The Circumcision Procedure
Neonatal circumcision, performed soon after birth, can be done by a pediatrician or an obstetrician in the hospital within hours of delivery. However, most patients are referred to a urologist after they are six months old; after this age the procedure must take place in a hospital operating room or at an outpatient surgery center.
Depending on the age of the patient, the patient needs either mild sedation or general anesthesia. Afterward, the physician applies a local anesthesia to the penis to reduce the infant’s post-operative discomfort. All of the stitches from the surgery will dissolve on their own and need no removal. It can take up to two weeks for the sutures to completely disappear.
At the conclusion of the procedure, the urologists covers the penis in a dressing, recommending that the dressing stay for three days, although it usually falls off sooner. Some bleeding on the gauze is normal.
After removal of the dressing, the penis is generally bruised and swollen, taking three to four weeks until it starts to look normal. Also, there may be some intermittent bleeding from the incision.
Please be patient with recovery. Call the doctor if a fever, excessive swelling or bleeding develops, or if there are any unanswered questions. The doctor will provide a prescription for pain medicine, though sometimes an over-the-counter pain reliever such as Tylenol is adequate.
- Buried penis is when the penile shaft buried below the surface of the pubic skin. It is recommended that after the circumcision you push at the base of the penis to expose the glans. This maneuver can help reduce the risk of a buried penis.
- Chordee is an abnormal bend of the penis, caused by scar tissue on the penis. This rarely occurs.
- Complications from the anesthetic are a risk of virtually any surgery.
- Meatal stenosis is the narrowing of the urine channel (urethra) at the top of the penis. The symptoms are usually a deflected urinary stream; this can easily be fixed by a urologist.
- Poor cosmetic appearance.
- Skin bridges are when the foreskin reattaches to the glans, easily reparable by a urologist. The best way to avoid a skin bridge is by exposing the glans and applying a topical ointment.
- Tearing of the sutures, usually due to erection.
- Pain. A circumcision hurts. Local anesthesia can block nerve sensations during the procedure. Post-operative pain medicine will be prescribed.
- Bleeding or infection.