Circumcision: The Surgical Procedure
David Perlstein, MD, MBA, FAAP
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
- Circumcision facts
- What is a circumcision?
- Is a circumcision safe?
- How is a circumcision done?
- What should one expect after a circumcision?
- Is a circumcision painful for a baby?
- How can the pain be reduced?
- What are the contraindications to circumcision (the reasons against doing it)?
- What is the chance of a complication from a circumcision?
- Newborn circumcision is a generally safe procedure if it is done under proper circumstances.
- Circumcision should be done by a trained, experienced practitioner.
- Circumcision should not be done if an infant is sick or in unstable health.
- A premature infant should not have circumcision until the baby meets the criteria to be discharged from the hospital.
- Infants with genital anomalies (including hypospadias) should not be circumcised.
- Babies with a family history of bleeding should not be circumcised until tests are done to make sure the child does not have a bleeding problem.
- Local analgesia should be given to reduce the pain associated with the procedure.
- Care of the infant after circumcision is simple and generally well tolerated.
What is a circumcision?
A circumcision is a surgical procedure that removes the foreskin (the loose tissue) covering the glans (rounded tip) of the penis. Circumcision may be performed for religious or cultural reasons, or for health reasons. Newborn circumcision is thought to diminish the risk for cancer of the penis and lower the risk for cancer of the cervix in sexual partners. It is also believed to decrease the risk of urinary tract infections in infants and lower the risk of certain sexually transmitted diseases, especially HIV.
Is a circumcision safe?
Circumcision is generally a safe surgical procedure if the following conditions are met:
- The circumcision is performed carefully, using strict aseptic (sterile) technique;
- the circumcision is performed by a trained, experienced practitioner;
- the circumcision is performed only on a healthy, stable infant; and
- there is no medical reason not to have circumcision performed (see below).
How is a circumcision done?
The circumcision may be performed using surgical clamp techniques or with a special disposable plastic device called a Plastibell. The results are equally good.
What should one expect after the circumcision?
Following completion of the circumcision, the practitioner may apply gauze impregnated with petroleum jelly. You should follow any instructions regarding the care of the infant given to you by the practitioner, and these might include the following:
- Generally it is recommended that the area be cleaned several times a day with warm water.
- At each diaper change, you can apply a small amount of unscented petroleum jelly, or your doctor might recommend application of an antibiotic ointment as well.
- It may take up to seven to 10 days for the incision scab to slough off.
- After the scab falls off, no further care is required except for normal hygiene.
- At the first well-baby visit following hospital discharge, the penis should be carefully examined by the doctor and the parents given more information concerning further care.
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