Boys are born with a piece of skin that covers the head (or glans) of the penis. This is called the foreskin. A circumcision is when the foreskin is surgically removed.
Most of the time, a circumcision is done during the first 10 days after a baby is born (often within the first 48 hours). It will take place in the hospital or, for some religious ritual circumcisions, at home. If you decide to have your son circumcised, your pediatrician, family doctor or OBGYN will do the surgery before you bring your baby home. The doctor can tell you about the surgery and the possible risks.
If circumcision is done after the first 10 days, it can be harder and may need general anesthesia (medicine to make the baby sleepy and not feel as much pain). Sometimes doctors decide to do the surgery at a later date or not do it at all. Some reasons a circumcision might be done at a later date may be:
- Premature babies or those who have special medical concerns may not be circumcised until they're ready to leave the hospital or will need circumcised in the future.
- Babies who are born with physical abnormalities of the penis that need to be corrected surgically often aren't circumcised at all because the foreskin may need to be used as part of a reconstructive surgery.
One of the hardest parts of the decision to circumcise is understanding that it can be painful. The two main types of local anesthetic used to make it less painful for a baby are:
- A topical cream (a cream put on the penis) that needs about 20 to 40 minutes to take its full effect
- An injectable anesthetic that requires less time to take effect and may provide a slightly longer period of anesthesia
Sometimes acetaminophen is also given with the anesthetic. This helps lessen pain during the surgery and for several hours after. Giving a pacifier and swaddling a baby also can help lessen stress and pain.
After your baby has a circumcision, you will need to keep the area clean. Gently clean with warm water — do not use diaper wipes. Soapy water can be used if needed.
If there is a dressing on the surgery site, put a new one on (with petroleum jelly) every time you change a diaper for the first day or two. Even after the dressing is no longer needed, put a dab of petroleum jelly on the penis or on the front of the diaper for 3 to 5 days. This can help your baby avoid pain from rubbing and sticking to the diaper.
Most of the time it takes between 7 to 10 days for a penis to heal. At first the tip of the penis may appear slightly swollen and red and you may notice a small amount of blood on the diaper. You may also notice a slight yellow discharge or crust after a couple of days. This is a normal part of healing.
If you notice any of the following problems, call your doctor right away:
- Bleeding that is not stopping
- More than a quarter-size amount of blood on the diaper
- Redness getting worse or not going away after 7 to 10 days
- Other signs of infection, such as swelling or discharge getting worse, or pus-filled blisters
- Not peeing normally within 12 hours after the circumcision
However, with quick intervention, almost all circumcision-related problems are easily treated.
caring for an uncircumcised penis
As with a penis that's circumcised, an uncircumcised one should be kept clean, too. Also, no cotton swabs or any special bath products are needed — just warm water every time you bathe your baby will be good.
At first, do not pull back the foreskin to clean under it. Over time, the foreskin will pull back on its own so that it can be pulled away easily from the glans toward the belly. This happens at different times for different boys, but most can pull back the foreskin by the time they reach puberty.
When a child is circumcised, sometimes extra skin from the penis attaches to the head of the penis and attaches itself. This can occur because too much skin was left behind during the original circumcision (incomplete circumcision/extra foreskin). The extra skin can also be uneven with more skin on one side versus the other side. Often, a redo is done because the extra skin may lead to irritation or infection. Fortunately, this is a very minor surgery and correcting the circumcision does not take a long time.
same day circumcision
Our pediatric urologists perform same-day circumcisions for patients in the clinic. Ask your provider if your child is a good fit for the same-day clinic circumcision program.
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