CIRCUMCISION FOR OLDER BOYS

Anaesthesia

It is not advised to perform a circumcision in a child of more than 1 year old under local anaesthesia alone. It is very stressful for the child because of being immoblisied and restrained on an special bed. The agitation could be a risk factor to the safe completion of the procedure.

Hence, the circumcision in older boys is best performed under general anaesthesia. The child is asleep and the procedure can be carried out in a safe way. A local anaesthetic is also given to make the initial recovery as comfortable as possible.

Surgical technique

We advise a surgical circumcision for the older boys (more than 1 year old).

Plastibell circumcision is feasable in young babies with normal anatomy of the penis. The procedure is quick, there is hardly any blood loss, there is no stitching required and the cosmetic result is very satisfactory.

This procedure is not advisable, however, in older children due to a higher complication rate, such as infection, and in some cases there is an increased risk of bleeding and a requirement for further interventions, the ring might not fall off or may descend towards the base of the shaft.

Surgical circumcision consists of the removal of the foreskin (or prepuce), the sleeve of skin that falls forward from the shaft of the penis covering the tip of the penis. This operation exposes the head (or glans) of the penis. Disolvable sutures (stitches) are used to hold the remaining skin edges together while they heal. We use surgical glue instead of a bandage, so there are no issues with change of dressings or taking a shower. Healing takes 7-10 days. The aftercare is simple and the cosmetic result is generally very good.