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Marlton Pediatrics

Circumcision Problems

Definition

  • A circumcision is the removal of most of the male foreskin
  • Questions about caring for the normal circumcised penis in a baby boy

Call or Return If

  • Starts to look infected
  • Bleeding occurs
  • Plastic ring moves onto shaft of the penis
  • Plastic ring does not fall off by day 14
  • You think your child needs to be seen
  • Your child becomes worse

 

About This Topic

Symptoms

  • The incision starts off red and tender. The tenderness should be much less by day 3.
  • The head of the penis is bright red. It stays that way for a few weeks.
  • The shaft of the penis is skin colored, not red.
  • The incision can bleed 1 or 2 drops if it is irritated.

Normal Circumcision Healing

  • The scab at the incision line comes off in 7 to 10 days.
  • If a Plastibell (plastic ring) was used, it should fall off by 14 days. 10 days is the average. While it can't fall off too early, pulling it off can cause bleeding.
  • Complications: Wound infections occur in less than 1 out of 200 circumcised boys.

American Academy of Pediatrics (AAP) Policy

  • Based on new research, the AAP revised their position on male circumcision (2012).
  • They now state that the health benefits outweigh the risks of the procedure.
  • But, the benefits are not great enough to recommend routine circumcision for all newborns.
  • Parents need to decide what is best for their child.

After Care Advice

Overview:
  • The tip (head) of the penis can be red after the foreskin is removed. This is normal.
  • The rest of the penis should not be red.
  • Most circumcisions heal quickly.
  • Infections are rare.
  • Here is some care advice that should help.
Plastic Ring:
  • Gently wash the area with warm water twice a day.
  • Also, do this if it becomes dirty with poop.
Incision (No Plastic Ring is Present):
  • The dressing is gauze with petroleum jelly. Take this off 24 hours later. Sometimes, it will fall off on its own. If you need to remove it, use a warm wet washcloth.
  • Gently wash the area with warm water twice a day. Also, do this if it becomes dirty with poop.
Ointment for Pain:
  • Put a layer of ointment on the incision line. This should lessen any pain and crying.
  • To prevent pain, use petroleum jelly. Put it on the incision line and head of the penis. Do this after each cleansing for the first 4 days. Other option: You can also use an antibiotic ointment. No prescription is needed.
  • Reason: Helps keep it soft and stops the diaper from sticking during healing.
Crying - Don't Give Pain Meds:
  • Circumcisions are usually not that painful.
  • Covering the wound with an ointment usually is all that is needed.
  • Do not give pain medicine (such as Tylenol) routinely.
  • If your baby is crying a lot, he may need to be seen. Call your doctor if you think your baby is in pain.
  • Your baby's doctor will decide if pain meds are needed.
Bleeding - How to Stop:
  • The circumcision wound can normally bleed a few drops. Most often, this is caused by the diaper rubbing on the wound.
  • Will stop on its own or with a few minutes of direct pressure.
  • Can stop bleeding by keeping the area soft with an ointment.
Prevent Infections:
  • Fasten the diaper loosely to prevent friction against the penis.
  • Avoid tub baths until 2 days after the cord has fallen off.
  • For circs done later, avoid tub baths for 7 days.
What to Expect For A Plastic Ring:
  • The plastic ring will normally fall off between 7 and 14 days (average 10).
  • It often hangs by a small piece of tissue for a few days.
  • It will come off on its own.
  • Pulling it off can cause bleeding.
  • It can't fall off too early.
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