications that may occur include :

• Meatitis (inflammation of the penis opening)
•  meatal stenosis (disorders related to urination)
• penile injury such as partial amputation, penis necrosis and urethral fistulas.

In rare cases , too much foreskin is removed which results in painful erections during adulthood

How is circumcision performed ?

It may take place in the hospital or doctor’s office. It usually takes from 5 to 20 minutes and is done before you leave the hospital. There are different types of possible procedures. These include the Plastibell, the Gomco clamp or Mogen clamp which all require the use of a scalpel. Discuss with your healthcare provider which one you will be using. All of these procedures first separate the foreskin from the glans with a device followed by surgery with the scalpel to remove the foreskin.

During the procedure, local anesthesia is used to reduce pain. These include

• topical cream
• nerve block via injection at the base of the penis
• nerve block via injection under the skin around the penis shaft

How do I care for my circumcised baby ?

After circumcision

• using warm water, clean the area several times a day
• change soiled gauze. Apply lubricants as instructed by health care provider
• light bleeding, yellow discharge or scabbing may occur. Avoid excessive rubbing of the area when you notice these symptoms
• use pain medication as directed by your doctor. These include use of infant pain medication, topical creams and increased breastfeeding

When should I contact my doctor ?

You need to call your  doctor right away if the following symptoms occur :

• fever
• persistent bleeding
• redness at the tip of the penis that worsens after three days
• any signs of infection   such as the presence of pus-filled blisters or  foul-smelling drainage from the tip of the penis
• inability to urinate normally after 6 to 8 hours
• the Plastibell device (a device that may be used during the procedure) does not fall off within 7-10 days

NOTE
Your doctor may delay circumcision if

• baby is not medically stable or was born prematurely
• baby has physical abnormalities to the penis that require surgical correction