As part of your investigation into whether or not you would like your son to be circumcised, you need to know what actually happens during the circumcision procedure.

What is circumcision and when is it done?

Newborn baby boys are usually circumcised within the first two days following birth. (1,2) Jews circumcise their male babies eight days after birth.

Circumcision is the surgical removal of the foreskin from the penis. The foreskin is a piece of skin that covers the tip of the penis (glans).

Only baby boys that are in good health and born without any physical abnormality of the penis are usually circumcised. (2)

Circumcision performed outside of Judaic and Islamic faith is carried out in the hospital. The baby is taken to the surgery room and the clothing and diaper removed, as needed. The baby will be placed in a special restraining device that will prevent him from wiggling during the procedure.(2)

Sometimes the doctor will give the baby a pacifier that has been dipped in sugar water to soothe the baby during the procedure.

The doctor will then administer an anesthetic cream or injection. (2) The foreskin is then pushed away from the head of the penis and clamped with either a metal or plastic ring. The metal ring actually cuts off the foreskin. With the plastic ring, a piece of suture is tied tightly around the foreskin to push it into a groove in the plastic. (3)

What can I expect after the procedure?

If the metal ring is used, the foreskin will fall off and then the wound is allowed to heal for up to seven days. (3) You may see mild bleeding and redness at the site. It is important to keep the area clean to avoid the potential for infection.

If the plastic ring is used, then in five to seven days (10 to 12 days according to Johns Hopkins), the plastic covering falls free leaving the site completely healed. (3)

Post-operative care (especially in metal ring cases) will involve:

• Cleaning of the area with water at every diaper change

• Application of petroleum jelly like Vaseline and/or antibiotic ointment with every diaper change

• Changing of the dressing, if a dressing was applied after the procedure

• Pain relief with acetaminophen such asTylenol

Post-operative causes for concern: When to call the doctor

If you see any of the symptoms below following your son’s circumcision, call your pediatrician or family doctor immediately:

• New bleeding or bleeding marks in the diaper larger than a quarter

• Pus drainage from or around the surgical area

• Increased pain or pain that doesn’t ease after four to seven days

• Redness and swelling of the penis that does not improve after three days or worsens

• Your baby does not urinate six to eight hours after the procedure

• Yellow discharge or yellow coating on the penis after seven days

• A fever of 100.4 degrees or higher

Sources:

1. Circumcision. American Academy of Pediatrics. Web. Apr 7, 2012.
http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Circumcision.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

2. Circumcision. Johns Hopkins Medicine. Web. Apr 7, 2012.
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/circumcision_135,31

3. Circumcision. A.D.A.M. Web. Sept 13, 2012.
http://adam.about.net/encyclopedia/Circumcision.htm

Reviewed September 14, 2012
by Michele Blacksberg RN
Edited by Jody Smith