Circumcision

Circumcision is the surgical removal of a hood of skin called the foreskin which covers the tip of the penis. It is a procedure usually performed on a newborn before he gets discharged from the hospital. It can also be done in older boys and adults. Circumcision is generally done as a cultural or religious custom.

Anatomy

The foreskin is a portion of skin that covers the head of the penis. It protects the delicate tip of the penis from cold and rubbing against undergarments, and keeps the tip lubricated. It should be kept clean to prevent bacterial infection.

In babies, the foreskin is attached tightly to the penis, but can be pulled back by age 2 during urination or erection.

Indications

Circumcision is most often performed for religious reasons. Some also undergo this procedure for personal hygiene, or to prevent penile cancer, urinary tract infections and sexually transmitted diseases. It can also be conducted as a treatment for phimosis, when a man cannot pull back the foreskin completely, or for balanitis, when the penis tip gets infected.

Contraindications

Circumcision may not be advised if you or your son is suffering from certain blood-clotting disorders or in premature babies who are under medical care.

Procedure

Circumcision is usually performed 1 to 10 days after birth. Your child will be restrained during the procedure. Local anaesthesia will be given to numb the region. A clamp or plastic ring is placed and tightened to minimize bleeding. The foreskin is then cut below the clamp.

The procedure in older children and adults is the same, but may require general anaesthesia and suturing to prevent bleeding.

Postoperative care

Your child will most likely be discharged on the same day of the surgery. You may notice that the skin of the penis is red and swollen or forms a yellow crust on the tip. You will be instructed to keep the operated area clean and dry by changing your child's diaper more frequently and keeping it loosely fastened. With each diaper change, you will also have to change the bandage and apply petroleum jelly on the tip of penis so that it does not rub against the diaper. If a plastic clamp is used, it will fall off when the area heals.

Adults who have undergone circumcision should avoid rigorous exercises and any sexual activity for four to six weeks.

Recovery

Circumcision is generally considered a safe procedure in newborns and children. The operated area heals in about 1 week in newborns and up to 3 weeks in older boys.

Risks

As with any surgery, circumcision may be associated with certain risks such as bleeding and infection. Although rare, foreskin problems can occur if the foreskin is trimmed too short or too long, the incision does not heal properly, or the leftover foreskin reattaches to the tip of the penis requiring surgical correction.

Complications

You will be instructed to contact your doctor if your son does not urinate within 12 hours following the procedure, bleeding or redness persists, foul-smelling drainage occurs, or the plastic ring remains in place even after 2 weeks.