What is Circumcision?
This is a common procedure in which the foreskin (the skin covering the tip of the penis) is removed with surgery. This exposes the head of the penis. Circumcision is not medically required, but studies show that it lowers certain health risks. In fact, according to the American Academy of Pediatrics (AAP), the benefit of the procedure outweighs the risks. Most parents make the decision about circumcision based on cultural, religious, or personal reasons (such as whether other male family members have been circumcised).
Benefits Include
– Reduced risk of urinary tract infection in the first year of life
– Easier to keep the penis clean (although boys can be taught how to properly clean the foreskin after it becomes retractable)
– Later in life, studies show that men who are circumcised may be at a lower risk of contracting STD/HIV
Risks Include
– Usually there are no complications or risks, but rarely complications that might occur are
– Infection
– Bleeding at the site
– Incomplete removal of foreskin; if excess skin appears uneven, a corrective procedure later in life may be needed
– Damage to the penis has only been reported in rare cases. Precautions taken almost always prevent this.
Pain control is provided by
– Topical anesthetic ointment
– Injected anesthetic
– Soother
Contraindication / Precaution
– Family history of bleeding disorder
– Family history of, or known deformity/concern on the child’s kidneys/penis/urinary tract
– If your child has any of the conditions, please contact the clinic (587-393-3866, extension 2) before booking for the procedure.
Things To Know
Cost: 0-1 month $350 + GST / 1-3 month $450 + GST / 4-6 month $550 + GST / > 6 month $750-$1250 + GST
Duration of the appointment: 1 hour
What to bring for the procedure: Your baby’s Alberta Health Care Card, 6 diapers, Soother if your baby takes one, Baby blanket, Baby formula if your baby is not fully breastfeeding.
What not to bring: Please do not bring siblings.
During The Procedure
You will learn about after care. Dr. Honardar uses the Mogen clamp procedure. The Mogen Clamp technique is as follows; the foreskin is separated from the head of the penis with the clamp with a slot and the foreskin. The clamp is held in place while the foreskin is cut with a scalpel and remains for a few minutes after this to make sure that bleeding has been controlled.
After The Procedure
General: Please book a follow up appointment 1 week later. Please contact the clinic ASAP if there are any concerns. Every child heals differently. It can take up to a month for the penis to appear fully healed.
Dressing: Leave the dressing on for 24 hours after the procedure. The dressing falls off by itself usually within 24 hours. If it does not fall off on its own in 24 hours soak if off in the bath.
Medications: Please give Tylenol regularly for the 1st 24 hours. Some babies will need it on the 2nd day as well. Please follow the instructions on the medication bottle for dosing.
During the healing phase, please apply petroleum-based ointment (such as Vaseline) to the end of the penis after each diaper change and bath. Point your infant’s penis up in his diaper to ease any swelling of the area behind the bland. Your newborn infant should have a warm bath every day for one week. When the dressing comes off, it is normal for the pneis to be discoloured with small spots of blood at the tip. After the circumcision, the glans may appear red, or purple because the skin that was covering it was a mucous type membrane; once exposed, it will become dark and thickened. The glans may have yellow to white to green patches in the first few days after the procedure. These are a type of swab and are completely normal. This is normal healing, not pus. There may be swelling behind, or under the head of the penis and may look like a blister. The swelling is simply another sign of healing. It resolves in 1-2 week(s).
Bleeding: Small amount of blood on the diaper and clot at the penis tip is normal. Bleeding that is concerning would be bleeding that drips from penis. If this happens, please apply Vaseline to a diaper and hold it firmly against the penis for 15 minutes. If the bleeding does not stop after 15 minutes, please go to the ER.
Infection: Normal healing changes include bruising and swelling along the length of the penis and possible blisters at the bottom of the penis from the site of anesthetic injection. White scab and yellow discharge are also normal. These start to resolve after 24 hours. Infection is very rare. Signs to watch out for infection include increased redness, or increased swelling after 24 hours. Other signs include fever, increased drowsiness, not feeding, or significantly less wet diapers. If you notice these signs, please go to the ER.
Diaper change: Continue to change your baby’s diaper as often as usual. Blood stain on the diaper is common. At each diaper change, drip some water from a washcloth over the tip of the penis. You may wipe everywhere else. At each diaper change, please check for active bleeding. Normal bleeding appears as spots of blood no bigger than a two-dollar coin (about an inch wide). Apply Vaseline to the entire area at each diaper change for a week. When closing the diaper, point the penis down and apply the diaper firmly. For the first 6 hours post the procedure, it is best to keep your newborn in a diaper as much as possible and change the diapers quickly as possible. Air drying will slow healing and it is not recommended. If poop is on the penis tip, wipe it off gently.
Bathing: Do not bath for the first 3 days post the procedure.