What is circumcision?

Circumcision is a surgical procedure to remove the skin (called “foreskin”) around the tip of a boy’s penis.  This leaves the end of the penis without the usual skin covering.

Is it necessary to have a circumcision?

There is no absolute medical reason for doing a circumcision.  There is no right or wrong choice.  Some parents want their son to look like his father or brother.  Some parents wish to have the circumcision done for religious reasons.  Others choose not to have their son circumcised.  Some children who are predisposed to urinary tract infections may benefit by becoming circumcised.

What are the benefits of circumcision?

  • The penis is easier to clean.
  • Fewer urinary tract infections.
  • A lower risk of penile cancer

What are the possible complications?

  • Bleeding
  • Infection
  • An allergic reaction to the medicine used to numb the skin of the penis.
  • Pain during and shortly after the procedure.
  • Rarely, scar formation or deformity requiring correction by a plastic surgeon.
  • Rarely, removing the skin necessary to repair an underlying congenital anomaly.

How is the circumcision done?

  • Your son will be placed on a special board to keep him from moving too much.  He may be given a pacifier for obvious reasons.  The penis will be cleaned off and a local anesthetic will be injected or EMLA cream will be applied to temporarily “numb” the area.  Then the foreskin is gently cut off around the special metal “bell” (Gomco Bell – fitted in a Gomco clamp) or around a plastic ring (Plastibell) that covers the head of the penis while the foreskin is removed.  If a Plastibell is used, your baby will go home with a plastic ring that will fall off in 5 – 10 days.  The Gomco Bell and Gomco clamp are totally removed immediately after the circumcision.
  • The circumcision is usually performed 24 – 48 hours after delivery before leaving the hospital.  If the circumcision is not performed before discharge, you will be referred to a urologist for the procedure to be performed at a later date.

How should I care for my baby after circumcision?

  • In 30 – 60 minutes, the anesthesia will wear off and your son may become fussy.  Cuddle and hold him.
  • For the first 3 days, you may give Tylenol Infant Drops (or a comparable liquid medicine) to help reduce any discomfort.  Do not use these more the 4 times per day or for more than 3 days unless you are advised otherwise by your physician.
  • Your baby should urinate normally and wet his diaper regularly.  Do not be alarmed if there is a little blood stain in his diaper.
  • The penis will look red, swollen and bruised.  This will go away after a few days.  You may see spots of bleeding as the penis heals.  For the first few days, your son’s urine may look pink.  This is normal.
  • Your baby will probably be more comfortable if he lies on his back or side.
  • Do not put diapers on too tight.  Hold your baby so that you do not put undue pressure on his penis.
  • Sometimes, a yellow or yellow-green crust will form for 1 – 2 weeks.  This is a normal part of healing (caused by the clotting part of the serum).
  • If your baby was given local anesthesia by an injection, you may see small needle holes at the injection sites.
  • Usually 2 weeks after the circumcision is performed, the penis is healed.

How should I clean the penis?

  • Wash your hands before touching the penis.
  • Carefully clean the circumcised penis by gently blotting it with a cotton ball soaked in warm, clean water.  Never use alcohol.  Use 3% peroxide to loosen up the yellow crust when it is getting “messy”.
  • Wash your hands again when you are finished.
  • Apply Bacitracin ointment around the circumcision each time you change the diaper for about 2 weeks.

Call your pediatrician or the physician who performed the procedure if you notice any of the following…

  • Excessive bleeding after the procedure
  • A bad odor or drainage from the penis
  • Abnormal swelling of the penis
  • The penis is not completely healed in 1 month
  • Swelling the scrotum and/or testicles
  • The development of a fever (rectal temperature over 100.4°F), uncontrolled crying for more than 3 – 4 hours, difficulty feeding and/or abdominal distension
  • If there is any blistering or if the penis remains red and swollen after 2 weeks