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Circumcision In Children
WHAT YOU NEED TO KNOW:
Circumcision is surgery to remove the foreskin of your child's penis. The foreskin is the fold of skin that covers the tip of the penis.
WHILE YOU ARE HERE:
Before your child's procedure:
- Informed consent is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.
- Preoperative care: Medicine may be given to help your child relax. Your child will be taken to the room where the procedure or surgery will be done.
- An IV is a small tube placed in your child's vein that is used to give him medicine or liquids.
- Anesthesia medicine: This is medicine to make your child comfortable during his procedure. Your child may have any of the following types of anesthesia medicine during his procedure:
- General anesthesia: This medicine puts your child to sleep and makes him comfortable during his procedure. It may be given in an IV or as a gas through a breathing mask. This medicine may also go through a tube placed in your child's mouth and throat. A mouth tube is called an endotracheal tube or ET tube. General anesthesia is normally used when your child is no longer an infant.
- Local anesthesia: This is medicine used to numb the penis and dull your child's pain. Your child may still feel pressure or pushing during the procedure after getting this medicine. There are two kinds of local anesthesia. One is a cream or gel that is applied to the area before the procedure. The other is given as a shot of medicine at the base of the penis. The base of the penis is the part that this closest to the body.
During your child's procedure:
- If your child is a baby, he may be placed on a special padded board. This board will help keep him from moving during the procedure. Your baby may be given a sweetened pacifier to help decrease his pain and crying. If your child is older, he may be asked to lie on his back.
- For babies, the foreskin is opened wide so that the head of the penis is seen. The inner lining of the foreskin is separated from the skin of the head of your baby's penis. A small cut is made on the foreskin to expose the head of his penis. A special tool, such as a clamp or plastic ring, is placed on the head of his penis. If a ring is used, a thread may be tied around a groove in the ring, and around the foreskin. The thread will stop blood flow to the foreskin. The foreskin is then cut and removed. The plastic ring may be left on your baby's penis until it falls off on its own.
- In older children, the foreskin will be pulled back to show the glans. Two cuts will be made around your child's penis. One cut will be near the middle of the penis and the other near the glans. Another cut is then made to between the two cuts to connect them together. Once the cuts are made, the foreskin will be removed. The skin at the base of your child's penis will be moved over the area where his skin was removed. The skin of your child's penis will then be sewn together with stitches. After the procedure, a bandage is used to cover your child's penis.
After your child's procedure:
Your child will be taken to a room where he can rest after the procedure. Healthcare providers will watch him closely. When healthcare providers see that your child is OK, he may be allowed to go home. If your child is a newborn baby, he may be brought back to your hospital room. If healthcare providers want your child to stay in the hospital, he will be taken back to his hospital room. Your child's healthcare provider may give him the following:
- Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.
- Antibiotic medicine: Antibiotic medicine may be put on your child's circumcision as a cream or gel. It may help prevent an infection caused by bacteria.
- Anesthesia medicine may be painful when injected and cause bruising, swelling, and redness of your child's skin. Rarely, anesthesia medicine may cause seizures or decreased oxygen in your child's blood. The special tool placed on the head of his penis may become buried in his skin or displaced. Your child may bleed large amounts during the procedure, called hemorrhage. His wounds may not heal properly. Your child may be at risk for phimosis if not enough foreskin was removed during the procedure.
- The opening where your child's urine passes may become red and painful, or narrow. Lumps may form on his penis, which can become large and infected. This may turn the penis to one side when erect, and cause pain. Your child may develop a small opening from his urethra to his skin called a fistula. The urethra is the tube that carries urine from the bladder to outside the body. The tip of his penis may be cut or injured during the procedure. An abnormal skin connection may form between a damaged glans and the body of his penis. Your child may need to have another procedure or surgery to fix these problems.
- Your child may get an infection after the procedure. This infection may spread to his blood, other areas of his skin, or to his brain. Very rarely, circumcision can lead to death. Without circumcision, problems such as phimosis and balanoposthitis may recur often. Your child may also have an increased risk for UTIs while he is a baby. His chances of having penile cancer, genital warts, and a HIV infection may increase later in his life. Ask your child's healthcare provider if you are worried or have questions about your child's procedure, medicines, or care.
CARE AGREEMENT:You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.