Circumcision is an operation done for removal of the foreskin of the penis in boys.
Why is circumcision done?
In many cultures this is routinely performed for all boys at various ages called religious or cultural circumcision.
Sometimes it has to be done for recurrent infections of the skin in children called Balanoposthitis.
Is it necessary to do circumcision if the foreskin cannot be pulled back?
It is common for the foreskin to not be retractile in boys up to 3 years of age and hence before this age, circumcision is very rarely indicated. This condition is called physiological phimosis and it may persist up to 10 years of age but at an older age some treatment such as gentle retractions in warm water bath and steroid ointments may be recommended by your child’s paediatric surgeon. Sometimes despite best measures this may also require surgery.
How is circumcision done?
Circumcision is done by a paediatric surgeon usually as a day care procedure. This means that the child can be brought to hospital in the morning and get discharged the same day after surgery. Read more about day care procedures here.
The procedure is performed under general anaesthesia as that ensures that the child does not feel any pain and is not aware of the procedure. read more about the safety of general anaesthesia in children here.
The paediatric surgeon cuts the foreskin at the level where the glans penis joins the shaft, called coronal sulcus. The two layers of the skin may be sutured or glued together.
A dressing is usually not required but can be applied if the child or parents wish to have it.
An antibiotic and pain killer are given and the child is discharged home once he has passed urine and is fully awake, usually 4-6 hours after surgery.
What are the complications of circumcision?
Although complications are rare (<5%) they may include persistent bleeding or infection of the wound. Bleeding may occur from the operated wound and it may be controlled by firm pressure and rarely may need be stopped under anaesthesia.
Infection is also rare but can be usually controlled by oral antibiotics and sitz bath.
What care is required after surgery?
No special care is required except keeping the wound clean and not using tight undergarments. After 2-3 days, the child may be given a sit bath once a day. Read more about sitz bath here.