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Circumcision Problems

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Does this describe your child's symptoms?

Definition

  • Recent circumcision, questions or concerns about

  • Mainly addresses circumcision of newborns

Normal Circumcision Healing

  • A circumcision is the removal of most of the male foreskin.

  • The incision is initially red and tender; the tenderness should be minimal by the third day.

  • 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 on the average). While it cannot fall off too early, pulling it off can cause bleeding.

  • Complications: Wound infections occur in less than 1 out of 200 circumcised boys. 

First Aid:

FIRST AID Advice for Bleeding: Apply direct pressure to the area with a clean cloth.

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When to Call Your Doctor

call 911

Call 911 Now (your child may need an ambulance) If

  • Large blood loss and baby is pale or cold

  • Not moving or very weak

call now

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick

  • Age under 1 month old and looks or acts abnormal in any way (e.g., poor suck, poor color)

  • Bleeding is more than a few drops

  • Head of penis is dark blue or black

  • Severe swelling of penis

  • Can't pass urine or only can pass a few drops

  • No urine for over 8 hours

  • Crying and your child can't be comforted after trying this advice for over 2 hours

  • Age under 12 weeks with fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen)

  • Circumcision looks infected (shaft of the penis become red)

  • Tiny water blisters occur on skin

  • Plastibell has moved onto shaft of penis

  • You think your child needs to be seen urgently

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently

  • Bleeding is few drops BUT occurs 3 or more times

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Plastibell present over 14 days

  • Penis looks abnormal (e.g., looks strange or has an extra tag of tissue)

home care

Parent Care at Home If

  • Normal circumcision and you don't think your child needs to be seen

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HOME CARE ADVICE FOR CIRCUMCISION PROBLEMS

  1. Reassurance:

    • The tip (head) of the penis is normally very red after the foreskin is removed.

    • The shaft of the penis should not be red.

    • Most circumcisions heal easily.

    • Infections are rare.

  2. Plastibell Ring: Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.

  3. Incision (No Plastic Ring is Present):

    • Remove the dressing (which is usually gauze with petroleum jelly) with a warm wet washcloth 24 hours after the circumcision was done. Often, the gauze has already fallen off on its own.

    • Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.

  4. Ointment for Pain:

    • Apply a layer of ointment to the incision line. This should reduce any pain and crying.

    • To prevent pain, also apply petroleum jelly or an antibiotic ointment (no prescription needed) to the incision line and head of the penis after each cleansing for the first 4 days.

    • Reason: to keep it soft and prevent the diaper from sticking during healing.

  5. Bleeding:

    • The circumcision wound can normally bleed a few drops.

    • Cause: usually friction from a diaper

    • Will stop on its own or with a few minutes of direct pressure

    • Can prevent by keeping the area soft with an ointment

  6. Expected Course For Plastibell 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.

  7. Prevention of Infections: Fasten the diaper loosely to prevent friction against the penis.

  8. Call Your Doctor If:

    • Looks infected

    • Large bleeding occurs

    • Minor bleeding recurs 3 or more times

    • Plastibell ring moves onto shaft of penis

    • Plastibell ring does not fall off by day 14

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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