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What is circumcision?
It is the removal of the foreskin or loose skin around the tip of the penis.
Why is it needed?
The two most common reasons are:
• Repeated infections of the foreskin (Balanitis).
• A very tight foreskin (Phimosis) making it difficult to pass urine.
What are the benefits of the treatment?
• It will reduce the risk of infection.
• It will be easier for your son to pass urine.
Are there any risks involved?
The two main risks are bleeding and infection of the wound site. Both are small risks and can be discussed with your doctor before surgery.
What happens when my child comes into hospital?
• You may stay with your son.
• Your son will be starved for surgery (please phone the ward the night before for instructions).
• Your son will be given a named nurse, who will prepare you and your son for surgery.
• Your nurse will tell you what to expect and answer any of your questions.
• The doctor will ask you to sign a consent form to say that you agree to the surgery and will answer any questions you may have.
What happens after my son’s surgery?
• A loose dressing is applied around the penis by surgeons in theatre. The dressing may still be attached or dangling from the penis 4 – 5 days after surgery. Do not forcibly remove the dressing and allow it to fall off naturally, or soak it off in the bath/shower.
• Minor bleeding is to be expected.
• You will see some stitches, but these will dissolve without removal over the next few weeks.
• There will be some swelling and bruising of the penis.
• The wound may look ‘crusty’ and ooze clear/straw coloured fluid – this is quite normal.
How long will my son be in hospital?
Circumcision is usually done as a day case. When he is ready to go home he will:
• Have passed urine freely.
• Be taking and tolerating food and drink.
• Need some Calpol/Paracetamol and Nurofen/Ibuprofen to control pain at home. This can be purchased over the counter at your local pharmacy/supermarket.
• Need to go home by car or taxi (not public transport).
He will probably be tired when he arrives home. There is a protocol for Nurse led patient discharge. If nurses have any concerns, they will call the surgeon to review the patient.
What about pain?
At first your son may experience pain or discomfort when passing urine or when the wound is touched, this will start to settle as the wound heals. Encourage him to drink more fluids to help
dilute the urine and reduce stinging. He will benefit from regular Calpol/Paracetamol and Nurofen/Ibuprofen for the first days after surgery, each child has different needs (always follow the instructions on the bottle).
Calpol/Paracetamol last given at…………
Nurofen/Ibuprofen last given at ………….
At first, the bed clothes and quilt may be uncomfortable. A young child may not wish to wear any clothes below the waist. Dressing gowns or large t-shirts are ideal. If clothing is worn it needs to be loose and comfortable. When comfortable he can wear his normal clothing.
How do I keep the wound clean?
• From the next day following the operation your son will need a shower/bath once a day until the wound is healed.
• Do not add anything to the water or use soap as the may cause the wound to sting.
• Make sure the water is a comfortable temperature.
• If your child wears a nappy do not use baby wipes as they may find this uncomfortable, water and cotton wool can be used instead until the wound is healed.
What about going to the toilet/nappies?
Your son should pass urine freely, if not it may be necessary to let him pass urine in the bath. If urine sprays instead of a straight stream, an extra soak in the bath may help. If possible no nappy should be worn. If necessary it should be worn loosely and changed often.
When should I seek help?
The wound may look swollen and unpleasant for up to a week after surgery and may ooze a small amount of clear fluid, this will settle down on its own. Minor bleeding may occur, this should be
observed closely and should begin to stop as clot begins to form. Should bleeding persist you should seek medical advice by either phoning the Children’s Community Team (CCN). Or if you are concerned take your child to A&E.
Please contact your GP or CCN for advice if:
• The wound becomes very red, swollen or tender. This may indicate an infection.
• The wound starts to bleed (a small amount may be due to a caught scab or stitch and should stop, quickly.)
• Your son will not pass urine.
• You have any concerns about your son.
• Concerns regarding the dressing
What about school/activities?
Your son may return to school when he is comfortable wearing his own clothes. He should avoid strenuous activities such as bike riding, skateboarding and contact sports until all swelling and discomfort have gone, probably 1-2 weeks. If you feel he is ready before this, please check with your GP.
Will my son need to see the doctor again?
Your child will not usually have a follow up appointment. However if you have any concerns following surgery please contact your GP and CCN.
If your son has stayed in overnight or discharged with a dressing, following the operation the CCN will contact you at home the next day to answer any queries and visit if necessary.
Visits are only to Milton Keynes addresses.
Children’s Community Nurses Telephone No: 01908 660033 Ext.2703.