Background

Male Infant Circumcision

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If you're considering a medical checkup or treatment, trust Cleggs Surgicare Clinic for expert care you can rely on.

Book an appointment today!

Schedule an Appointment 01204 806821
Overview

Circumcision is one of the oldest surgical operations known to man. It is a simple surgical procedure which involves removal of the foreskin behind the head of the penis.
Circumcision can be done for medical, cultural, or religious reasons.When done for cultural reasons most are done in male newborn and infants within the first year of life.

Benefits of circumcision in males include easy hygiene; reduced risk of sexually transmitted infections, reduced risk of penile cancer, removes risk of foreskin problems.

There are many methods of circumcision ranging from freehand to use of device. The intended outcome is the same, although the healing may not be the same. In the UK it is encouraged that both parents should consent before circumcision.


Plastibell ring circumcision

This is the circumcision method we use in majority of our male infant. We accept infants from first week of birth to 9 months with very little waiting time. Older children can be done by special arrangement. We will do a health screening to ensure that your child is suitable for the procedure. There are situations where the baby would not be suitable, such as conditions affecting the panic; bleeding disorder; prematurity requiring ongoing hospital treatment; fever. The procedure we usually monitor the baby for about half an nout to ensure that they are settled before discharge.

Both parents are required to sign a consent before the procedure, guardians or grandparents cannot sign the consent. In special circumstances we can get consent by telephone or video consultation if on parent is unable to attend.
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PRE-OPERATIVE ADVICE
  • Not to feed the baby 1 hour before the procedure. This is to prevent the infant from vomiting and choking.
  • Please bring along two NAPPIES. This will be used after the procedure.
  • Dr Umeadi will explain the procedure in detail and obtain the consent for the procedure from both parents.
  • The surgery will be performed under local anaesthesia (injection at the base of the penis) and circumcision is performed using Plastibell device*.
  • The procedure takes about 10 minutes to complete; that is 5minutes for the injection to work and 5 minutes for the operation. You may have to be in the surgery for a total of up to one hour, as we want to make sure that your baby is OK before leaving.
How it's done

Plastibell® : It’s a disposable plastic ring device shaped like a bell. The bell is inserted over the glans penis and under the foreskin and the foreskin is tied around the ring with a string. By this procedure the blood flow to the foreskin is ceased and the skin forward of the string is cut off. After 5-10 days the ring falls off leaving a healed wound.

Procedures
  • Preparation: Our team provides thorough guidance on how to prepare your infant for the procedure.
  • During the Surgery: The procedure is performed under local anesthesia to ensure the baby’s comfort.
  • Post-Surgery Care: Detailed aftercare instructions are provided to ensure proper healing.
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AFTERCARE FOR YOUR BABY

Once the circumcision has been completed we will bring the baby back to you. He will then be checked approximately 30 minutes later. During this time, it is best to give your baby a feed to comfort him and help him settle.

After this, the doctor or nurse will check the baby with you and show you the dressings and advice on things to look for after taking him home. You will also be given a pack containing dressings and other items that will be required for the next week.

Once you have taken your baby home
  • Always keep him on 2 nappies for 24 hours; this is to provide extra support to the operated area.
  • Remember to check the baby for bleeding for the first 5-6 hours (this is very important).
  • If there is any significant bleeding please inform the doctor immediately. There may be some minor blood stain on the dressing, this is normal and occurs when your baby passes urine on the first few occasions. Over the first few hours this redness should slowly become lighter.
  • If at any time you notice the bleeding is becoming heavier or if there are clots present in the nappy please take your baby to A&E. This situation is very rare.
  • Apply paraffin (in your pack) on to your dressing every time you change his nappy till the ring falls off. This will keep the dressing lubricated. (Keep the paraffin away from fire).
  • Give bath as you normally would; also change his dirty nappy as soon as you can.
  • Following the separation of the ring you will notice a white ring-shaped area like a thread (which is a dead skin) which should disappear over few days and it is not an infection.
  • A dark brown or black area around the plastic ring is natural. This will disappear when the ring drops off.
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PLASTIBELL CIRCUMCISION FREQUENTLY ASKED QUESTIONS (FAQ'S)
Infant circumcision is mostly carried out for cultural reasons. It does not require a GP referral; therefore, you can book directly by contacting us.
You can get a direct booking from 0-9 months. Older infants can be booked after speaking to us.
Do not feed the baby up to 1 hour before the procedure. This is to prevent the infant from vomiting and choking.
Please bring along two extra nappies. This will be used after the procedure. While this is not advised by the manufacturers of Plastibel device, we feel that double nappies provide extra cushion for your baby after the procedure and makes handling easier for them in the first 24 hrs.
The GP will explain the procedure and obtain the consent for the procedure from both parents. By law both parents have to sign for consent for circumcision. Grandparents cannot sign a consent for circumcision. For single parents, only the parent named on the birth certificate can sign.
It is important to inform us on time , so that arrangement can be made for parents to sign the consent form by post or email. We can also take consent by video consultation, if this satisfies appropriate criteria.
The surgery will be performed under local anaesthesia. The baby will receive injection around the penis and there will be a five to seven -minute wait to enable this to work. We also use Emla numbing cream and oral sucrose to improve pain relief.
Your baby may cry during circumcision, most of the time this is not due to feeling pain but due to being upset by what`s going on. This is more likely as babies get older and more aware of their surroundings.
Unfortunately, we do not allow parents in the operating room. There will be experienced assistants looking after your baby, and your baby is brought back to you as soon as procedure is over.
After the procedure, we like to observe your baby for about 30 minutes, and then check the operation to ensure there is no bleeding. During this time, you can feed your baby in our bespoke breast- feeding room.
Every baby can have pain killers if required, though not all babies need them. Paracetamol is usually sufficient for pain relief. We will assess your baby and advise further before discharge.
After Plastibell Circumcision, you do not need to change your routine for bathing and cleaning your baby. It is our usual practice to give you Vaseline and gauze to cover the penis and keep it lubricated until the ring falls off.
This is not essential, to we advise to continue with whatever you were using
Stool will not affect the plastibell ring, but we advise not to delay in changing your baby when the poop.
We usually review your baby for bleeding before discharging him. If there is no bleeding before discharge, it is extremely unlikely that there will be bleeding at home. Some blood stain in the nappy is allowed. If however the gauze starts soaking with blood please take your baby to the Emergency Department. This is very rare in our experience, but extremely important, to ensure that bleeding is assessed.
The ring takes between five to ten days to drop off depending. If the ring has not dropped off ten days after circumcision, please call us for assessment. Sometimes it needs further waiting; if the ring is stuck have to remove the ring manually.
Bleeding- go to A&E Baby not passed urine- check that your baby has passed urine within 4 hours of the procedure. If not, then give plenty of fluid or call us f this has not helped. Infection- this may present as swelling, redness with pain and pus discharge. Please contact us and we will prescribe antibiotics. Ring retracted up- this will require manual removal of ring, please contact us. There is a small risk that too much or not enough foreskin is removed.
There is not fee for requesting a review of your baby after the procedure. We also offer video consultation via Acurx software, which is a secure portal.
Please see fees section.
The procedure takes about 10 minutes to complete; that is 5minutes for the injection to work and 5 minutes for the operation. It is our policy not to bring parents into the operating room during the procedure.
COMPLICATIONS OF PLASTIBELL CIRCUMCISION

Please be sure to notify the doctor immediately if any of the following occurs:

  • Excessive swelling
  • Bleeding as explained above
  • Baby not passed urine in 4 hours
  • Infection of the penis
  • The plastic ring has not fallen off by 10th day after circumcision.
  • The ring has slipped on to the shaft of the penis
  • If the wound has not healed as advised by the doctor
   Review Appointment

If you would like to have a review of your baby by video or face to face appointment please contact the clinic. There is no charge for review. If the ring has not dropped off by day 10 please phone the doctor.

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