Knowledge Base

Knowledge Base > FAQ > Circumcision

1. What is circumcision?
2. What techniques are used to perform a circumcision?
3. Is anesthesia used for circumcisions?
4. Who can perform a circumcision?
5. Is it necessary to circumsize my child?
6. Are there any medical reasons to circumsize my child?
7. I can't make up my mind about circumcision just yet. When do I have to decide?
8. I would like Dr. Alvis to perform my child's circumcision but I am delivering at a hospital he does not go to. How do I go about getting him to do the circumision?
9. Is is necessary to have the circumcision done before leaving the hospital?
10. What do I need to know about post-operative care for my child's circumcision?
11. How long does it take for a circumcision to heal?

1

Circumcision is the removal of the male prepuce (aka foreskin) of the penis.

2

There are 3 main techniques used in circumcision:

1. Gomco Clamp: In this technique a metal bell is inserted between the head of the penis and foreskin and is clamped. The foreskin is then removed with a scalpel. This technique was first introduced in 1935 and is the technique that Dr. Alvis uses.
2. Plastibell: In this technique a plastic bell is inserted between the head of the penis and foreskin. The foreskin is then tied with a tight string and the excess skin is cut away. The plastibell and string is left in place and falls off usually between 3 and 7 days.
3. Mogen Clamp: In this technique the foreskin is stretched away from the head of the penis and placed between the metal jaws of the clamp. The excess skin is then cut away with a scalpel.

The Gomco and plastibell techniques are the safest and most commonly used technique by physicians. Most physicians are trained on only one of these techniques. It is generally best to let the physician performing your child's circumcision to use whatever technique he/she is most familiar with to ensure the best outcome.

3

Dr. Alvis recommends anesthesia for all newborns receiving a circumcision. In the past, doctors used to rely on infants' endorphins (natural pain-killers released by the brain) as the sole source of pain relief for circumcision. Recently there has been convincing scientific evidence suggesting that infants who receive anesthesia seem to have a better overall experience than those who do not.

There are several forms of anesthesia that can be used:

1. Nerve blockade: A small amount of 1% lidocaine is injected at the base of the penis where the nerves that supply the sensation to the penis emerge. This technique essentially "numbs" the entire penis for about 1-2 hours. It is safe and effective. This is the method of anesthesia that Dr. Alvis uses.
2. EMLA cream: A small amount of anesthetic cream is placed on the tip of the penis for approximately 30 minutes prior to the procedure. This gives reasonably good anesthesia for the procedure.
3. Sweet-Ease™: This is an sucrose (table sugar) based syrup that is put on the tip of a pacifier or gloved finger and given to the newborn during the procedure. It is a highly effective adjunctive treatment to the above two forms of anesthesia. Dr. Alvis strongly recommends the use of Sweet-Ease™
4. Acetaminophen (Tylenol®): A small dose of acetaminophen can be given orally just prior to the procedure and can be a helpful adjunctive form of pain control.

Regardless of who you choose to perform your child's circumcision, Dr. Alvis strongly recommends that your child receive some form of anesthesia. Unfortunately, not all physicians use anesthesia for circumcision. If you are considering allowing someone else beside Dr. Alvis to perform your child's circumcision please ask them whether they use anesthesia.

4

Until recently, pediatricians were primarily the ones that performed circumcisions on newborns. Now, both pediatricians and OBGYNs can perform circumcisions on newborns.

5

No. Uncircumsized children do just fine. Circumcision is primarily a cosmetic procedure.

6

There is some evidence to suggest that circumsized males are less likely to develop urinary tract infections (UTIs) and penile cancer than uncircumsized males. However, the incidence of UTIs and penile cancer in males is already so small to begin with that this is not felt to be a significant medical reason to circumsize. For the most part, circumcision is plastic surgery for the penis. Dr. Alvis usually recommends that parents consider how they would like their child to look to help make their decision.

7

In general, Dr. Alvis will circumsize infants up to 3 weeks of age in his office. Beyond 3 weeks of age he generally refers to a pediatric urologist.

8

On your discharge day from the hospital or the day after, call our office to set up an appointment.

9

No. Many parents believe that you have to "go home circumsized" but this simply is not true. Circumcision can be done both in the hospital and in the outpatient setting. Dr. Alvis frequently performs circumcisions in his office.

10

Dr. Alvis recommends that you ask whomever performs the circumcision for their preference on how you care for it postoperatively. If Dr. Alvis performs your child's circumcision, he normally recommends that you keep the head of the penis moistened with either Vaseline or KY Jelly and then put a small piece of gauze over the top. The purpose of this is to protect the wound and to keep the penis from sticking to the inside of the diaper so that when you change diapers it does not hurt.

11

It generally takes about 7-10 days for a circumcision to completely heal.