CIRCUMCISION

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Circumcision is the surgical removal of the foreskin of the penis. The foreskin is not necessary for any urinary or sexual functions. The procedure has been safely performed for thousands of years and is done mainly for cultural reasons. Having an uncircumcised penis does slightly increase the risk for urinary tract infections, sexually transmitted diseases and penile cancers. These risks are reduced if the boy practices proper hygiene. Circumcisions are necessary in about 25% of boys who were not circumcised at birth (because the foreskin becomes infected or retracted behind the head of the penis and won't return to its normal position, based on a study of British military recruits whom were not circumcised at birth). Also, if you desire your boy to be circumcised and do not have it done before your son leaves the hospital, then the procedure will have to be done by a urologist, your son will probably have to go under general anesthesia and it will cost you several hundred dollars, therefore, you do want decide now whether you want it done or not.

An UNCIRCUMCISED foreskin will be adherent to the head of the penis at first. Usually only good cleansing is required and the foreskin should be retractable by 4 to 5 years of age. Occasionally the opening of the foreskin is tight or small and will require gentle traction at each bathing to GRADUALLY expand the opening so that the foreskin is retractable by several years of age. A whitish material about the head of the penis is normal and should be cleaned off. As your son learns how to bathe himself, teach him how to clean and retract the foreskin to its normal position to prevent swelling and tightening.

After the CIRCUMCISION is done, your baby may have Vaseline gauze around the penis. The penis will also look beefy red and will be sticky for about 5-10 days. So long as the penis is sticky, apply Vaseline to it to prevent irritation from the diaper and urine and to prevent the penis from sticking to the diaper and foreskin. Should the gauze dry out, do not pull it off as it will be stuck to the penis. First soak the dry gauze with saline to make it easier to take off. The head of the penis will normally have a yellow-green discharge on it starting on day 2-4 and lasting a few days. Some doctors use a plastic bell for circumcision that will leave a plastic rim on your boy's penis. A dark ring around this rim is normal and it will disappear when the rim falls off. Remember that you still need to clean the penis well and retract the foreskin gently everyday during his bath. Occasionally the foreskin will grow over the head of the penis again or will adhere to the head of the penis. If this happens, then gently pull the foreskin off of the head of the penis a little each day. This process may take months to separate the foreskin from the head of the penis. I will show you how to do this at the 2 week visit if you are unsure how. Occasionally you may also notice a whitish material under the adherent foreskin. This is normal and is just skin cells that are being shed off from the trapped skin. Notify the doctor that performed the circumcision or me immediately if the rim has not fallen off in 8 days, notice any unusual swelling or redness, a foul odor or if the rim slips off onto the shaft of the penis.

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Copyright 2006, Joe Matusic, MD, FAAP, AME