Circumcision
by San Diego IM/Peds
To Circumcise or Not to Circumcise The official recommendation on circumcision has changed over the last 15 years. In the past, circumcision was recommended for medical reasons because it decreases the risk of urinary tract infections, scarring conditions of the foreskin and carcinoma of the foreskin later in life. However, after thorough research, these problems have turned out to be quite rare if proper hygiene is followed. The decision to circumcise is now more of a cosmetic and cultural choice rather than recommended for medical reasons. When to Do It Both Dr. Upton and Dr. Mansour have extensive experience with performing newborn circumcision. This can be done in the hospital at Sharp Mary Birch or later in the office. In most instances the circumcision is performed in the hospital. Office circumcisions can be performed on Tuesdays and Thursdays. Note, circumcision is covered by most insurance plans with the exception of MediCal and Molina. In these cases, circumcision can be performed on a cash pay basis in the office. Circumcision can be performed safely anytime in the first 2 weeks of life. The Procedure The procedure is safe but does have some minor risks involved. These include 1) Bleeding, which usually easily stops with gentle pressure. 2) Infection, which is greatly minimized with the use of sterile equipment. 3) Pain, which is reduced with the use of a lidocaine penile block. Nursing staff will have you sign a consent to the procedure stating you agree to these minor risks involved. We use an instrument called a gomco clamp to do the procedure which takes about ten to twenty minutes. After Care After the procedure, the penis will be wrapped in a vasolineguaze which should stay on anywhere from hours to days. Whenever it falls off on its own, simply cover the end of the penis as well as the diaper with vasoline for up to one week. The circumcision heals on its own and no other special care is required. Complete healing should occur after one week. If the vasolineguaze remains on after one week, you may safely wet it and unravel it off. Very commonly small fibrinous yellow or white areas can be seen on the end of the penis. These are areas of healing mucous membranes. The end of the penis can also become swollen and red for several days after the procedure. These findings resolve spontaneously and are not infections. Infection is signaled by swelling and/or redness extending down to the base of the penis and up the groin.