Male circumcision is a simple procedure that involves removal of the foreskin that sheaths the head of the penis. This procedure is performed in the office and under local anesthetic. Circumcisions are a safe and simple procedure to perform with a quick recovery. Dr. Goldie has performed thousands of circumcisions over the past 30 years in Calgary and relocated to Surrey /White Rock in 2012. Circumcisions are done for newborns up to 6 weeks of age but exceptions are made for premature babies.
Since circumcision is not currently considered a medical necessity, it is not covered by public health care. The cost is $300 (cash, credit or debit only please). The receptionist will issue a receipt so that you may claim the cost as a medical expense on your income tax or seek reimbursement through private insurance plans if they cover the procedure.
Current evidence suggests that the health benefits of newborn male circumcision outweigh the risks.
· Reduced risk of acquiring some sexually transmitted infections including Human Papilloma Virus (HPV), Genital Herpes, Chlamydia and AIDS (HIV).
· Prevents phimosis, which is a condition where the foreskin cannot be retracted, causing tears and infection. This leads to circumcision at a later age with increased risks.
· Reduced risk of urinary tract infection (risk decreases from 1/100 to 1/1000).
· Reduced risk of balanoposthitis, an inflammation of the glans penis and the foreskin.
· Reduced risk of penile cancer and cervical cancer in female partners.
· Research suggests a decreased risk of prostate cancer, although this research is ongoing.
· Eliminates the need to do it later in life. Up to 6% of males will require a circumcision due to various medical conditions. When preformed later in life, it is a more costly, problematic and painful procedure requiring general anesthetic.
· Small risk of excess bleeding that is very rare with a Plastibell.
· Rare risk of meatal stenosis (narrowing of the urethra).
· Occasionally the penis can become "buried" or "concealed" within fatty tissue overlying the pubic bone. If there is an excess amount of pubic fat, the penis will tend to retract inward forming adhesions. This may affect the healing process. Dr. Goldie will discuss prevention measures during the initial consultation and again during the follow up visit.
· Sub-optimal cosmetic outcome that is an uncommon complication.
· Infection requiring antibiotics that is extremely rare.
· You should bathe your son as normal.
· He should have his normal feeds up to one hour before the circumcision.
· If you can dress him in a onesie or undershirt, it will help him stay warm for the procedure.
· Please bring a soother if you have one.
In order to perform the circumcision safely, your son will be undressed from the waist down and placed in an infant circumcision bed. Once in the bed, his legs will be secured by Velcro straps. While this will not hurt him, some babies will cry initially when their legs are secured, but most of the babies will settle very quickly. If you agree, the baby can receive TootSweet, an oral sugar solution. Sucrose is a proven, effective method of helping to calm and soothe babies.
At this point, Dr. Goldie will then place local anesthetic just under the skin at the base of the penis. After waiting for the freezing to occur, the circumcision will be performed.
The Plastibell is a plastic bell that is inserted between the foreskin and the head of the penis. The Plastibell is then secured to the foreskin to ensure the bell stays in place and to help stop any bleeding. The excess foreskin is then removed.
Your son will go home with the bell still attached to the penis and it will fall off within I- 14 days. The plastic ring has an opening through which he can urinate. Bruising on the penis may occur when the local anesthetic is placed. The bruising will go away after a few days. You will also see that the skin past the ring will become white and ultimately dry out, much like the umbilical cord before it falls off. The bell, string and remaining foreskin will fall off on its own. Just prior to the bell falling off and a few days following, the penis will be red and swollen.
DO NOT REMOVE THE PLASTIBELL. While the bell cannot fall off under normal situations, like cleaning and bathing, pulling directly on the bell may dislodge it.
You can bathe and clean your son normally, taking care not to touch the top of the penis-just wipe around the penis. Baby wipes and a soft cloth are recommended for cleaning.
Tylenol may be needed the first night but, by the next day, the baby is typically back to normal. You may give your son 0.5mls of baby Tylenol every 4 hours, as needed, up to 5 times in a 24 hour period.
Things To Watch For
· Redness and swelling are normal. Foul smelling discharge is not normal. Please call the office if you notice this.
· You may see a bit of blood in the diaper with the first few changes. This is normal. Baby's blood does not clot as fast as an adult, so a small amount of oozing may occur. If the baby is bleeding like a cut does, use a cold wash cloth and apply pressure. If you are concerned, please call the office.
· Watch for urine output. If the amount of wet diapers decreases or if he stops urinating, please call the office.
· Adhesions may occur when healing skin comes into contact with the glans of the penis (head of the penis). Dr. Goldie will explain how to prevent this from happening and will review it again during the follow up visit.
The College Of Physicians And Surgeons: Search Circumcision
BC Women's Hospital
· http://www.theglobeandmail.com/life/health/new-health/paul-taylor/a-fringe-benefit-of-circumcision-prostate-cancer-protection/ article2370803/