Division of Pediatric Surgery
What is circumcision?
Circumcision is the most common surgical procedure done in the United States. That being said, the most common reasons for doing circumcisions are social and religious.
What are indicators for circumcision?
- True Phimosis - Phimosis is a medical condition in which the foreskin of the penis of an uncircumcised male cannot be fully retracted.
- Paraphimosis - Inability to bring prepuce back over glans
- Recurrent Infections - If a patient has a recurrence of urinary tract infections or vesicoureteral reflux
One must be able to practice good genital hygiene. Until the age of 3 years the prepuce is not fully retractable and should therefore not be pulled back. This carries the risk of phimosis and cicatrix formation.
Benefits of circumcision include prevention of penile carcinoma, phimosis, neonatal urinary tract infection and STD's later in life.
What happens during surgery?
Two methods of circumcision:
- Plasti-bell - a ring is left in place. After surgery you are to wash daily in soapy water and apply Neosporin, or any other antibiotic ointment, to the head of the penis with every diaper change. The ring will fall off on its own in 7-12 days.
- Free hand - there will be sutures in place and occasionally a bandage around the penis. Depending on the surgeon, post op day 1, you are to remove the dressing andbathe in soapy water. Apply Neosporin, or any other antibiotic with every diaper change (or 3-4 times a day if not wearing diapers) as per your discharge paperwork.
Neither procedure is without discomfort and patients should be treated with over the counter Tylenol as needed (doses vary dependant on age and weight).
Contraindications and Possible Complications
Hypospadias - a developmental anomaly characterized by a defect in the wall of the urethra so the (urethral) canal is open for a greater or lesser distance on the undersurface of the penis.
(Rate of 2-10%) Bleeding and infection are the two to be aware of. If bleeding continues after discharge home, you should call the doctor immediately. Daily you should be cleaning the penis and checking for signs of infection. Call if there is any purulent drainage or extreme sensitivity at the penis. Expect to see some swelling and redness immediately post op which may last up to 2-3 weeks.