NEWBORN CIRCUMCISIONS
THE PROCEDURE
A circumcision is the removal of the male foreskin. Dr. Goldenberg will perform circumcisions on infants up to 4 weeks of age. The baby boy should be full term and in good health with no medical conditions. If the baby is born with a defect of the penis or there is a personal or family history of a bleeding disorder then the procedure may be delayed.
No referral is necessary from your family doctor or pediatrician. An appointment can be arranged by calling the office within a few days of the baby's birth.
Circumcision procedures are not covered under OHIP. The cost of the procedure is $350. CASH - WE DO NOT HAVE CHANGE IN THE OFFICE AND THERE IS NO ATM.
To perform the procedure the baby will be placed on a special table to prevent movement of his legs. He will then have his penis and foreskin cleaned and a local anesthetic will be injected into the base of the penis. While this is happening he will be given an oral sugar solution to help with pain relief. The foreskin will then be removed with a Gomco clamp. Finally the penis will be wrapped with a petroleum gel impregnated gauze to protect it from sticking to the diaper. Parents are welcome to stay during the procedure but it is not necessary.
The baby may cry during the procedure and for a short while afterward. Local anesthesia can greatly reduce the baby's discomfort. The procedure takes about 15-30 minutes but you will be in the office for 1 hour after the procedure to observe for bleeding.
WHAT TO EXPECT AS YOUR CHILD HEALS AFTER A CIRCUMCISION
Once your child is circumcised, a lubricant gauze dressing will be applied to the area. The lubricant helps to prevent the dressing from sticking to the glans. The gauze usually falls off on its own within 24 hours.
Over the following days, your child will heal from the surgery in stages. Every child heals differently, it can take up to a month for the penis to appear fully healed.
BLEEDING
Within minutes, hours or an entire day, the cut edges of the glans close up and bleeding stops.
COLOUR CHANGES
Immediately after the circumcision, the glans may appear red and glossy or even purple. This occurs because the skin covering the glans of an uncircumcised penis is a mucous membrane. Once the membrane is exposed, it thickens and becomes darker.
Your child's glans may have off-white or yellowish patches in the first few days after surgery. These are a type of scab and are completely normal. Two or three days after the circumcision, the skin may look green and yellow. This is a sign of normal healing, not pus.
SWELLING
You may notice some swelling behind or under the head of the penis and believe it looks like a blister. The swelling is simply another sign of healing and will disappear within a week or two.
CHANGES IN SIZE
The penis may appear smaller after circumcision. This is mostly because the skin surrounding the penis is relaxed, while before circumcision it usually held the penis more erect.
HELPING YOUR CHILD
How to care for your child after a circumcision
CHECK FOR BLEEDING
Blood staining of the diaper is common after circumcision. During the first 24 hours, check your child's diaper at every diaper change for active bleeding. It is normal to see spots of blood no bigger than a two-dollar coin (about an inch wide), but you should see a doctor if there is more blood.
EASE SWELLING
Point your infant's penis up in his diaper to ease any swelling of the area behind the glans.
BATHE YOUR CHILD FREQUENTLY
After circumcision, your infant should have a warm bath every day for one week. You can allow the lubricant gauze to come off by itself, unless you are instructed to remove it. If the gauze does not fall off on its own within 24 hours, soak it off in the bath.
When the gauze comes off, it is normal for the penis to be discoloured with drops of blood and pieces of skin at its tip.
PREVENT SKIN STICKING
Gently push back the edges of the penile skin from the glans after the first two weeks of healing. This will prevent the skin from sticking to the glans as healing continues.
APPLY A BARRIER OINTMENT
Apply a topical barrier ointment (such as petroleum jelly) on the end of the penis after every bath and with each diaper change until the penis has healed completely. A topical barrier prevents the penis from sticking to the diaper.
GIVE PAIN RELIEF IF NEEDED
Infants may be fussy and in pain for some hours after a circumcision, but this usually does not last more than a couple of days.
Signs of pain can include crying and problems with sleep and feeding. During the first 24 hours after circumcision, you may give acetaminophen regularly to manage your child's pain.
WHEN TO SEEK MEDICAL ATTENTION
When to see a doctor after a circumcision
Go to the nearest emergency department (ED) right away if your child has excessive bleeding (small pools of blood or spots larger than a two-dollar coin on the diaper).
To help slow down any bleeding before you go the ED, use your thumb and index finger to create a ring around the top of the penis and squeeze for five minutes.
Also go to the nearest emergency department if your child has:
Redness of the skin spreading to abdomen and legs
Poor feeding and/or vomiting
Yellow liquid draining from the incision
Difficultly with urination (peeing) after circumcision, for example if diapers are less wet than usual
If you have any other questions or concerns regarding your childs circumcision or booking please contact the office directly at 416-229-6300. Online bookings will NOT be permitted.