PAEDIATRIC PATIENT
INFORMATION
Circumcision
Your son has been recommended to have a circumcision. This leaflet explains the procedure
and aims to answer the main questions you’re likely to have. If you have any additional
questions please feel free to discuss them with your son’s doctor or nurse before the
procedure.
What is circumcision?
Circumcision is a simple operation to remove the foreskin from the penis. Circumcision may be done
if the foreskin is too tight and difficult to pull back over the head of the penis.
What are the alternatives?
If your son has a tight foreskin there are creams that may help thin and soften the foreskin so that
it’s easier to pull back. However there is no scientific proof that they work permanently. Alternatively
the surgeon may suggest your son has a procedure called preputioplasty. This involves making one
or two small slits in the foreskin to help it stretch.
Preparing for your son’s operation
If your child has a cold or infection in the week before the operation, it’s important to let us know. The
operation may need to be postponed until your child has fully recovered.
Circumcision is usually done as a day case procedure under general anaesthesia. This means your
child will be asleep during the operation. It also means he must not eat anything or drink milk for
about six hours beforehand. He can drink water until two hours before the procedure.
When you arrive at the hospital, a nurse will measure your son’s heart rate and blood pressure and
ask you questions about his general health. You must tell the nurse if your son has any allergies or if
there is any history of bleeding problems in the family. The surgeon and anaesthetist will usually visit
your child before the operation.
You will be asked to sign the consent form if you have parental responsibility for the child. People
with parental responsibility are usually the child’s birth parents. Your child may wish to sign this form
too. In some circumstances a child can sign their own consent form independently, providing he or
she understands what they are being asked to do.
About the procedure
During the operation, the foreskin is pulled forward and trimmed away. The skin edges are closed
using dissolvable stitches and/or special glue.
Your son’s penis may be wrapped in a paraffin-based dressing to protect it from rubbing against his
clothing. The dressing is usually removed after 24 to 48 hours.
Your son may be given a local anaesthetic before he wakes up, either by injection or by gel applied
to the area. This means that he will feel less pain immediately after the operation.
What to expect afterwards
Your son will be monitored for a short while in the recovery area and then brought back to the ward.
He may be sleepy, and feel or be sick. It’s possible that he will be upset after the procedure. Your
son will need to rest until the effects of the general anaesthetic have passed. He should be able to
eat and drink soon after the operation.
Your son should be able to go home around three to four hours after the operation, as long as he
has passed urine before then.
Recovering from the operation
Pain relief
Local anaesthetic will reduce your son’s pain for up to eight hours. We advise that you give him
pain relief for the first 24 to 48 hours. You can give him either:
paracetamol or ibuprofen syrup (for example, Calpol or Calprofen). Follow the
instructions on the leaflet that comes with the medicine and ask your pharmacist for
advice. Do not give aspirin to children under 16 years old.
lignocaine gel applied to the site of the circumcision every three to four hours.
Stitches
Your son’s stitches are dissolvable and will disappear within two to three weeks. The wound may
bleed slightly until all the stitches have dissolved.
Dressing
You don’t need to replace your child’s dressing when it comes off.
Bathing
It’s important to keep the tip of his penis clean. The area should be kept dry for 48 hours after the
operation. After this, give your son warm baths once or twice a day, without adding bubble bath or
scented soaps, as these may irritate the healing wound. His penis should be left to dry naturally after
each bath.
Clothing
Your son should wear loose underwear and clothing until the wound is fully healed. If your son is
very young and still in nappies check the nappy isn’t too tight and change it frequently. If possible try
and let your son go without wearing a nappy or underpants for a while each day. This will help his
penis to heal but make sure he doesn’t pull on his healing wound. Your child may need to take a few
days off school and shouldn't ride a bike or swim for at least two weeks.
Passing urine
Some children may have difficulty passing urine once they get home. Make sure your son has plenty
of clear drinks and adequate pain relief as this usually helps. He will find it painful when passing
urine for the first few days. Putting petroleum jelly (for example, Vaseline) to the tip of his penis after
he has passed urine may help to ease this and stop clothes or the nappy from sticking to it.
Your son will be able to return to school when he can walk normally and is able to wear school
clothes comfortably. This is usually within seven to ten days. He should not do strenuous activity
such as PE, games or cycling for at least two weeks.
Follow-up
Your son will be seen again in outpatients, generally six to eight weeks after the operation. This will
be arranged by the nurse or the consultant’s secretary.
What are the risks?
Circumcision is commonly performed and generally safe. However, in order to make an informed
decision and give your consent, you need to be aware of the possible side-effects and the risk of
complications of this procedure.
Side-effects
These are the unwanted, but mostly temporary effects of a successful procedure, for example
feeling sick as a result of the general anaesthetic. Common side-effects include pain, swelling and
bruising of the skin around the penis, which may last several weeks.
Complications
This is when problems occur during or after the operation. Most boys are not affected. The possible
complications of any operation include an unexpected reaction to the anaesthetic, excessive
bleeding or infection. Bleeding is usually stopped by applying pressure. Very rarely, heat (diathermy)
or fine stitches are used to seal the blood vessels. Your son may need to stay in hospital overnight
for observation. Infection is usually mild and treated with antibiotics.
Specific complications of circumcision are rare, but can include:
removal of too little or too much of the foreskin.
abnormal scar tissue formation - it may be possible to correct this with further surgery.
damage to the penis or urethra (the tube which carries urine out of the body) - this is
very rare but if it happens another operation may be necessary.
It’s possible that circumcision may affect future sexual sensation (although this is impossible to
measure).
What to look out for
Contact Starfish Ward for advice if:
your child complains of severe pain or shows signs of worsening pain - babies and
toddlers cry more when they are in pain and are difficult to settle.
the wound becomes swollen, bleeds heavily, smells or starts to weep yellow or white
discharge.
Contact
With these, or any other concerns, contact Starfish Ward directly on 020 7460 5991 and you will be
able to speak to a paediatric nurse or a doctor.
Bupa Cromwell Hospital
162 – 174 Cromwell Road
London SW5 0TU
+44(0)20 7460 2000 (hospital switchboard)
[email protected]
www.bupacromwellhospital.com
Published: November 2012
Review: November 2013
This information is published by Bupa Cromwell Hospital and is based on reputable sources of medical evidence and experience from over 25
years of treating patients. It has been peer reviewed by Bupa Cromwell Hospital doctors. The content is intended for general information
only and does not replace the need for personal advice from a qualified health professional. If you have any feedback on the content of
this patient information document please email [email protected] or telephone 020 7460 5901.