What is a Circumcision?
A circumcision is the name given to the procedure to remove the foreskin from the penis. It is normal for the foreskin to be stuck to the head of the penis (glans) in infancy. It begins to separate from the glans in the toddler age. You will notice some white drainage (smegma). This is the normal way the foreskin begins to separate. The foreskin does not require any special care. Attempting to pull back the foreskin before it is separated to clean can hurt the baby and irritate the foreskin and glans. This can result in phimosis, a condition when the foreskin gets stuck. This usually requires a circumcision.
Two other abnormal conditions requiring circumcision are balanitis and paraphimosis. Balanitis is an infection of the foreskin. Paraphimosis occurs in older boys when the foreskin is pulled back and gets stuck. This causes swelling and pain. If there is obvious swelling, your son may need to be seen immediately.
Some boys are not circumcised as newborns for numerous reasons. Later, parents may want it done for cosmetic reasons. This is a decision you can discuss with the surgeon. Some insurance companies will not pay for a cosmetic circumcision.
What Can I Expect from Surgery?
The foreskin is removed during surgery. Your son's penis will be very red and swollen after surgery. The operation is done on an outpatient basis. Your son goes to the hospital the day of surgery and goes home when he is recovered. Lab work is not needed unless your child has other medical conditions.
Time off Work
Plan on a total of 3-5 days off work including the surgical day. This will allow for 2 quiet days after the operation.
- Please keep the office staff up to date with a change in phone number, address or pediatrician. We may need to reach you in an emergency.
- If your child becomes ill (fever, rash, cold) the week before surgery please contact our office immediately (410) 328-5730.
Tips for the Day of Surgery:
Bring for your son:
A variety of favorite toys, music tapes, or books to encourage quiet time.
A special toy or security blanket that may help to comfort you child.
Extra pacifiers or teething toys to help soothe your baby.
A change of clothes and loose clothes to wear home from the hospital.
Bring for Yourself:
- Any activity you enjoy to help pass the time.
- Change and phone numbers of people you may wish to contact.
- Snacks or money to buy yourself a meal. Please do not eat in front of your child.
It is best, when possible, to make arrangements for siblings to stay at home on the day of surgery, in order for you to participate fully in your child's care.
Post Operative Discharge Instructions:
Care of the Incision:
Tegaderm: If the bandage is clear plastic, if it has not fallen off by 5 days, gently peel it off.
Vaseline or Xeroform gauze: If the bandage is gauze, it will fall off with diaper changes.
Completely cover the penile suture line with Triple Antibiotic Ointment (i.e. Neosporin) with each diaper change for 5 days. This will keep the penis from sticking to the diaper or underwear.
Feeding Your Child After Surgery:
Your child may have a regular diet for age, however his/her appetite may not be normal for 24-36 hours. This is normal. If so, give frequent small amounts of clear liquids (juice, soda, sugar water).
Constipation is common after surgery. Anesthesia and pain medicine (Roxicet) can contribute to constipation. Give your child plenty of clear liquids after surgery. Call the office if you child goes longer than 48 hours without a bowel movement.
Keep the penis clean and dry. The penis may be gently washed and patted dry. DO NOT rub or pull. There will be some swelling and bruising around the penis for 3-5 days. Only a sponge bath or shower for 5 days.
- 0-8 months: Normal activity for age.
- 8 months - 2-1/2 years: Be careful of toddler accidents.
- 2-1/2 years - 12 years: Quiet supervised play for 24-48 hours. No running, contact sports, or vigorous activity for 4 weeks.
Your child must be closely supervised to avoid accidents for 14 days. He may return to school 48-72 hours after surgery. No physical education classes for 4 weeks.
- Bleeding or excessive drainage.
- Fever above 101 F.
- Not making urine (or decrease in wet diapers).
*If you have any questions about the surgery, please call: the nurse practitioner or surgeon caring for your child: 410-328-5730.