Circumcising a child

Circumcision of baby boys: Information for parents

Circumcision of baby boys is an optional surgical procedure to remove the layer of skin (called the foreskin or the prepuce) that covers the head (glans) of the penis. It is most often done during the first few days after birth.

The Canadian Paediatric Society does not recommend routine circumcision of every newborn boy.

Parents who decide to circumcise their newborn boys often do so for religious, social or cultural reasons. If you are trying to make a decision about circumcision, talk to your baby’s health care provider. Ask for up-to-date information about the potential medical benefits and risks of circumcision.

Potential benefits of circumcision

A few studies suggest that boys who have been circumcised may be:

Less likely to develop cancer of the penis later in life – although this form of cancer is extremely rare.
Less likely to get HIV and HPV infections.
Less likely to get a urinary tract infection during childhood.

Female partners of men who have been circumcised are less likely to get cervical cancer.

Potential risks of circumcision

Circumcision is a painful procedure.

Problems resulting from the surgery are usually minor. Although serious complications are very rare, they do occur. These can include:

Too much bleeding or infection in the area.
Too much skin removed.
Side effects from the method or medicine used for pain relief.

The risk of complications is lower in young babies than in older children. To minimize the risks, the procedure should be done by a trained and experienced practitioner using a sterile technique. Someone should follow up with you in the days after the procedure to make sure that bleeding has not increased.

Caring for an uncircumcised penis

The foreskin covers the head (glans) of a boy’s penis. During the early years of a boy’s life, the foreskin starts to separate from the glans, but may not be fully retractable (meaning it can be pulled back) until a boy is 3 to 5 years old, or even until after puberty. This is a natural process that occurs over time. You do not need to do anything to make it happen.

An uncircumcised penis is easy to keep clean and requires no special care:

Keep your baby’s penis clean by gently washing the area during his bath. Do not try to pull back the foreskin. Never force it.
When your son is old enough, teach him to keep his penis clean as you’re teaching him how to keep the rest of his body clean.
When the foreskin separates, skin cells will be shed and new ones will develop to replace them. These dead skin cells will work their way down the penis through the tip of the foreskin and may look like white, cheesy lumps. These are called smegma. If you see them under the skin, you don’t need to force them out. Just wipe them away once they come out.
When the foreskin is fully retractable, teach your son to wash underneath it each day.

If you decide to have your baby boy circumcised

In Canada, most circumcisions are done by medical practitioners or skilled traditional providers.

Talk to your baby’s health care provider about the issues involved in circumcision:

Cost: Circumcisions for non-medical reasons are not covered by any provincial and territorial health plans.
Possible complications, such as the ones described above.
Pain relief:
- Newborn babies feel pain. The practitioner performing the circumcision should use some type of local anesthetic, given by a needle in the area where the circumcision is done.
- Additional methods of relieving pain include sucking on a pacifier dipped in a sugar solution, topical anesthetic cream and acetaminophen.
- Anesthetics do carry risks and the needle can cause bruising or swelling. Creams may cause redness or swelling.
Contraindications (a condition that makes a particular treatment or procedure not recommended): Sometimes, babies have health problems. which increase the risk of complications after circumcision.

Caring for a circumcised penis

After the circumcision, you can comfort your baby by holding him and nursing him often.
The penis will take 7 to 10 days to heal. The area may be red for a few days and you may see some yellow discharge, which should decrease as it heals. Talk to your baby’s health care provider about what to expect.
Follow the instructions given by the practitioner who did the circumcision about caring for the dressing, using petroleum jelly, keeping the area clean and bathing.
Call your health care provider if:
- You see persistent bleeding at any time during the healing process.
- The redness and swelling around the circumcision do not start to go down in 48 hours.
- Your baby develops a fever (rectal temperature of 38.0° C or higher).
- Your baby seems to be unwell.
- Your baby does not pass urine within 12 hours of the procedure.
- There is a greenish or foul smelling discharge from the penis.

More information from the CPS

Reviewed by the following CPS committees

Community Paediatrics Committee
Fetus and Newborn Committee

Last updated: February 2021

The Circumcision Decision | Patient Education

If you give birth to a boy, you will be asked if you'd like him circumcised. This is a matter to be considered carefully before the baby is born, while you have time to think about it and discuss it with your care provider and pediatrician.

At birth, boys have skin that covers the end of the penis, called foreskin. Circumcision is the surgical removal of this foreskin, exposing the tip of the penis. It is usually done in the first few days of life before the baby leaves the hospital. A baby must be stable and healthy to be circumcised.

It Is Your Decision

The American Academy of Pediatrics considers circumcision a choice for parents to make. Some parents choose circumcision for religious or cultural reasons. It is important to consider the pros and cons, how the surgery is performed and the potential complications.

Not all insurance companies pay for the procedure. If you plan to circumcise your son, you should contact your insurance provider for information about coverage.

Medical Reasons Parents Might Choose Circumcision

Research suggests that there may be some medical benefits to circumcision, including:

A slightly lower risk of urinary tract infection (UTI). A circumcised boy has about one in 1,000 chance of getting a UTI in the first year of life. A baby who is not circumcised has a one in 100 chance of getting a UTI in the first year of life.
A slightly lower risk of getting sexually transmitted diseases (STDs), including HIV.
A lower risk of cancer of the penis. However, this is very rare in both circumcised and uncircumcised men.
Prevention of foreskin infections.
Prevention of phimosis, a condition in which it is impossible to pull back the foreskin.

Medical Reasons Parents Might Choose Not to Circumcise

Risks of circumcision surgery, although rare, include bleeding, infection and injury to the penis or urethra.
The foreskin protects the tip of the penis. When the foreskin is removed, the tip may become irritated and cause the opening of the penis to become too small. This can cause urination problems that may need to be corrected by an operation.
The foreskin has more nerve endings than the glans, or sensitive tip of the penis, and its removal decreases sensitivity to touch.
Almost all uncircumcised boys can be taught proper hygiene that can lower the chance of getting infections, cancer of the penis and sexually transmitted diseases.

The Procedure

Circumcision is usually performed before your baby goes home from the hospital. Like all surgery, circumcision is painful. To relieve pain, anesthetic is given to numb the area. About one hour before the procedure, a numbing cream is placed on your baby's penis.

Right before the procedure, the doctor injects a local anesthetic at the base of the penis. The penis and foreskin are cleaned. A clamp is attached to the penis and the foreskin is removed by scalpel. The procedure takes just a few minutes. You can be with your baby during the operation if you choose.

Recovery

A nurse or doctor will give you directions for caring for your baby after circumcision. Clean the penis as you would with any diaper change. Apply the provided ointment to the penis with each change so that the penis does not stick to the diaper. It takes about one week to 10 days for the penis to fully heal. Call your doctor if you notice any signs of infections such as redness, swelling or foul-swelling drainage.

Caring for an Uncircumcised Penis

A nurse or doctor will give you directions for caring for an uncircumcised penis as part of routine baby care. Wash the outside of the penis with soap and water. Do not attempt to pull back the foreskin. By the time your son is about 3 or 4 years old, the foreskin will begin to pull back and your son can be taught to wash the head of the penis and inside the fold of the foreskin. Pull the foreskin back over the head of the penis after washing.

when, how and where is it better to do? — Healer Medical Center

Boy circumcision is a traditional surgical operation in which the foreskin is excised and removed to expose the glans penis. Such an operation is within the competence of the urologist and surgeon. For example, among Muslims, the rite of circumcision is part of the religious norm, and in some cases this procedure is carried out in order to release the head of the penis in order to eliminate signs of the disease (phimosis).

Why is a child circumcised?

In Dagestan, the surgical operation of male circumcision is carried out mainly according to religious traditions, for hygienic reasons. However, it is not uncommon for doctors to prescribe and perform circumcision on male representatives strictly for medical reasons, that is, when such a need is caused by the presence of a disease. This, for example, can be:

phimosis, in which an insufficient opening of the foreskin does not allow the head of the male genital organ to be completely exposed. Accordingly, in such cases, problems with urination often occur, as well as the risk of developing inflammatory processes;
fasting - an inflammatory process of the foreskin, often accompanied by purulent discharge;
balanoposthitis - inflammation of the foreskin and glans penis in males.

You should know that according to the research of medical scientists, circumcision is one of the medical procedures that significantly reduces the likelihood of cancer of the foreskin.

When is the best time to do it and why?

I am often asked, at what age is it better to have circumcision, how old should a child be? And I always answer that the sooner the circumcision is done, the better. In principle, of course, you can do it at any age. But preferably in the period from 10 days to 6 months, until the baby began to crawl, and even more so to walk and understand everything. And a child who eats breast milk is less sick. During the first 1.5 months, maternal antibodies are still present in his blood. They reliably protect against any diseases. That is, in this age period, the baby is under effective protection.

Moreover, the milk that the baby receives from the mother contains interferon. This is a protein that is synthesized by the cells of the child's body. It provides reliable protection of the baby's body from viral invasion from the outside. Therefore, circumcision of newborns by specialists is only welcome. The fact is that circumcision (circumcision) by breastfed babies is well tolerated. Mother's milk is also a good natural pain reliever and sedative, and is even often used by pediatric specialists during a surgical operation.

What are the other benefits of early circumcision?

Before the age of 1 month, the microflora has not yet fully formed in the child. To put it more clearly, in his body the pathogenic flora is present in small quantities. Therefore, a surgical operation to circumcise the foreskin is recommended before the baby is one month old. At this age, the infant is relatively sterile, and the risks of wound infections are very low.

From the position of a practicing surgeon who has considerable experience working with young children, I would like to draw the attention of parents to another advantage of early circumcision - this is a relatively small throughput size of blood vessels. In a newborn, they are still very thin, and therefore surgical intervention does not threaten any serious bleeding. In addition, young children are characterized by little physical activity. They behave relatively calmly, do not disturb their body, due to which the wound heals faster. Infants differ from older ones and have higher regenerative abilities.

What are the methods of circumcision?

Pediatric specialists use various surgical techniques for circumcision. The classical method of circumcision remains in demand, when an ordinary surgical scalpel and scissors are used. In recent years, the radio wave method of male circumcision is gaining more and more popularity.

Which option is better and why?

With more than 35 years of practical surgical experience behind me, I can confidently say that today the radio wave method is considered the best. Currently, this modern method of surgical intervention is effectively used in our medical clinics "Healer" in Makhachkala. For these purposes, we use a modern American-made radio wave device "Surgitron", with the help of which our surgeons effectively perform male circumcision surgery for children and adults.

Why is the radio wave method preferred?

If we talk about the advantages of circumcision with a radio wave scalpel compared to the traditional method, then these are:

Less traumatic.
Accelerated wound healing.
The risk of blood loss is almost eliminated (not only for children who are very active physically, running and jumping, but also for older patients).
Powerful disinfection effect from the radio waves themselves.
There is no need for long-term follow-up and care after surgery.

I think the most important advantage of the radio wave method is that the chance of bleeding decreases qualitatively and really tends to zero.

What are the contraindications for circumcision?

Despite the undeniable benefits of the procedure for men's health, circumcision is like a surgical procedure. still has some contraindications for medical reasons. There are situations when surgical intervention can cause significant harm to the health of the patient. In this case, it could be one of the following reasons:

certain forms of cardiovascular disease;
acute inflammation in the foreskin and head of the male genital organ;
the presence of purulent processes in the area of operation;
exacerbation of existing chronic diseases;
a serious condition of a patient who needs constant monitoring.

In addition, surgeons may refuse to perform a circumcision if:

insufficient blood clotting;
birth defects and individual characteristics of the penis;
diabetes mellitus;
increased leukocytosis in urine;
immunodeficiency, etc.

Where is the best place to have a male circumcision done in Makhachkala?

To sum up, I would like to strongly recommend all parents to circumcise the foreskin of boys as early as possible. The little man endures the operation much easier, there is no stress for him or his parents, the wound heals faster, at the same time, the likelihood of infectious complications is much lower.

Contact our medical clinic "Healer" in Makhachkala. The best pediatric surgeons work here, who will perform the circumcision of the foreskin of your child according to the canons of Islam without pain, tears and any complications.
At the request of the patient, the specialists of the Medical Center "Healer" can perform circumcision in children and adults in a traditional surgical way or with a laser. So the people call the procedure of circumcision using radio waves. As noted above, recently this technique has become very popular among our population.

Gadzhikuliev Nuri Babayevich, surgeon, urologist, specialist of the highest category, Excellence in Public Health of the Republic of Dagestan.

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Circumcision in boys - answers to important questions

Many parents are interested in the topic of child circumcision. Some are sure of its necessity, others doubt its usefulness.

What is circumcision, why and at what age is it done for boys, how is it carried out and what is the care of the child after the procedure?

Circumcision, or circumcisio - surgical excision of the foreskin of the male penis. The operation can be performed on men at any age.

WHY DO CIRCUMCISO

Perform circumcision for medical or religious reasons.

Medical indications:

Phimosis. With phimosis, the opening of the foreskin is narrowed, which makes it impossible to expose the glans penis. Symptoms of phimosis are swelling of the foreskin during urination, a weak stream and urinary retention, a tendency to inflammation and infections.
Balanitis. In young boys, balanitis is often observed - inflammation of the glans penis and foreskin (balanoposthitis). The disease is characterized by redness and swelling of the foreskin, pain during urination, purulent discharge. A doctor may recommend circumcision if the condition recurs frequently.

HOW CIRCUMITION IS MADE

The child is first anesthetized. Usually circumcision is performed under general anesthesia and local anesthesia is additionally used.
The surgeon then removes the foreskin around the glans penis with a scalpel. In this case, a special clip is used to protect the head of the penis from accidental damage.
Stop bleeding by suturing with absorbable sutures.
Bandaging.

The whole procedure takes no more than 15-20 minutes.

HOW TO PREPARE FOR CIRCUITION

As with any operation, circumcision is performed after examination and elimination of contraindications. For example, a child should not be circumcised if he was born prematurely or has malaise, problems with blood clotting.

HOW TO TAKE CARE OF A CHILD AFTER A CIRCUNITION

On the first day after surgery, the patient may experience some pain, restless sleep is possible. In this case, the doctor may prescribe pain medication for the child.

Swelling in the area of the operation and slight bleeding after circumcision is normal. The swelling will completely disappear in 7-10 days, but the general well-being of a small patient will improve after 3-4 days.

During this time, you need to see a doctor. After removing the bandage, you need to be especially careful about hygiene.

WHO DOES THE CIRCUMISSION

In the EMC, the circumcision is performed by a pediatric surgeon or pediatric urologist.

WHAT ARE THE RISKS IN CIRCUITION

Complications after surgery, subject to the high professionalism of the doctor, are minimized, but not excluded.

Approximately 2 out of 100 children may experience minor bleeding after surgery. This problem is short term. You should immediately consult a doctor if the wound does not heal for a long time or the child has a fever.

SHOULD A CHILD 9 BE CIRCUIZED?0005

Physicians' views on circumcision vary. Some consider circumcision as an important measure in the prevention of diseases and recommend it. Others see it as devoid of scientific justification and offer to perform only if it is due to religion.

Circumcision benefits: