Circumcision is an operation where the foreskin is excised exposing the head of the penis. The majority of children do not require a circumcision. Most children are referred with a "tight" foreskin but in fact this is quite normal in the majority of cases and loosens up as the child heads towards puberty. This is called physiological phimosis and does not require treatment. Occasionally the foreskin develops a condition called Balanitis Xerotica Obliterans or BXO. This results in quite profound scarring of the foreskin and can lead to significant irritation and difficulty passing urine. A circumcision is certainly needed in this situation. So although every child needs to be assessed individually, the vast majority will need little or no intervention.
A circumcision is an operation to remove the foreskin of the penis. Circumcision is only necessary for medical reasons. During the first four to five years of a boy’s life, it is normal for the foreskin to be attached to the head of the penis and not pull back.
As the foreskin starts to separate from the head of the penis, it is usual to see the foreskin ‘ballooning out’ when your son passes urine. This can occasionally lead to infection (balanitis) but this usually settles down with time.
If the foreskin is damaged, usually by severe infection, and it will not slide back over the head of the penis (true phimosis), circumcision is necessary. This is extremely rare before five years of age. The most common reason for needing a circumcision is a condition called balanitis xerotica obliterans (BXO). This affects the tip of the penis, causing the foreskin to become scarred, sometimes following prior surgery, infection or an inflammatory condition. The urethra may narrow making it more difficult to pass urine.
Your son will have a general anaesthetic and will be fully asleep and unaware of what is happening. Local anaesthetic is also given in order to make sure the child is as comfortable as possible. During the operation, the foreskin from under the glans is excised intact, exposing the top of the penis. The skin is then reattached underneath this. It is normally a very successful day case procedure. The stitches will dissolve and you will not need to visit the doctor to have them removed. Your son’s penis will take up to six weeks to fully heal.
When your son returns from the operation, his penis may be covered with a small dressing. This will protect the area and absorb any slight bleeding. It will be removed before your child goes home. He will be able to go home once he has passed urine. This may be uncomfortable at first. Your son’s penis will look sore and inflamed for a week or so, and may look worse a few days after the operation than it did immediately afterwards. The surgeon may prescribe some ointment to put on the area for a few days to help it heal. Your child may be more comfortable with loose clothing or without clothes on his bottom half for a few days. Peeing will be more comfortable while the penis is sore if your son pees in the bath or shower.
Your son will have been given pain relieving medicine during the operation, but this will begin to wear off. He will need to have regular pain relief for at least three days, usually Paracetamol or Ibuprofen The day after