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.

The Dangers of Circumcision from an Unlicensed Practitioner

Understandably, as with any surgical procedure, there are some risks associated with circumcision, for example, pain, a risk of bleeding and infection, irritation of the glans (head of the penis) and some risk of further injury should patients not follow aftercare instructions.

At Birmingham Circumcision Clinic, we provide comprehensive aftercare services to ensure that there are no complications after the procedure. We give round the clock access to a doctor, as well as comprehensive written aftercare information, informing parents and patients of exactly what steps they should follow after circumcision. Providing that patients take care to follow aftercare instructions carefully, any further risks are unlikely.

Whilst circumcision is a safe procedure when carried out by a licensed and experienced physician, unlicensed circumcision can lead to many complications, in some cases even resulting in death. Although death from a botched circumcision is extremely rare in the UK, unfortunately non-fatal complications from circumcisions carried out by unlicensed practitioners are much more common.

In a report by Manchester Royal Children’s hospital, it was found that around three cases of bleeding circumcisions were treated every month, whilst in 2009, in one Birmingham hospital, 105 boys were treated in A&E for complications related to circumcision, with a small amount of injuries being life threatening. Parents and patients place themselves in considerable danger by choosing an unlicensed practitioner to carry out a circumcision, as there is no proof that they are trained in this operation or that they are following the right procedures, raising a huge risk of pain, infection and future complications.

By visiting a licensed circumcision clinic, parents and patients can be sure that either they or their children will be treated by a highly trained physician under anaesthetic, in a sterile environment with strict infection control procedures, complete with the latest electro-surgical equipment that is used in advanced circumcision techniques. Before the procedure, the doctor will explain everything and answer any questions, ensuring that you understand what will happen during the circumcision surgery.

Whereas an unlicensed physician may not take proper care of a patient that may be put at risk by being circumcised, trained circumcision practitioners carefully examine all patients to make sure that they are healthy and that circumcision can proceed completely safely. To ensure that patients feel no pain during the procedure, they will be weighed beforehand to make sure that the correct dose of anaesthetic is used.

For men of different ages, there are different surgical techniques used to carry out circumcision. The surgical technique that is used is decided by the doctor, and explained to the patient. Untrained circumcision practitioners are far more likely to use an incorrect surgical technique, likely leading to complications.

To find out more about the circumcision service offered at Birmingham Circumcision Clinic, take a look at our guide. If you have any queries, call today on 0121 250 0386 to arrange an appointment or speak to one of our team.

Patient Feedback for July, August and September

At Birmingham Circumcision Clinic, in order to offer the best care and aftercare services for our patients, we ask our patients to fill in a questionnaire rating their experience with us in order to help us improve our services to ensure that all patients have a positive experience of Birmingham Circumcision Clinic, from an initial enquiry and booking and appointment, through to aftercare treatment.

How did you find out about the Birmingham Circumcision Clinic?

We asked our patients our patients whether they found out about is from an Internet Search, a TV Advert, a Poster/leaflet, a Recommendation, or another source. We are glad to see that in the months of July, August and September, a large percentage of patients found us through recommendation.

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

We asked our patients whether their reason for having the circumcision procedure carried out was due to their Muslim Faith, Jewish Faith, Christian faith, Cultural Reasons, Personal Hygienic Reasons, or for Other Reasons.

 

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

 

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

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

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

 

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

We are glad that a very high percentage of patients found that their appointment letter told them all that they needed to know. If you are a patient and have further questions, please feel free to contact us at the clinic and we will be glad to try and help you with your queries.

 

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

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

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

 

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

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

 

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

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

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

 

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

We asked our patients to rate the length of time they waited to be seen as either Excellent, Good, OK, Poor, or Unsatisfactory.

 

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

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

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

 

How would you rate the nurse you saw today?

We asked our patients to rate the nurse that they saw as either Excellent, Good, OK, Poor or Unsatisfactory.

 

How would you rate the nurse you saw today?

How would you rate the nurse you saw today?

How would you rate the nurse you saw today?

 

 

How would you rate the doctor you saw today?

We asked our patients to rate doctor they saw as either Excellent, Good, OK, Poor or Unsatisfactory.

 

How would you rate the doctor you saw today?

How would you rate the doctor you saw today?

How would you rate the doctor you saw today?

 

 

How would you rate the overall service you received today?

We asked our patients to rate the overall service that they received as either Excellent, Good, OK, Poor or Unsatisfactory.

 

How would you rate the overall service you received today?

How would you rate the overall service you received today?

How would you rate the overall service you received today?

 

We pride ourselves on offering patient-centric care, so our patient’s views are extremely important to all of our staff. By gaining valuable feedback from our patients, we can constantly look to improve the services that we provide. For more information visit www.circumcisionbham.co.uk.

 

 

 

 

Testimonial From Adult Circumcision Patient

After performing his circumcision in July, we received this testimonial from an Adult circumcision patient:

Good morning Dr Shafii,I would like to take this opportunity to thank you for your professional and excellent service which I had received in July.

The circumcision healing process went brilliantly and the instructions were spot on.

My friend who is meant to get his done is still considering.

Again I thank you, and I would not hesitate in recommending a friend.

Patient,
Omar Madden
Yorkshire

At Birmingham Circumcision Clinic, we are completely focused on offering patient-centric care, so that our patients and parents have a positive experience of our clinic, from booking an appointment, through to aftercare. We are always happy to receive feedback from our adult patients, or from the parents of infant patients.

For more testimonials, you can visit the Birmingham Circumcision Clinic website.

Phimosis and Circumcision

Phimosis is a condition in males where the foreskin is too tight to be fully pulled back over the glans (head of the penis). This is quite normal in babies and toddlers; most uncircumcised baby boys have a foreskin that will not retract, however, at around the age of two years old, the foreskin should start to separate from the glans.

Whilst Phimosis is generally not a problem to most males, it can in some cases lead to symptoms such as soreness, redness, swelling and even difficulty urinating. Should you or your child suffer from these symptoms, it is important to seek treatment immediately.

The swelling of the glans is known as Balanitis. This is a condition that is most common in uncircumcised males suffering from Phimosis, where the foreskin is too tight to retract, making it more difficult to thoroughly clean the penis. In some cases, if the penis is not kept clean, this can lead to a build-up of discharge called smegma which can irritate the skin, causing the glans and the foreskin to swell uncomfortably.

For many men who suffer from Balanitis, this can be treated with prescription-only medication such as antibiotics, however, in some cases of Phimosis, if Balanitis is persistent and other treatment is unsuccessful, circumcision is viewed as an option. Whilst other options such as medication or steroid cream to encourage the foreskin to stretch and retract will be suggested first, in some cases where Phimosis leads to persistent Balanitis, circumcision may be the best option to prevent the occurrence of any further problems.

Whilst Phimosis is a condition where the foreskin is too tight to be retracted over the glans, Paraphimosis is where the foreskin cannot be returned back to its normal position after being retracted. Linke Phimosis, this can lead to the glans becoming very painful, and requires immediate medical treatment to prevent complications that could occur from swelling and restricted blood flow to the penis.

Whilst Paraphimosis can usually be treated under a local anaesthetic, with a doctor pressing on the glans whilst pushing the foreskin forward, in some cases, a small slit may need to be made to the foreskin to help relieve pressure and bring it forward. In some more severe cases, or when it is likely that there will be further problems in the future, circumcision may be recommended.

If you or your child are suffering from Phimosis or Paraphimosis, and it has been recommended that you are circumcised, you can visit a circumcision clinic in Birmingham. Circumcision clinics offer specialist care and aftercare services, as well as state of the art facilities.

A Rise in Circumcisions during August

Approximately a third of males are circumcised throughout the world by adulthood, most individuals having been circumcised soon after birth, or prior to going through puberty. In the United Kingdom, a study that took place in 2000 found that 16% of males between 16 and 44 years old were circumcised, whilst 20% of men aged been 40 and 44 years old and 12% in the 16 to 19 year age group.

August was an incredibly busy month for us at Birmingham Circumcision Clinic as we saw a three-fold increase in circumcisions in babies, older boys and adults. As well as local patients, we saw adults travelling from York and Nottingham, and babies travelling from as far away as Ireland to undertake the procedure and benefit from our high quality care and 24-hour aftercare services.

We provide extensive written aftercare information so that all parents and patients understand what to do and what to expect after circumcision. We also provide 24 hour access to the doctor should parents or patients have any concerns or queries relating to the circumcision.

Throughout the month of August, our patients were circumcised for a number of different reasons. Including:

  • Religious
  • Cultural
  • Personal hygienic
  • Cosmetic

For more information on circumcision procedures for babies, young children, older children and adults, you can visit circumcisionbham.co.uk.