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Circumcision Problems  
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Does this describe your child's symptoms?

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). While it cannot fall off too early, pulling it off can cause bleeding.
  • Wound infections occur in less than 0.5% of circumcised boys. 
First Aid:

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

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 100.4° F (38.0° 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
HOME CARE ADVICE FOR CIRCUMCISION PROBLEMS

  1. 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.
  2. Plastibell Ring: Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.
  3. 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.
  4. 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.
  5. 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
  6. 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.
  7. 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.
  8. 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.

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

Copyright 1994-2009 Barton D. Schmitt, M.D.

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