Circumcision

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What is circumcision?

Circumcision is a surgical procedure to remove the foreskin - that is the skin which covers the penis's tip. In general, the procedure is carried out on newborn boys for religious reasons, and may also be done on older children.

What foreskin problems are common in children?

Foreskin problems can be fairly common in male babies and children, including the inability to retract the foreskin (phimosis). Mr Stefano Giuliani, a leading paediatric surgeon, explains why these issues affect babies and children and how they can be treated. To make an appointment with Mr Giuliani, do so here:

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Who is a good candidate for circumcision?

The medical indication for circumcision is when your baby or child develop a scar which is impeding the foreskin to retract. In medical term, this is called phimosis with scar, and it may be caused by recurrent infections (balanitis) in the area or a laceration occurred during forceful retraction of the foreskin within the first few years of life.

Circumcision can also be chosen for cosmetic, personal, religious and cultural reasons.

What does circumcision involve?

Circumcision on newborns is usually done within the first few weeks of life. Parents will be asked to sign a consent form before the procedure is carried out. In the case of older children, the procedure is performed under general anaesthesia, and the child is able to return home on the same day.

In circumcision for newborns, the baby lies on his back with his legs and arms secured, before a local anaesthetic is administered via a numbing cream applied to the penis, or an injection. Various surgical techniques can be used, and the exact method chosen will depend on the age and characteristics of the child.

There are three main methods of circumcision. The Gomco Clamp uses an instrument known as a probe to separate the foreskin from the penis head before a bell-shaped device is fitted over the penis head, and underneath the foreskin. After the foreskin is pulled over the bell, a clamp tightens around it, reducing blood flow. The foreskin can then be cut and removed using a knife.

The Plastibell Technique is similar to the Gomco Clamp, using a probe for separation before a plastic bell goes over the head of the penis and under the foreskin. A suture is tied around the bell, cutting off the foreskin's blood supply, before a scalpel is used to cut off the surplus foreskin. The suture is left on and naturally falls off in a few days. 

Surgical circumcision is the most common technique for older infants and children. It is performed under general anaesthesia as a day case. It is the removal of the foreskin using a surgical knife and then putting fine stitches to repair the wound.

Compilations after circumcision are possible, and the most common ones are bleeding, infection, scar and bad cosmetic result.

Recovery from circumcision

Following the procedure, an ointment is applied to the penis before it is wrapped with a dressing. There is rarely a significant amount of bleeding from the procedure, but the penis may be sore for a few days, so extra care may be required when bathing your baby.

"Mr Giuliani treated our 7 years old Son. It was our first experience at the hospital and we were very tense. Mr Giuliani was a perfect choice, we knew we were in safe hands from the first visit. We were impressed by the whole process, professionalism, personal touch and knowledge of the doctor and his team. Please do not hesitate to use his services, we are highly recommending Mr Giuliani!"

"Mr Giuliani treated our 7 years old Son. It was our first experience at the hospital and we were very tense. Mr Giuliani was a perfect choice, we knew we were in safe hands from the first visit. We were impressed by the whole process, professionalism, personal touch and knowledge of the doctor and his team. Please do not hesitate to use his services, we are highly recommending Mr Giuliani!"

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