Circumcision Problems

DEFINITION

• Recent circumcision, questions or concerns about
• Mainly addresses circumcision of newborns

• A circumcision is the removal of most of the male foreskin.
• The incision is initially red and tender; the tenderness should be minimal by the third day.
• The scab at the incision line comes off in 7 to 10 days.
• If a Plastibell (plastic ring) was used, it should fall off by 14 days (10 days on the average). While it cannot fall off too early, pulling it off can cause bleeding.
• Complications: Wound infections occur in less than 1 out of 200 circumcised boys. 

WHEN TO CALL YOUR DOCTOR

HOME CARE ADVICE FOR CIRCUMCISION PROBLEMS

1. Reassurance:
   • The tip (head) of the penis is normally very red after the foreskin is removed.
   • The shaft of the penis should not be red.
   • Most circumcisions heal easily.
   • Infections are rare.
2. Plastibell Ring: Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.
3. Incision (No Plastic Ring is Present):
   • Remove the dressing (which is usually gauze with petroleum jelly) with a warm wet washcloth 24 hours after the circumcision was done. Often, the gauze has already fallen off on its own.
   • Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.
4. Ointment for Pain:
   • Apply a layer of ointment to the incision line. This should reduce any pain and crying.
   • To prevent pain, also apply petroleum jelly or an antibiotic ointment (no prescription needed) to the incision line and head of the penis after each cleansing for the first 4 days.
   • Reason: to keep it soft and prevent the diaper from sticking during healing.
5. Bleeding:
   • The circumcision wound can normally bleed a few drops.
   • Cause: usually friction from a diaper
   • Will stop on its own or with a few minutes of direct pressure
   • Can prevent by keeping the area soft with an ointment
6. Expected Course For Plastibell Ring:
   • The plastic ring will normally fall off between 7 and 14 days (average 10).
   • It often hangs by a small piece of tissue for a few days.
   • Pulling it off can cause bleeding.
   • It can't fall off too early.
7. Prevention of Infections: Fasten the diaper loosely to prevent friction against the penis. Avoid tub baths until 2 days after the cord has fallen off.
   
8. Call Your Doctor If:
   • Looks infected
   • Large bleeding occurs
   • Minor bleeding recurs 3 or more times
   • Plastibell ring moves onto shaft of penis
   • Plastibell ring does not fall off by day 14

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.