The Circumcision Process – Before, During and After

There is no doubt that surgery can be a frightening and worrying experience for anyone, adults and children included. When it comes to circumcision in boys, knowing what to expect can go some way in alleviating any anxiety and may prepare them for what is to come.

At The Birmingham Circumcision Clinic, we like our patients and their families to be in the know, which is why we have  come up with a brief ‘before, during and after’.

Before Surgery:

Prior to surgery, the doctor will  explain the procedure along with its risks. You will need to tell the doctor about any medical conditions or  medicines your child is taking just in case they have any side effects that may impact the circumcision surgery. For example, if your child is taking the blood thinner warfarin, it is important for the doctors to know as it can increase the risk of bleeding.

It can be  challenging for parents to alleviate a child’s anxiety about surgery, Explaining the process along with the reason for circumcision at a level of your child’s understanding, may help calm his nerves. When talking to your child try to avoid words such as ‘cut’ or ‘sew’.

We encourage parents to plan the circumcision during the school holidays, however if the procedure is during term time you will need to inform the school of his surgery, allowing a few days off for the recovery period

Surgery Day:

You should ensure you have read all the documents we have sent you. Your child can eat and drink as normal.

If closer to or on the day of surgery, your child becomes unwell you should contact the clinic to seek further advice about whether to reschedule or attend the appointment.

Packing something that your child finds comforting is key in making them feel more relaxed. Whether it’s a stuffed toy or his favourite DVD, remember to take something that reminds him of home.

Both parents or guardian must attend  with the child to sign the  relevant consent forms before the operation takes place. . After surgery, you and your son will be taken to the recovery room, the doctor will check your child and all being well you will be discharged. Your whole booking including discharge is approximately 1 hour long.

Going Home:

Your child will probably be slightly drowsy for the rest of the day and should be encouraged to rest. Before you go home, your doctor will give you clear instructions on when your son can resume normal activities and give any further advice on how to manage him at home.

If you have any concerns, or if your child becomes ill  after the surgery, you should call the mobile number you will be provided with. This is part of the aftercare and is available 24 hours a day.

For more information on the circumcision process, please see here. If you have any further questions you can call us on: 0121 250 0386, or email: circumcision.bham@nhs.net.

An A-Z of Circumcision

It can be difficult to understand all of the medical terminology related to surgical procedures, so we have put together an A-Z of circumcision that aims to be a useful point of reference for you.

Whilst there are many words related to circumcision, we have picked the top ones that we think you could come across. But if you read a word that is not listed below and you would like it explaining, please feel free to contact the clinic and one of our team will be able to help.

 

Anaesthetic: This is a substance that causes a lack of feeling or awareness during the procedure.

 

Ballooning: A condition where urine cannot escape from the tip of the foreskin as fast as it is flowing from the bladder. The foreskin may become swollen, which can be painful and could cause potential bladder and kidney damage.

 

Circumcision: The process of removing the foreskin, through minor surgery. It can be removed for a variety of reasons, from religious reasons and medical problems to sexual pleasure.

 

Dorsal Slit: The phrase ‘dorsal slit’ refers to an incision made through the top surface of the foreskin that exposes the glans.  In some societies, it is classed as a circumcision.

 

Epispadias: This is a rare penis malformation in which the urethra ends on the top side of the penis instead of the tip of the glans, which results in urine and semen being discharged at an abnormal position.

 

Frenulum: A web of skin that helps the foreskin to retract during an erection and return to normal when flaccid. After circumcision, it may be retained or removed.

 

Glans: The rounded part at the end of the penis that forms its head.

 

High: In circumcision, this term is used to describe the position of the scar line. It means closer to the penis base and further away from the glans.

 

Intact: Uncircumcised.

 

Meatus: The opening of the urethra at the end of the glans.

 

Neonatal: Relating to the new born child.

 

Overhang: The portion of the foreskin that extends beyond the tip of the glans.

 

Phimosis: This is a condition where the foreskin is too tight to be drawn back over the glans. This is readily corrected by circumcision.

 

Redundant Prepuce: A foreskin that ‘overhangs’ the penis when it is flaccid.

 

Skin Bridge: A natural and often unintended sticking together of two skin surfaces. These sometimes form between the circumcision scar and the corona, and can be corrected by minor surgery.

 

Tyson’s glands: These secretory glands are located on either side of the frenulum and produce an oily lubricant for the foreskin.

 

Urethra: The tube through which urine and semen flows.

 

Ventral: An anatomical term that means ‘the underside’ of something.

 

At Birmingham Circumcision Clinic, we always like our patients to feel as well informed as possible. If you would like to find out further information, please call our specialist team on: 0121 250 0386 or read our ‘complete guide to circumcision’.

Methods of Circumcision

Whilst we recognise that there are a number of methods of circumcision for adults, children and babies, at Birmingham Circumcision Clinic, we prefer to carry out the following techniques:

Circumcision Methods for Adults and Boys

For adult men, and boys of between the ages of 2 and 16, formal surgical techniques are used:

Sleeve Resection

Sleeve resection is a freehand method. It is the preferred method for adults as it provides better cosmetic results than forceps guided or dorsal slit circumcision. This method requires a highly skilled surgeon and is carried out under a local anaesthetic.

In this procedure, the foreskin is slid back along the shaft of the penis so that a freehand cut can be made around the shaft at the point where the scar line will be placed. The foreskin is then returned to cover the glans (head of the penis) and a second cut is made around the shaft at the same position along the penis as the first cut. A longitudinal incision is then made between the two cuts around the circumference of the penis and the strip of skin is removed. The edges are then pulled together and stitched.

Forceps Guided

The guided freehand method is sometimes used for adults and older boys. In a forceps guided circumcision, the foreskin is pulled out past the front of the glans. Locking forceps are then clamped across the foreskin, immediately in front of the glans and parallel to the base of the glans. A cut is then made across the forceps to remove the foreskin, whilst the glans is protected by the forceps.

Dorsal Slit

This method of circumcision is sometimes recommended for patients suffering from phimosis, when the foreskin cannot be pulled back over the glans, or paraphimosis, when the foreskin cannot be returned to its normal position.

We understand that every patient is different, so we will also choose the right circumcision method to suit the individual. In some cases, when necessary, our highly experienced surgical team will combine or modify methods of circumcision.

Circumcision Methods for Infants and Babies

The Plastibell

For boys under 2 years of age, the most common circumcision technique uses the Plastibell. This is a clear plastic ring with a handle and deep grooves running around it. After a local anaesthetic is administered, the penis and foreskin are gently separated. To place the Plastibell in position, a small cut is made from the top of the foreskin and it is pushed back.

Once in place, the Plastibell is covered over by the foreskin and tied in place. The excess foreskin is carefully trimmed away and then the handle of the Plastibell is broken off. After around 10 days, the ring falls off, leaving a small wound that heals over the next few weeks without the need for stitches.

If you have questions about circumcision, please feel free to contact the Birmingham Circumcision Clinic on 0121 250 0386, or by completing our online enquiry form.

Circumcision for Toddlers

If you feel like you’ve missed the window to get your son circumcised, you need not worry. Here at the Birmingham Circumcision Clinic, we are experts in the matter.

We have highly skilled doctors who are able to perform the procedure in the most effective way. Whether your child is still a baby or a toddler, our experienced surgical team are well equipped to treat children of all ages.

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Our Specialists:

Whether you are opting for your toddler to undergo circumcision for religious or medical reasons, it may be helpful to know that we offer a great after-care service. From advice on how to clean him, to the medication given, our specialists are there for you from beginning to end.

Benefits:

Whilst it may seem like a drastic procedure, circumcision does not actually have any negative health implications. On the contrary, it has a rather long list of health benefits, having been scientifically proven to reduce the risk of sexually transmitted diseases in men. It also protects against penile cancer and reduces risk of cervical cancer in female sex partners. Circumcision can also prevent inflammation of the gland and foreskin.

Why circumcise when your son is a toddler?

There are many reasons why parents prefer their child to be circumcised at a very young age, and although the procedure is usually performed a few days or weeks after birth, some parents may wait until their son is a toddler. In some cases, babies may not have been strong enough for the procedure shortly after birth and so circumcision is instead delayed until they are a little healthier and at a steady weight. Delaying circumcision can also allow new parents to get used to changing nappies and caring for their son.

From a religious perspective, it’s good to circumcise your child at a young age so that he will see this as normal practice as he grows older and will be able to understand the religious significance of circumcision.

Book your consultation

If you need further information about circumcision, please read our complete guide.

Happy New Year – A Look Back at Our Blogs From 2016

ladyandsleepingbabyAs we start 2017, as well as making new plans, the New Year is also a great time to reflect on what we have achieved. In 2016, we published regular blog posts, which we hope that you have found useful and informative.

We believe that the more information you have about circumcision, the better informed you are to make important decisions. We thought that we would look at some of the articles we wrote for you last year and present you with some of the highlights. If you want to learn more, just click on the link to the original articles.

We started the year looking at Aftercare for children or adults who have had circumcision surgery. It is important to differentiate here as aftercare does differ dependent on your age. Put simply, this is because procedures vary at different ages. Aftercare for babies and young children is relatively simple, including regular daily washing of the healing area, preventing unnecessary touching, and watching out for any signs of bleeding or unexpected swelling, irritability or difficulty passing urine.

Older children and adults can expect stitches to dissolve in the weeks following the circumcision. Keeping the area clean is vital, as is the careful redressing of the wound. For comfort, it is advisable to wear supportive underwear that helps prevent friction, at least for a short while.

Our June article provided a little more detail about What to expect if your baby has been circumcised. With the seven signs to watch out for during the healing process and some techniques for safe and effective cleaning and bathing, this provided extra information for parents.

In September, we discussed How adults can best prepare for circumcision surgery. Everyone wants their procedure and aftercare to go smoothly and this is often helped by a few earlier preparations. Avoiding alcohol prior to surgery, making sure the team are aware of any medications you are taking and arranging for transport home following the procedure are all useful tips for someone preparing for their circumcision.

Many people ask us about The health benefits of circumcision, so in April we thought it would be useful to put some of the main points together. Did you know for example that men’s health experts have concluded that circumcision can help solve some fertility problems? It has also been found that circumcision can help the risk of an STD and lower the risk of penile cancer.

We look forward to providing you with more important information about circumcision and the care that you can expect from the Birmingham Circumcision Clinic in 2017. If you have any questions, just give our friendly team a call on 0121 250 0386 or contact us via our website and we will be glad to help.

Circumcision in Baby Boys – Information for Parents

Whilst some parents choose to circumcise their infant son for religious or cultural reasons, for some parents, making the decision is difficult. As with any surgery, parents may be worried about whether the benefits of circumcision outweigh the risks involved in the procedure. Another common reason for indecision is because parents, particularly fathers, are concerned about the appearance of their son’s penis in comparison to other males. When making such an important decision, it’s crucial that parents are educated about circumcision and feel comfortable discussing their concerns or questions with a doctor.

Health benefits of circumcision

If you are considering circumcision for your child, it’s important to read up on the related health benefits:

  • Smaller risk of UTIs – whilst urinary tract infections are quite uncommon in males, the greatest risk is in infants of less than a year old. Studies have found that circumcised infant males are at a lower risk of UTIs when compared with uncircumcised babies.
  • Hygiene – It can be argued that it is much easier for circumcised males to maintain proper hygiene. Uncircumcised males must regularly clean the space between the foreskin and head of the penis (glans), making it more difficult.
  • Protection against infections – studies suggest that circumcision can help to decrease the risks of viruses such as HIV, HPV and Herpes simplex virus type 2, as well as protecting against other problems such as trichomonas and chancroid infections.
  • Penile cancer – whilst penile cancer is rare, due to the difficulties that can be involved with keeping good hygiene, uncircumcised men face an increased risk for developing the disease.

The associated risks of the infant circumcision procedure

As is the case with any surgical procedure, no matter how simple, there are some risks involved with carrying out circumcision on an infant boy, however, complications during the procedure and within the first month post-surgery are extremely low. Some bleeding is common during the procedure, however, this is usually only very minor and can be controlled by a doctor, providing local pressure.

As with any surgery, there is a risk of infection following infant circumcision, however, parents can help to prevent this by ensuring that the penis is kept clean as it heals. Your doctor can provide advice on the best aftercare practices to help prevent infection.

Where to find guidance on circumcision

If you are a parent and have chosen to have your baby circumcised, or are in the process of making the decision, it is always wise to consult your doctor with any questions that you may have. At Birmingham Circumcision Clinic, operating from The Laurie Pike Health Centre in Aston, we carry out circumcisions for religious, cultural and hygienic reasons and we encourage parents to contact our team at any time with any questions or queries.

Call today on 0121 250 0386 to talk to our specialist team.

What to Do Before Adult Circumcision Surgery

Whilst most circumcised males undergo the procedure as an infant or child, it’s not uncommon for men to choose to be circumcised as adults. As well as understanding what will be involved in the surgery, along with the associated options, risks and benefits, there are also a number of things that adults will need to do before undergoing the adult circumcision procedure to ensure that they are fully ready and prepared.

Preparing for adult circumcision surgery

  • Inform your doctor of all medicines and natural health supplements that you take. Some medicines and products can increase the risk of bleeding during surgery, or interfere with anaesthesia. You may need to stop taking certain medicines a week or so before surgery, for example, if you take blood thinners, your doctor will tell you stop taking these medicines. It’s essential to fully understand what your doctor wants you to do and why.
  • You should avoid eating or drinking at least 6 hours prior to surgery if you will be under general anaesthetic. This doesn’t apply for patients under local anaesthetic.
  • Men are advised to clean and shave the pubic area before surgery for hygiene reasons. It’s also recommended that you bring tight fitting underwear to wear after the circumcision procedure as this helps to keep the surgical gauze in place. Tight underwear should be worn after the procedure until the swelling and soreness reduces.
  • You should arrange for someone to drive you home after the operation. After any kind of anaesthetic, general or local, it’s not advisable to drive on the same day as your reactions are likely to be slower than normal.
  • Avoid alcohol in the 48 hours before your circumcision as alcohol can prevent anaesthetic from being fully effective. Alcohol can also leave you dehydrated.
  • Ensure that you have arranged time off work to allow you to recover from the circumcision procedure. To help you to heal and recover as quickly as possible, rest is important. The discomfort associated with surgery can also be a big distraction at work, so a few days off are always a good idea, especially if your job includes manual work. Your GP can provide a sick note that states you are having minor surgery if you feel embarrassed about telling your employer about your circumcision.
  • If you are a smoker, it’s advisable to stop smoking before your surgery as this can interfere with the healing process.

If you have questions about the adult circumcision procedure, you can contact the specialist team at Birmingham Circumcision Clinic today. For help and guidance, call 0121 250 0386.

Caring For Your Baby Following Their Circumcision

Whether you have decided to have your son circumcised for hygiene, medical, cultural or social reasons, it’s perfectly normal to be a little nervous about the circumcision procedure and caring for your baby’s penis afterwards until it heals. However, whilst the penis may appear fragile, infant circumcision is a simple operation and is much less traumatic than some parents might imagine.

In most cases, circumcision in babies is usually carried out within 10 days after birth. At Birmingham Circumcision Clinic, our youngest patient to date has been 4 days old. Providing that your baby weighs more than 2.5kg, circumcision is safe, unless there is a contraindication to say otherwise. Once the operation is complete, your son’s circumcised penis will normally heal in around 7 to 10 days. In the mean-time, you should be sure to follow these instructions:

Keep the penis clean

This is the most important element of circumcision care for newborn babies. Whenever you change your child’s nappy, be sure to gently wipe away any faeces or urine, using warm water and unscented soap rather than a baby wipe. Until your child’s penis is healed, stick to sponge baths rather than getting the area wet in a bath. To avoid irritating the wound, leave the area to dry naturally.

Keep the penis protected

After the circumcision surgery, a light gauze with petroleum jelly is placed on your son’s penis, however, this will normally fall off the next time that they urinate. In some cases, it may be necessary to replace this with a clean dressing to help keep the penis clean until it heals.

Make sure your child is healing properly

It is perfectly normal for the tip of a circumcised baby’s penis to appear red and a small amount of yellowish secretion is also expected – this means that the body is healing the area. Even a small amount of blood shouldn’t ring alarm bells. However, there are a number of symptoms that you should look out for:

  1. Continued bleeding
  2. Redness that persists for more than 5 days after the operation
  3. Yellow discharge that lasts for more than a week after the operation
  4. Swelling
  5. Fluid-filled sores
  6. Trouble urinating normally
  7. Signs of fever

Once your baby’s circumcision is healed, it’s important to continue to keep the penis clean by wiping away any stool or urine and bathing your child regularly, gently wiping the groove under the head of the penis.

At Birmingham Circumcision Clinic, your surgeon will always discuss aftercare in detail and provide you with an extensive written guide so that you will know what to expect once you get home. We also provide a telephone number that will allow you 24 hour access to the doctor so that you can get in touch in the event of any worries or problems.

To book an appointment, you can call our administrative team on 0121 250 0386, or if you prefer, leave a voice message or send us an email to request a call back at a time that best suits you.

The Health Benefits of Circumcision

Whilst the circumcision procedure is still most commonly carried out on babies and young children,  there is a steady increase in the number of adult men that were not circumcised as infants, who are now choosing to be circumcised for health reasons.

Men’s Health experts have explained that circumcision can have a number of health benefits:

Circumcision can help to reduce the risk of STDs

Data from US governmental sponsored trials suggest that the circumcision procedure may help to prevent the spread of viral STDs, including Herpes, HIV and HPV (human papillomavirus), which is linked to genital warts and cervical cancer. The theory amongst Men’s Health experts is that the foreskin acts as a reservoir for the secretions that contain STD viruses.

Circumcision can lower the risk of Penile Cancer

Whilst Penile Cancer is very rare, the disease is virtually non-existent in men that have been circumcised. Scientists suggest that like cervical cancer, Penile Cancer may be instigated by HPV; as circumcision is believed to reduce the risks of HPV, this suggests that the procedure also reduces the chances of a man developing Penile Cancer.

Circumcision can help solve some fertility problems

Some uncircumcised men suffer from the inability to retract the foreskin; this is known as Phimosis. When the foreskin is too tight, this can cause some problems during sex and with fertility, as well as Balanitis. This is a condition where the head of the penis becomes red, itchy and inflamed –  it is much more common in uncircumcised men and is harder to eradicate as the head of the penis is always covered.

Circumcision remedies Phimosis as the foreskin is removed and as a result, Balanitis is far less likely to occur. When these problems are removed, fertility is rarely a problem.

At the Birmingham Circumcision Clinic, whatever the reason for adults deciding to be circumcised, our surgeons will make every effort to ensure that the cosmetic outcome of the procedure is of a high standard. Our experienced surgeons will discuss the methods available and choose and the circumcision method based on what is best suited to the individual patient.

To learn more about the adult circumcision procedure, you can visit our website. If you have any further questions, you can contact us by emailing circumcision.bham@nhs.net or by calling 0121 250 0386.

Circumcision Aftercare for Babies, Infants, Older Children and Adults

At Birmingham Circumcision Clinic, we are committed to providing excellent aftercare for patients of all ages. As well as talking about aftercare in detail after the procedure, we also provide an extensive written aftercare guide to be taken home to ensure that both patients and/or parents understand what to expect and how to take care of the wound as it heals.

We also encourage patients and parents to contact us should they have any questions relating to the circumcision and provide them with a telephone number for 24 hour direct access to the doctor that carried out the procedure.

As the circumcision procedure differs for babies and infants, and older boys and adults, aftercare also differs. In general, for babies who are circumcised using the plastibell technique, it normally takes around 10 days for the wound to heal. As the circumcision procedure for older children and adults is more complicated, the healing process can take around 4 to 6 weeks.

Circumcision Aftercare for Babies and Infants

circumcision aftercare

Aftercare for babies and infants is fairly simple, however, parents should contact their doctor should their boy have trouble passing urine, if they are unusually irritable, or if there is any sign of bleeding or swelling.

It’s important to also follow these tips:

  1. Parents should wash their boy on a daily basis – at least once.
  2. It’s important not to interfere with the wound as it heals, other than making sure it is clean.
  3. Infants may want to inspect the circumcised area – it’s important to consider that too much touching could increase the possibility of infection, so parents should keep a watchful eye on their child.
  4. If healing is not as described in the aftercare guide, parents should contact the doctor immediately. Whilst a little swelling occurs within 24 hours of the operation, this is likely due to the needle used for the anaesthetic, however, any swelling after 48 hours or so should be reported to the doctor.

Circumcision Aftercare for Older Children and Adults

circumcision aftercare

At Birmingham Circumcision Clinic, we use dissolvable stitches which will dissolve over 2 to 6 weeks, so they will not need to be removed by a doctor. After the circumcision procedure, it is normal for the patient’s penis to be swollen and appear bruised; this will gradually reduce over the next week or 2.

After treatment, patients may wish to wear supportive underwear that will hold the penis in position as loser underwear may lead to increased friction as the penis swings freely.

The penis is bandaged around the wound – after 4 or 5 days it’s important to change the dressing. As the bandage is likely covered in blood, rather than peeling it straight off, it’s important to soak the bandage first. Patients are advised to fill a bath with just enough water to cover the groin completely; salt can also help to promote healing. Once the dressing is soaked, it should be easier to detach from the penis without opening the wound.

The gauze should always be removed slowly, the patient stopping whenever any force is needed – as the water soaks the gauze and clotted blood so that it can be removed freely again. Once the bandage is removed, bloody water should be washed away and replaced with more lukewarm, salty water, allowing the penis to be soaked for a further few minutes to remove any blood.

circumcision aftercare

Once the penis is clean, it should be patted clean with a new gauze pad and then redressed. A small amount of Vaseline can help to prevent the new bandage from sticking to the skin. This whole process should be repeated every 2 days until the second week after the procedure.

Whilst time off school or work isn’t essential, it can be difficult to concentrate for the first few days after the circumcision procedure due to initial discomfort, so it is advisable to take a week off, or if a patient’s job involves heavy lifting, or being seated for long periods without being able to move freely, two weeks may be sensible.

If you have any questions about circumcision aftercare, please contact Birmingham Circumcision Clinic on 0121 250 0386, email circumcision.bham@nhs.net or fill out our online enquiry form.