Circumcision

Circumcision is a procedure to remove the foreskin, the loose sleeve of skin that covers the tip of the penis. It is one of the oldest and most commonly performed operations in the world.

In young boys the foreskin is normally attached to the head of the penis and cannot be pulled back. This is not a problem and usually resolves gradually as your child grows. Some families choose circumcision for religious or cultural reasons, while in other children it is recommended to treat a medical problem with the foreskin.

• Medical reasons for circumcision may include:
• Phimosis - a tight, scarred foreskin that cannot be retracted and causes ballooning, pain or difficulty passing urine
• Balanitis - repeated infections or inflammation of the foreskin and head of the penis
• Recurrent urinary tract infections in some boys, particularly where there is an underlying kidney or bladder condition
• Paraphimosis - a foreskin that has become stuck behind the head of the penisYour child's surgeon will examine your child, explain whether the foreskin is normal for their age, and discuss whether a circumcision, a smaller procedure, or simply time is the best option.

Circumcision is performed under a general anaesthetic so your child is asleep and comfortable throughout. Local anaesthetic is also given to numb the area, which helps keep your child settled when they wake.

The foreskin is removed and the skin edges are closed with fine dissolving stitches that do not need to be taken out. A soft dressing may be applied. The operation itself is usually short and your child can go home the same day once they are awake, comfortable and have passed urine.

Some swelling, redness and a yellowish film around the stitch line are normal in the first week and are part of healing rather than infection. Regular pain relief such as paracetamol or ibuprofen is usually all that is needed for the first few days.

Loose clothing helps, and a smear of petroleum jelly on the tip of the penis or the inside of the nappy can stop it sticking. Most boys are back to normal play within a week or so, avoiding bikes, swimming and rough sport until the area has healed. Contact the team if there is heavy bleeding, spreading redness, fever or your child cannot pass urine.