Circumcision

What is circumcision?

Circumcision is the surgical removal of the foreskin, which is the layer of skin that covers the head of the penis.

There are 2 broad indications for circumcision.

1. A Request Circumcision is a circumcision performed for non-medical reasons, such as parental preference, religious reasons or to potentially prevent disease at some future time (majority of cases in infants).
2. A Medical Circumcision is a circumcision performed to treat a disease, such as:
   • Inability to retract the foreskin (Phimosis) due to recurrent infection and scarring (Lichen Sclerosis).
   • Recurrent infection of the head of the penis (Recurrent Balanitis)
   • Recurrent urinary tract infections.
   • A medical circumcision is usually performed in older children / adults, rare in infants.

What are the health benefits associated with a request circumcision?

Recent research suggests that circumcision may bring medical benefits such as:

• A 10 times lower risk of a baby getting a urinary tract infection (UTI) in his first year of life
• No risk of infants and children getting infections under the foreskin
• Easier genital hygiene
• Much lower risk of getting cancer of the penis
• Possibly lower risk of men getting sexually transmissible infections (STIs) than men who are not circumcised (although these studies have not been scientifically confirmed and safe sex practices are far more effective in preventing these infections).

How is circumcision performed?

There are different methods of circumcision. They are performed under either local or general anaesthesia. They usually follow the steps below:

• The penis and foreskin are cleaned.
• One of the procedures, known as the Plastibell procedure, involves numbing the area with local anaesthetic creams or injection and inserting a bell-shaped instrument under the foreskin to separate it from the penis. The foreskin is then removed using scissors or a scalpel.
• Alternatively, circumcision can be performed as a formal surgical procedure with a clamp, using dissolving sutures or tissue glue.
• After the procedure, gauze with petroleum jelly is placed over the wound to protect the area.

Are there risks associated with circumcision?

Complications following circumcision are rare, but can include:

• Pain
• Excessive bleeding
• Infection
• Cutting the foreskin too short or too long
• Irritation to the head of the penis, since the foreskin seems to protect the head of the penis
• Narrowing of the meatus (the tube that allows urine to exit from the body)

Complications generally are less likely if the circumcision is done by someone well trained in the procedure. It also is less likely for complications to arise if the circumcision is done in a medical setting.

Some parents also may worry that circumcision harms a man’s sexual function, sensitivity, or satisfaction. However, current evidence shows that it does not.

What to expect immediately after a circumcision?

After the operation you can expect:

• Discomfort and swelling
• A small patch of blood in the baby’s nappy (smaller than a 10-cent piece – if it is any larger, contact your doctor immediately)
• The wound area looking unsightly for about 10 days.

How should I care for my circumcised son?

Be guided by your doctor, but general suggestions include:

• Giving your child lots of cuddles and comfort
• Applying a little petroleum jelly or ointment on a light gauze dressing to the wound
• Applying fresh petroleum jelly and a new gauze dressing at each nappy change. This reduces the risk of urine irritating the wound
• A daily bath to keep the area as clean as possible.

In most cases, the skin will heal in 7–10 days. You may notice that the tip of the penis is red and there may be a small amount of yellow fluid. This usually is a normal sign of healing.

How do I keep the circumcised area clean?

Use a mild soap to gently wash the penis. Remove any stool with soap and water during diaper changes. Change diapers often so that urine and stool do not cause infection.

Signs of infection include redness that does not go away, swelling, or fluid that looks cloudy and forms a crust.

Call our clinic on (07) 3255 1208 (West End Branch) right away if you notice any of these signs.