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Child Circumcision

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Child Circumcision

(Circumcision—Child)

Definition

Circumcision is the removal of the foreskin of the penis. The foreskin is a sheath of skin that covers the tip of the penis.
Circumcision
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Reasons for Procedure

Circumcision may be done for cultural or religious reasons. It is usually done during the first few days of life. Circumcision may be done on older boys as a treatment for medical problems. Problems may include foreskin that is too tight or foreskin that cannot retract.
Circumcision may be associated with a decreased risk of:
  • Urinary tract infection
  • Phimosis—tightening of the foreskin, which can be severe enough to close off the opening to the penis
  • Penile cancer
  • Cervical cancer in sexual partners
  • Certain sexually transmitted diseases, like HIV
Talk to your doctor about the risk and benefits of circumcision for your child.

Possible Complications

Complications are rare, but may include:
  • Infection
  • Bleeding
  • Reaction to anesthesia
  • Unsatisfactory cosmetic outcome—foreskin is cut too short or left too long
  • Foreskin does not heal properly
  • Decreased penile sensation
  • Damage to the tip of the penis
Factors that may increase the risk of complications include:
  • History of bleeding disorders in the family
  • Chronic illness
Talk to the doctor about these risks before the circumcision.

What to Expect

Prior to Procedure

Your child will have a physical exam. The penis will be examined for any abnormalities. Your child may also need blood and urine tests done.
Your child may not be able to eat or drink after midnight the night before the procedure. Ask your doctor when your child should stop eating and drinking.

Anesthesia

General anesthesia will be used. It will be given through an IV or inhaled. Your child will be asleep for the entire procedure.

Description of Procedure

The anesthesia will be given. After your child is asleep, the foreskin will be pulled away from the penis. The foreskin may have some areas attached to the head of the penis. The doctor will cut these attachments. The excess foreskin will then be cut away. If needed, stitches may be placed to stop bleeding.
Petroleum jelly or an antibiotic ointment will be smeared on the penis. A bandage may be applied.

Immediately After Procedure

Your child will be monitored in a recovery room.

How Long Will It Take?

Less than one hour

How Much Will It Hurt?

Your child will have some discomfort. Anesthesia will help block pain. Your child's doctor may recommend medication to manage discomfort after the circumcision.

Post-procedure Care

There may be swelling of the penis. A clear scab may also develop over the area. The penis should heal within 7-10 days of the circumcision.
At Home
It is important to keep your child’s penis clean while the circumcision heals. Follow these steps to promote good healing:
  • If there is a bandage, follow your doctor's instructions on when to remove it. In general, replace the dressing after your child uses the bathroom for the first 36-48 hours after surgery.
  • After the dressing has been removed, keep the penis clean with mild soap and water.
  • Supportive underwear may keep your child more comfortable.
  • If instructed, apply antibiotic ointment or petroleum jelly to the area
  • Ask your doctor about when it is safe for your child to bathe or soak in water.
  • Be sure to follow your doctor’s instructions.
Your child may have some discomfort while urinating for the first few days. Use pain medication as prescribed.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:
  • The penis or the area of the incision appears red, swollen, or is hot to the touch
  • Incision or penis is oozing a yellowish discharge after 3-5 days—some discharge is normal in first few days
  • Fever
  • Pain is not controlled by the medicine your child has been given
  • The head of the penis is blue or black
If you think you have an emergency, call for medical help right away.

RESOURCES

American Academy of Family Physicians http://www.familydoctor.org

American Academy of Pediatrics http://www.healthychildren.org

CANADIAN RESOURCES

AboutKidsHealth http://www.aboutkidshealth.ca

Canadian Paediatric Society http://www.cps.ca

References

Blank S, Brady M, Buerk E. Circumcision policy statement. American Academy of Pediatrics. Pediatrics. 2012;130(3):585-586.

The circumcised penis. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Caring-For-Your-Sons-Penis.aspx. Updated March 29, 2013. Accessed May 13, 2013.

Circumcision. American Academy of Family Physicians' FamilyDoctor.org website. Available at: http://familydoctor.org/familydoctor/en/pregnancy-newborns/caring-for-newborns/infant-care/circumcision.html. Updated December 2010. Accessed March 13, 2013.

Circumcision. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/Circumcision.aspx. Updated May 2, 2013. Accessed May 13, 2013.

Circumcision. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 9, 2013. Accessed May 13, 2013.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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