A circumcision is the surgical removal of the prepuce (foreskin) of the penis.
Medical indications for circumcision include:
The aim of the procedure is to remove the foreskin. The operation is performed under general anaesthesia and takes about 30 minutes. Your child should not have to spend the night in hospital.
Your child cannot eat for 6 hours before the procedure. In breast fed babies this time may be reduced by the anaesthetist. Your child can drink water for up to 2 hours before the operation. The Day Surgery Unit will instruct you the day before surgery to confirm fasting times. It is useful to bring your child’s favourite toy along on the day.
The anaesthetist will meet you and your child prior to the procedure. They will discuss the anaesthetic with you and take you through to the operating theatre. Your child will be anaesthetised using a face mask and then you will be taken to a waiting area. Once your child is asleep a drip is inserted often in the hand or arm, but occasionally it may need to be sited in the leg.
Once your child is asleep, the foreskin is removed. The wound is closed with absorbable stitches. No dressing is required but an antibiotic ointment is applied to prevent infection.
On completion of the operation your child will be taken to the recovery area. Children often initially appear distressed and a little confused upon waking up but will quickly settle down once you are with them and if offered a drink or something to eat. Full recovery usually takes about 2-3 hours after which you can go home.
Children’s paracetamol should be given for pain relief for 24 hours. After that use paracetamol only if needed. Some children need additional medication such as ibuprofen or celecoxib. Opiate (morphine-type) medications are not usually required. Paracetamol and ibuprofen can be given at the same time and work well together. Follow the dosages recommended on the packaging or by the anaesthetist. Never give more than has been prescribed.
Bathing is safe after the operation. Antibiotic cream (Chlorsig) should be applied 2-3 times a day or after a nappy change. In addition, applying a generous dollop of Vaseline to the inside of the nappy prevents the tip of the penis from sticking to it. The skin of the glans has to change from being soft and moist to dry skin. This takes about 2 weeks and once it has occurred, the Vaseline is no longer required.
For a few days after the operation, a small amount of bloodstaining of the nappies or underpants should be expected. The urinary stream may spray because of post-operative swelling. It will resolve as the swelling subsides.
The tip of the penis (glans) and the shaft itself may look swollen and bruised for a few weeks after surgery. This too is temporary and will resolve.
In general, your child may eat a normal diet after surgery. Vomiting is common on the day of surgery. It is temporary, and usually due to the anaesthetic and pain-relief medications that are used. If vomiting occurs, start with clear liquids and add solids slowly for the first day.
I will review your child 4-6 weeks after the surgery to ensure healing of the wound. For patients from rural areas this may be deferred to your General Practitioner or Paediatrician. Please ring soon after the operation to arrange a convenient time.
This is a common operation with a low complication rate. The vast majority of children who have this operation recover well and have no serious complications of surgery. However, complications can occur. Some of the recognised ones include:
This occurs in <1% of boys. Some oozing is not uncommon for a few days. If it is a steady trickle or the nappy is soaked with blood, please contact me or present to the emergency department of your local hospital. Bleeding will usually cease with pressure or a compression dressing. Rarely a return to theatre is needed to control the bleeding.
The wound and glans should look red and crusty. As the glans heals, it may also become covered with white or yellow discharge. This is normal healing and does not represent infection. It will resolve by about two weeks post circumcision. A thick yellow discharge, increasing pain, redness and fever suggest infection which, if it occurs happens between days four and seven.
Rarely the cosmetic outcome is not satisfactory, and a revision may be needed.
Damage to the Penis
Though very rare, cases have been reported of damage to the glans penis or penis itself.
This page is intended to provide you with information and does not contain all known facts about circumcision. Treatment may have uncommon risks not discussed here. Please do not hesitate to ask any questions you may have.