Timing of Circumcision

The procedure is generally performed on healthy, medically stable, term infants between one and eight days after birth. A minimum period of 24 hours of observation after delivery.

Most circumcisions are performed in the hospital before the infant (term or preterm) is discharged as this is convenient for parents, practical, and has a demonstrated record of safety. In some areas, the procedure on term infants is performed after discharge to assure that the infant is medically stable (e g, no longer losing weight, tolerating feeding, free voiding,and jaundice has resolved or is waning).

Benefits

• Reduce urinary infections

• Reduce risk of penile cancer

• Decrease risk of sexually transmitted diseases.

• Decrease the risk of HPV infection.

Contraindication

• Bleeding diathesis

• Infection

• Congenital penile anomalies

• Medical instability: This includes term newborns who are ill, as well as low birth weight/premature infants who are not ready for discharge from the nursery.

Post-Procedure Care

Activity

No need to restrict the activities of newborns

Bathing

It's best to avoid full-body bathing until the second day after surgery,

but sponge bathing is fine. After the second day, newborns can be showered as normal, but wash the penis very quickly not beyond 2 minutes. Penis should be put into warm water for 15 minutes, every day 2 times, from 7 days after surgery until the ring falls off and the wound swelling is gone, the totally days of the ring’s falling off is about 12-14 days after surgery.

Incision Care

1. The circumcision site should be cleaned 2-3 times every day after circumcision day until the ring falling off and the incision swelling is gone. Clean should be performed immediately if the incision is dirty by stool. Use NS（immerse penis with 1 potassium permanganate solution add 500ml water in a cup for 5 minutes instead 3 days after circumcision）and take 2ml iodine by syringe to clean the incision, then smear antibiotic cream on the incision and then wrap the penis with Vaseline gauze.

2. Normally, the infant urinates within 4-6 hours after theprocedure.

3. Do not loosen the sting of the bell and do not pull the bell by yourself.

4. At first, the penis will appear red. In a few days, a soft yellow scab will develop. Gradually, the skin on the plastic-ring will be gangrene and the bell will be fallen off in 12-14 days after procedure. This is part of the normal healing process. During this process, parents should watch for worsening redness, swelling, bleeding (larger than a quarter-size on the diaper) or unceasing drainage or plastic-ring doesn't fall off after 2 weeks. Any of these signs should prompt a call to the surgeon.

Follow-up

Follow up OPD 1 week after operation and the ring falls off as needed. If the ring can’t fall off from the penis 2 weeks after operation, please contact your doctor.

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