CIRCUMCISION

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Last Updated : 12/21/2010
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Vivek M. Rege
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There is no ideal age for circumcision, depending upon the presence of the problem, if the indication exists; the age or weight of the child is no bar to having the boy circumcised. This is a small minor operation and is always done on a Day care basis. The surgery is done under complete general anesthesia, which is extremely safe even in a small infant. The boy comes to the hospital in the morning, undergoes surgery, and walks home the same evening. The procedure is simple - both the outer and inner layer of the folded prepeucial skin are cut leaving 2 cut edges of the skin which are then brought together with multiple interrupted absorbable sutures. These sutures fall off on their own after 7 - 9 days no sutures need to be removed or cut.

Problem & Precautions
The prepucial skin is lose unhealthy, and very vascular, hence cutting and suturing always causes a swelling in the post operative period. This looks ghastly and worries the parents - but this disappears by itself within a few days and nothing specific needs to be given for this. I usually do not give any dressing and the child is allowed to pass urine, some blood may ooze from the suture site the first day, which later dries up and forms a scab. These scabs too are to be left alone and will fall off by themselves. A clot may sit right on the urinary opening and partially block it so the child passes urine from the side of the hole with multiple streams again worrying the parents - but these streams will disappear as the clot falls off to a single stream.

After a circumcision

, I avoid any pants being worn for 8 days. The

area of operation

is very sensitive and anything that touches or rubs against that part gives exquisite pain to the boy. Thus the child either wears a Lungi or a girl's dress/ nighty for the first 7 days. After 4 days the boy is given a regular bath and is made to sit in a tub of hot water to give fomentation to the part. With the hot water fomentation, the edema subsides, the sensitivity goes away, the scabs loosen and along with the sutures fall off by themselves. This hot hipbath is given with hot water at least 15 minutes each time and 3-4 times a day and is followed by

application of an antibiotic ointment

locally each time. This is continued till all the scabs and sutures have fallen off the local part is dry. The entire process of normalization may take up to 10 days though the healing is over in 4 days.

Post Circumcision
Post Circumcision




Contributor Information and Disclosures Vivek M. Rege
Pediatric Surgeon & Pediatric Urologist, B J Wadia Hospital For Children, Hurkisondas Hospital, Wockhardt Hospital, Mumbai, India


First Created : 12/8/2000
References
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