Your Complete Guide to the Circumcision Service at Birmingham Circumcision Clinic

How to book an appointment?

To book an appointment for circumcision please call the circumcision center and speak to a member of our administration team. You also have the option to leave a voice message or send us an e-mail to request a call back at a time that is convenient for you. Please see our contact details for more information.

What information is provided before the appointment?

After booking the appointment you will be sent detailed information about the circumcision procedure and aftercare service. This will allow you to read through all the necessary details and prepare any questions you may want to ask the doctor. You will also be sent directions to the clinic.

What documents will need to be brought on the day of the appointment?

For children under the age of 16 years old, you are required to bring along the child’s red book, birth certificate (if issued) and photographic ID (e.g. passport or driving license) for both parents. You will also need to bring along the information pack that will be sent to you after making the appointment.

Do both parents need to be present?

For children under the age of 16 years we require both parents to be present and sign the consent form. Exceptions to this rule apply to single parents and other similar cases. Please speak to one of our administration staff if both parents are not able to attend for the appointment and we will be able to advise you accordingly.

What will happen on the day of circumcision?

On arrival at the clinic please report to the front desk. You will take a seat in our waiting area and when the doctor is ready you will be called into the private operating room.

The information pack that you will receive prior to the appointment will contain details of the appointment, the consent forms and our refund and restraint policy. Please read these documents carefully.

Before the procedure you will have an initial consultation, during which you will have the opportunity to ask any questions you may have. Once you are happy, you will need to sign the consent form.

The patient will be examined by the doctor to make sure he is healthy and that the circumcision can proceed safely.

What type of anaesthetic is used and will my child feel any pain?

Before the circumcision, the penis is made numb by injecting a medicine around the base of the penis. This is called a local anaesthetic and ensures that there is no pain during the circumcision procedure. After the injection, the doctor will wait a few minutes for the anaesthetic to take effect, test the foreskin, and only when he is certain that the child is unable to feel localised pain, he will begin the circumcision. The type of anaesthetic we use can last for up to six hours.

Will my child cry?

Every baby and child is different. We have had babies and children who have not cried for the injection and have remained quiet during the entire circumcision procedure. Other babies and children start crying as soon as they are undressed and put on the bed.

One way to calm and settle babies and very young children is to give them a bottle of sugary water to drink during the injection and the circumcision procedure. We strongly advise this for all babies, infants and toddlers, even if they are breast-fed.

Will my child be awake?

We use a local anaesthetic to numb the penis. This means that the patient is not put to sleep. However some babies and young children find it soothing to suck the bottle of sweet water and can slowly fall off to sleep naturally.

Can parents stay in the room during the circumcision?

We encourage parents to stay in the operating room during the entire circumcision procedure. However some parents feel more comfortable to wait outside the operating room whilst the circumcision is being carried out. Sometimes other family members, like grandparents and aunts, remain with the child whilst the parents wait outside. We appreciate this can be an anxious time for parents and will try to accommodate whatever they are comfortable with.

Can we bring toys, computer games and other forms of distraction?

For some children it helps for them to watch or listen to something on an electronic device such as an iPad or mobile phone. Some children are distracted during the circumcision procedure by a song or cartoon that is playing on an electronic device. Older children may like to play electronic games whilst the doctor carries out the circumcision.

What method of circumcision is used for babies, infants and toddlers?

The Plastibell Circumcision Technique

Babies are classified as those boys under the age of 3 months, Infants are between the ages of 3 months to under 1 year and Toddlers are between the ages of 1 year and under 2 years old.

For the overwhelming majority of babies, infants and toddlers, we use the Plastibell circumcision technique.

The Plastibell is a clear plastic ring with a handle and a deep groove running around it. This was invented in America in 1950 and is now one of the most popular circumcision methods used in the UK, USA, Australia, and New Zealand.

After administering the local anaesthesic, the penis and foreskin are separated by gentle pushing. Then a cut is made from the top of the foreskin allowing it to be pushed back and the Plastibell to be placed in position.

The appropriate sized Plastibell is chosen and placed over the head of the penis. It is then covered over by the foreskin. A ligature is tied firmly around the foreskin in order to hold the skin against a groove in the Plastibell. Then the excess skin is carefully trimmed off. Finally, the handle of the plastibell is broken off at the end of the procedure. 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.

Formal Surgical Circumcision Techniques

The largest sized Plasibell that is available is 1.7cm in diameter. Thus in a very small percentage of babies, infants and toddlers the Plastibell method may not be suitable and one of the formal surgical circumcision teachniques may need to be used. The doctor will discuss this with you if the procedure becomes necessary.

The three formal surgical techniques are:

  • Forceps Guided Circumcision
  • Sleeve Resection Circumcision
  • Dorsal Slit Circumcision

All three of the above circumcision methods require stitching after the foreskin is removed. We use dissolvable stitches. This means that the stitches will automatically dissolve over a period of two to six weeks and do not need to be removed.

What method of circumcision is used for children aged 2 and under 16 years old?

For a small percentage of children aged 2 and above, the Plastibell method (details above) may still be suitable. However for the vast majority of older children our preferred and safest method is to use one of the formal surgical circumcision techniques as outlined above.

The formal circumcision techniques require the use of a scalpel to remove the foreskin, bipolar forceps to control any bleeding and then the cut edges are stitched with absorbable sutures. The area is then cleaned and a dressing applied. The entire process can take approximately 45 minutes.

What aftercare is provided?

Once the procedure is finished you will be taken to a separate recovery room. The doctor will go through the aftercare in more detail, you will also have the aftercare written guide to take home with you, this is so that you know exactly what to expect and how to take care of the wound. The Birmingham Circumcision Clinic provides comprehensive aftercare service. You are given a telephone number that will allow 24-hour direct access to the doctor. Detailed written circumcision aftercare information will also be provided so that our parents and patients know exactly what to expect and do.

Parents and patients are encouraged to contact us with any questions or queries relating to the circumcision.

What are your infection control policies?

Our circumcision clinic operating theatres are modern and of a high standard. They are equipped with electro-hydraulic operating beds and overhead theatre lights. This ensures a safe operating environment.

We have strict infection control procedures that meet all Care Quality Commission standards. We use only sterile single use equipment and instruments for the circumcision. This means we do not reuse any surgical instruments.

After the circumcision we dispose of all used materials. This ensures that we comply with the highest level of infection control and reduce the risk of our patients acquiring any type of infection. Because of this we do not use certain circumcision methods that require the same equipment to be reused on other patients.

What are your restraining and refund policies?

The clinic adheres to a strict non-restraint policy. We advise all parents and patients to read our Restraint and Refund Policy, before booking an appointment. Please click here to read the policy.

 

Making the appointment

To make an appointment for a circumcision please phone one of our reception staff at the circumcision centre.

After booking the appointment you will be sent detailed information about the circumcision procedure and aftercare service. This will allow you to read through all the necessary information and prepare any questions you may want to ask the doctor. You will also be sent directions to the clinic.

On Arrival

Before the circumcision procedure the doctor will explain everything and answer any questions you might have.

You will need to sign a consent form.

The patient will then be examined by the doctor to make sure he is healthy and that the circumcision can proceed safely.

Then the patient will be weighed to ascertain the maximum safe amount of local anaesthetic.

Local Anaesthic

Before the circumcision the penis and surrounding area is made numb by injecting a medicine around the base of the penis.

This is called a local anaesthetic and ensures that there is no pain during the circumcision procedure.

Once the anaesthetic has taken effect, and the patient is unable to feel localised pain, the doctor will begin the circumcision.

The type of anaesthetic we use can last for up to six hours.

Infection control and Cleanliness

Our circumcision clinic operating theatres are modern and of a high standard. They are equipped with electro-hydraulic operating beds and overhead theatre lights. This ensures a safe operating environment.

We have strict infection control procedures which meet all Care Quality Commission standards.

We use only sterile single use equipment and instruments for the circumcision. This means we do not reuse any surgical instruments.

After the circumcision we dispose of all used materials. This ensures that we comply with the highest level of infection control and reduce the risk of our patients acquiring any type of infection. Because of this we do not use certain circumcision methods which require the same equipment to be reused on other patients.

The Proceadure - Babies and Young Children

For babies and young children we use the Plastibell circumcision technique. The Plastibell is a clear plastic ring with a handle and a deep groove running around it. This was invented in America in 1950 and is now one of the most popular circumcision methods used in the UK, USA, Australia, and New Zealand.

First, after administering the local anaesthetic and ensuring the child does not feel any pain, the penis and foreskin are separated by gentle pushing. Then a cut is made from the top of the foreskin allowing it to be pushed back and the Plastibell to be placed in position.

The Plastibell comes in six sizes. The appropriate size is chosen and placed over the head of the penis. It is then covered over by the foreskin. A ligature is tied firmly around the foreskin in order to hold the skin against a groove in the Plastibell. Then the excess skin is carefully trimmed off. Finally, the handle of the plastibell is broken off at the end of the procedure. The entire circumcision procedure takes 5 to 10 minutes. The ring falls off within 10 days, leaving a small wound that will heal over the following weeks. No stitches are required.

The Proceadure - Older Children and Adults

For this age group we use one of three surgical techniques:

  1. Forceps Guided Circumcision
  2. Sleeve Resection Circumcision
  3. Dorsal Slit Circumcision

All three circumcision methods require stitching after the foreskin is removed.

We use dissolvable stitches. This means that the stitches will automatically dissolve over a period of two weeks and do not need to be removed.

The exact surgical circumcision technique to be used is decided by the doctor on the day, and will be discussed with the parents or patient.

Aftercare

The Birmingham Circumcision Clinic provides comprehensive aftercare service. We provide detailed written circumcision aftercare information so that our parents and patients know exactly what to expect and do. They also have 24 hour access to the doctor and are encouraged to contact us with any questions or queries relating to the circumcision.