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

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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

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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.

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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.

What You Need to Know about Having your Baby Circumcised

As a parent of a newborn boy, you may feel nervous at the prospect of having him circumcised, how it will affect him and at what stage this would be best. Although many procedures are carried out on older children, there is no minimum age limit before a baby can be circumcised and having the procedure earlier on may lower the costs and risks associated with the general anaesthesia that is needed in procedures on older children.

Circumcision is when the loose skin, known as the foreskin or prepuce, which covers the end of your baby’s penis is surgically removed. The foreskin covers and protects the top part of the penis and contains nerves, blood vessels, and a tiny amount of muscle. In the circumcision practice, babies are counted as those under the age of three months. A circumcision on babies or children under the age of five is rarely for medical reasons, and is usually carried out as a family decision, for social and cultural reasons, or as part of Islamic or Judaic religious traditions.

circumcision for babiesCarrying out the procedure

The World Health Organisation guidelines state that a baby must weigh more than 2.5kg in order for the circumcision to be carried out. It is safe for your newborn boy to undergo the procedure at any stage taking his weight into consideration, however, it’s advisable that if your baby is premature, you should wait until he is older to take into account how early he was when calculating his readiness.

For newborn babies, your surgeon is likely to use a local anaesthetic to numb the area. This will be either via an injection at the base of the baby’s penis, or the application of a cream, around an hour before the procedure. The procedure itself is considered to be minor surgery and won’t take long – there is no need for you or your baby to stay overnight at the clinic or hospital. If your baby is being circumcised for non-medical reasons, both parents must give their consent.

The Plastibell Circumcision Technique

The majority of babies, infants and toddlers undergo the Plastibell circumcision technique, which is an established and safe procedure. The method uses a clear plastic ring with a handle and a deep groove running around it, placed over the head of the penis. It is then covered over by the foreskin and the excess skin is carefully trimmed off.

The entire circumcision procedure takes 10 to 15 minutes. The ring falls off within 10 days, leaving a small wound that will heal over the following weeks – no stitches are required.

The largest sized Plastibell that is available is 1.7cm in diameter. Therefore, for a small percentage of babies, one of the formal surgical circumcision techniques may be the most suitable, which can be discussed in the consultation with your baby’s doctor.

How to prepare

There aren’t many special preparations you’ll have to make before the operation, though we’d advise that you change your baby’s nappy and keep a clean one ready to change him into after the surgery is complete.

We’d also recommend that you give him a bottle of sugary water to drink during the injection and the circumcision procedure, as this is a good way to help calm and settle babies or very young children. Although parents may feel more at ease staying in the operating room during the entire circumcision procedure, it can be a stressful time for parents and you may feel more comfortable waiting outside until it has been carried out.

As part of an award winning health care provider throughout Birmingham and the West Midlands, Birmingham Circumcision Clinic carry out safe and professional circumcision services on babies, children of all ages and adults. If you’d like to find out information about our circumcision clinic or have any questions, please contact us on 0121 250 0386, or email circumcision.bham@nhs.net.

Common Questions That Adults Ask About the Circumcision Procedure

When preparing for adult circumcision, to ensure that you are as happy as possible with the results, it’s always important to learn as much as possible about the procedure. Whilst your doctor will provide you with extensive information about circumcision and aftercare, it is always wise to ask any questions that might have before your procedure.

There are a number of questions that adults ask prior to their circumcision, whether the procedure is for cosmetic reasons or otherwise.

1. What style of circumcision will the doctor perform?

Before the procedure is carried out, it is always advisable to ask your doctor what style of circumcision they will perform. This will give you a better idea of how your penis will look and where any scarring will be.

The most common styles of circumcision are:

  • Medium
  • High and Loose
  • High and Tight
  • Low and Loose
  • Low and Tight

The different styles of circumcision refer to how much of the outer and inner skin of the foreskin is removed, as well as where the scar line will be positioned. If you have chosen to be circumcised for cosmetic reasons, it is important to learn exactly where the scar line will be placed to be sure that the procedure will provide the aesthetics that you are looking for.

2. What surgical technique will the doctor use?

The most common surgical techniques for adult circumcision are:

  • Sleeve resection circumcision
  • Forceps guided circumcision
  • Dorsal slit circumcision

Doctors should discuss with the patient the best technique to use for the individual on the day of the surgery. At Birmingham Circumcision Clinic, we will usually perform the sleeve resection technique as this technique provides better cosmetic results than either the forceps guided or dorsal slit circumcision techniques. This technique requires a high level of surgical skill.

3. Will the frenulum be removed as part of the circumcision procedure?

The frenulum is very sensitive and as a result, many men choose to keep it. However, in cases where the frenulum is overly tight, it should be removed as it would break as a result of circumcision. Generally, most men choose to keep the frenulum if it is normal.

4. What type of stiches are used for circumcision?

At Birmingham Circumcision Clinic, we use stitches that dissolve after around two weeks and as a result they do not need to be removed. Some doctors may use extremely fine, non-dissolving stitches that can be removed without causing much discomfort.

If you have any more questions about adult circumcision, you can visit the Birmingham Circumcision Clinic website, or call us on 0121 250 0386 to talk to one of our team.

Circumcision in Older Children

Whilst many boys are circumcised as a baby or an infant, circumcision for older children is also fairly common. In some cases, parents may wait for their children to be circumcised at an older age, or circumcision may not be suitable at birth due to medical reasons. For some boys, circumcision may be required or becomes beneficial during later childhood.

There are a number of reasons that circumcision may not be suitable for babies and young children, for example:

  • The child may have been born premature, making an operation like circumcision dangerous.
  • The child may be ill, so a simple operation like circumcision isn’t in the best interests of a child’s health.
  • There may be a problem with a child’s penis so circumcision can’t be carried out until a problem is fixed. For example, the urinary opening of the penis may be in the wrong place, the penis may be bent, or the penis may be partially attached to the scrotum.

Some boys are circumcised as older children, not because circumcision was not possible when they were infants, but because medical problems may occur to make circumcision a necessary solution. There are a number of medical problems that circumcision is used to treat:

Birth defects

In some cases, although the penis may be defected from birth, a boy may have to wait until they are older to be safely and successfully operated on to correct the problem.  In some cases, circumcision may be carried out at the same time as corrective surgery.

Urinary tract infections

In some extreme cases, circumcision may be carried out on boys that are prone to urinary tract infections. Some research suggests that boys that are circumcised are less likely to suffer from UTIs. In most children, UTIs are extremely rare after the first year of life and when they do occur, they are mild.

Balanitis

Balanitis is the inflammation of the head of the penis, however, more often than not, the foreskin is also affected. The symptoms of balanitis include redness and swelling around the head of the penis and foreskin, pain when urinating, a thick discharge between the head of the penis and foreskin, combined with itchiness, and often an unpleasant odour. This condition can occur when the foreskin is tight, preventing boys from cleaning their penis properly. In recurring cases of balanitis, circumcision can be a recommended treatment.

Phimosis

Phimosis is a condition where the foreskin is tight and can’t be pulled back over the head of the penis. Many boys can’t move their foreskin all the way back until around 10 years of age, however, by the time they reach puberty, they should be able to do this easily. Boys that suffer from phimosis may experience a number of problems; in some cases, when the foreskin is too tight, they may have problems urinating as urine collects in the foreskin and balloons out, or in some cases, the foreskin may pull back, but not pull forward again. This can cause the head of the penis to swell and be very painful. Circumcision is commonly recommended for boys suffering from phimosis.

If you feel that your child may require circumcision, or at least that circumcision may benefit them, you can call Birmingham Circumcision Clinic on 0121 250 0386 to make an appointment.

Patient Feedback for November 2014 – May 2015

At Birmingham Circumcision Clinic, we are committed to providing the best possible care and aftercare services for our patients. In order for us to understand what changes we can make to improve our services and ensure patient satisfaction, we ask all patients to fill in a questionnaire that rates their experience of Birmingham Circumcision Clinic, from their initial enquiry, through to aftercare treatment and advice.

How did you find out about the Birmingham Circumcision Clinic?

To get a better understanding of where our patients found out about us, we asked them whether they learned about Birmingham Circumcision Clinic through an Internet Search, a TV Advert, a Poster/leaflet, a Recommendation, or any other source.

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For what reason are you having the circumcision procedure carried out?

After each procedure, we ask our patients for more information on the reason that they chose to have the circumcision procedure carried out, for example; faith, personal reasons, or any other purposes.

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Did we offer you a choice of appointment dates and times?

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Did your appointment letter tell you what you needed to know?

We are committed to ensuring that all patients are provided with all the information that they need. If you are a patient and have any further questions about the circumcision procedure, please visit our website.

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How would you rate the reception/admin service that dealt with you?

We asked our patients to rate our reception/admin service as either Excellent, Good, OK, Poor or Unsatisfactory.

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How would you rate the length of time you waited to be seen?

In order for us to improve our waiting times, we asked our patients to rate the length of time they waited to be seen as Excellent, Good, OK, Poor, or Unsatisfactory.

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How would you rate the Nurse you saw today?

We asked our patients to rate our Nursing staff and are very pleased that the majority of people found our Nurses to be excellent.

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How would you rate the Doctor you saw today?

Feedback for our Doctors was extremely positive, with the majority of patients finding the Doctor that they saw to be excellent.

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How would you rate the overall service you received today?

We asked our patients to rate their overall service as again, Excellent, Good, OK, Poor or Unsatisfactory.

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At Birmingham Circumcision Clinic, in order to continually improve on our standards of care, we take all patient feedback very seriously and always look to make any changes that may help to give patients a better experience with us. For more information on our services, please visit www.circumcisionbham.co.uk.

 

 

 

 

Adult Circumcision Techniques and Styles

At The Birmingham Circumcision Clinic, we pride ourselves on the fact that our surgeons are highly skilled and trained and capable of carrying out circumcisions in all age groups. Our youngest patient to date has been 5 days old and our oldest, 56 years.

Adults decide to get circumcised for numerous reasons. At our centre we have carried out adult circumcisions for cosmetic, personal hygiene, religious/cultural as well as medical reasons. The common medical conditions that have led to some of our adult patients seeking a circumcision are phimosis and BXO (Balanitis Xerotica Obliterans). We have also “re-done” previous circumcisions carried out at other clinics. Whatever the reason for circumcision, our doctors make every effort to ensure that the cosmetic outcome is satisfactory to the patient.

The most preferred method of adult circumcision at The Birmingham Circumcision Clinic is the “sleeve resection” method. According to the World Health Organisation manual on Adult Male Circumcision, the sleeve resection method requires good surgical skill and cosmetic results are better than the forceps guided and dorsal slit method. At our circumcision centre the surgeons have the skill to carry out all three methods and will at times, when necessary, combine or modify the methods. This is because every patient is different and the experienced and skilled surgeon will be able to choose and adjust the circumcision method that is suitable for a specific patient.

The style of circumcision is also important to adults who seek to have the procedure carried out for cosmetic reasons. The commonly known styles of circumcision are: Medium, Low & Loose, Low & Tight, High & Loose and High & Tight. These differing styles of circumcision are dependent on how much outer and inner skin is removed and where the scar line is placed. Some men also prefer for the frenulum to be removed (frenulectomy).

The angle of the scar line is also important to those adults who seek a cosmetic circumcision. Again, the sleeve resection method allows for the “V” scar to be placed on the ventral aspect of the penis. This style of scar follows the natural outline of the sulcus of the penis and cannot be achieved with the forceps guided method of circumcision.

During the pre-operative consultation the doctor will discuss all of these issues with the patient and decide on the best procedure and style of circumcision.

For more information on Adult Circumcision procedures and what to expect following treatment, please visit our website.