Community Health Network

Circumcision Problems
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Definition

Recent circumcision, questions or concerns about
Mainly addresses circumcision of newborns

Normal Circumcision Healing

A circumcision is the removal of most of the male foreskin.
The incision is initially red and tender; the tenderness should be minimal by the third day.
The scab at the incision line comes off in 7 to 10 days.
If a Plastibell (plastic ring) was used, it should fall off by 14 days (10 days on the average).Â While it cannot fall off too early, pulling it off can cause bleeding.
Wound infections occur in less than 0.5% of circumcised boys.Â

First Aid:

FIRST AID Advice for Bleeding: Apply direct pressure to the area with a clean cloth.

Should I
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Care at
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When to Call Your Doctor

	Call 911 Now (your child may need an ambulance) If
	Large blood loss and baby is pale or cold Not moving or very weak
	Call Your Doctor Now (night or day) If
	Your child looks or acts very sick Age under 1 month old and looks or acts sick in any way (e.g., poor suck, poor color) Bleeding is more than a few drops Head of penis is dark blue or black Severe swelling of penis Can't pass urine or only can pass a few drops No urine for over 8 hours Crying and your child can't be comforted after trying this advice for over 2 hours Age under 12 weeks with fever above 100.4Â° F (38.0Â° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen) Circumcision looks infected (shaft of the penis become red) Plastibell has moved onto shaft of penis
	Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
	You think your child needs to be seen Bleeding is few drops BUT occurs 3 or more times
	Call Your Doctor During Weekday Office Hours If
	You have other questions or concerns Plastibell present over 14 days Penis looks abnormal (e.g., looks strange or has an extra tag of tissue)
	Parent Care at Home If
	Normal circumcision and you don't think your child needs to be seen

Symptom
Description

Care at
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HOME CARE ADVICE FOR CIRCUMCISION PROBLEMS

Reassurance:
- The tip (head) of the penis is normally very red after the foreskin is removed.
- The shaft of the penis should not be red.
- Most circumcisions heal easily.
- Infections are rare.
Plastibell Ring: Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.
Incision (No Plastic Ring is Present):
- Remove the dressing (which is usually gauze with petroleum jelly) with a warm wet washcloth 24 hours after the circumcision was done.
- Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.
Ointment for Pain:
- Apply a layer of ointment to the incision line. This should reduce any pain and crying.
- To prevent pain, also apply petroleum jelly (or an OTC antibiotic ointment) to the incision line and head of the penis after each cleansing for the first 4 days.
- Reason: to keep it soft and prevent the diaper from sticking during healing.
Bleeding:
- The circumcision wound can normally bleed a few drops.
- Cause: usually friction from a diaper
- Will stop on its own or with a few minutes of direct pressure
- Can prevent by keeping the area soft with an ointment
Expected Course For Plastibell Ring:
- The plastic ring will normally fall off between 7 and 14 days (average 10).
- It often hangs by a small piece of tissue for a few days.
- Pulling it off can cause bleeding.
- It can't fall off too early.
Prevention of Infections: Fasten the diaper loosely to prevent friction against the penis. Avoid tub baths until 2 days after the cord has fallen off.
Call Your Doctor If:
- Looks infected
- Large bleeding occurs
- Minor bleeding recurs 3 or more times
- Plastibell ring moves onto shaft of penis
- Plastibell ring does not fall off by day 14

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Symptom
Description

Should I
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 12/29/2008

Content Set: Pediatric HouseCalls Online