OHSU

Circumcision Problems

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 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 abnormal 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)
  • Tiny water blisters occur on skin
  • Plastibell has moved onto shaft of penis
  • You think your child needs to be seen urgently

Call Your Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen, but not urgently
  • 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)

Patient Home Care If

  • Normal circumcision and you don't think your child needs to be seen

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.
  • It will come off on its own.
  • 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.

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


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.

 

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Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 11/1/2011
Last Revised: 11/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

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