Booking Procedure
It is best to book your newborn’s circumcision within a few days after birth. Ideally the procedure should be done in the first few weeks of life and/or at a weight of less than 13 pounds.
To book your infant’s circumcision (maximum weight 13 pounds, ideal weight for the procedure is 6-10 pounds), please call the office number at 705-726-8281 or email us at urology.barrie@gmail.com
Please include your baby’s age, most recent weight, and your contact phone number in any messages.
Our staff will contact you within 1-2 business days to complete the booking.
Day of the Procedure
Administer a weight appropriate dose of Infant Tylenol/Acetaminophen 1 hour prior to your booked procedure time. For dosing assistance based on your babies weight please either contact our office or your local pharmacist. When administering liquid infant Tylenol it is easiest to have your baby suck on your finger or a pacifier while administering the medication in the side of their mouth; this will ensure they swallow the whole dose.
To prepare for the procedure dress your baby in a full length sleeper/onesie. Avoid pants or diaper shirts as they can be tight around the area of circumcision.
Please bring the following items with you on the day of your appointment:
- pacifier (if your baby uses one)
- extra diapers one size larger than baby is currently wearing
- receiving blanket
- bottle of breastmilk/formula if bottle feeding.
When you arrive our staff will go over the procedure and provide you with a information that covers all aspects of the procedure and post circumcision care. You and your baby will be brought into the procedure room and will have the opportunity to discuss any questions/concerns with Dr. Zadra. Parents will then wait in the waiting room while the procedure is performed.
Circumcision procedure
The infant is placed in a molded padded restraining board and legs are loosely strapped to prevent sudden movements as the procedure is delicate.
The penis and testis are examined for any abnormalities. A special chlorhexidine solution is used to disinfect the penis and surrounding area. 2-3 cc (based on weight) of local anesthetic is placed around the base of the penis via a very tiny needle (penile ring block) prior ensure your baby’s comfort during the procedure. Oral sucrose (sugar water) is provided while having your baby suck on either a pacifier or gloved finger to further decrease pain stimuli as needed.
Dr. Zadra performs the Mogan clamp circumcision method. Silver nitrate sticks are used as needed to control the small amount of bleeding that can occur when the foreskin is released from the head of the penis.
Once the procedure is completed parents are brought into the procedure room to view the circumcised penis and review the post procedure care.
Post Procedure Care
When you change the first diaper at home, the vaseline applied after the procedure will have melted away into the diaper and around the penis. Do not wipe the penis or remove any of the remaining vaseline. If you have any concerns please contact our office during regular business hours.
If the baby has had a bowel movement you may wipe around the baby’s bum and scrotum, not near the penis. Reapply vaseline as shown in the office starting at the base of the penis, and encircling it up to the tip. You can never use too much vaseline, when in doubt, always apply more as this will keep the diaper from sticking, protect the area of circumcision and promote healing. Warming tubes of vaseline in a cup with warm water helps it become easier to apply. It may take 7-14 days for the area of circumcision to heal completely. Continue to to use larger size diapers until the area is fully healed.
The local anesthetic used during the procedure will last for approximately 3-4 hours. If you find that your baby is more irritable than following the procedure you can repeat a dose Infant Tylenol 4 hours after the last dose was given. Most babies do not need further pain control but you know your baby best. We do not recommend using Tylenol for more than 24 hours after the procedure or to treat a fever. Circumcision will not cause a fever. A fever in an infant under 3 months of age should be assessed promptly in your closest Emergency Department.
24 Hours Post Procedure
You may start to bath your baby 24 hours after the procedure once daily as needed. Soak the baby’s bottom half for 2-5 minutes in warm water. Do not use any soap until the area is fully healed. You can sponge bath the rest of the baby’s body as needed and wash hair separately. Towel dry the area around the penis, but do not touch the penis or remove any remaining vaseline. Reapply new vaseline over the old. Continue this process for any baths over the next 10-14 days, until the area of circumcision is fully healed, then you can resume your normal bathing routine.
Day 2-3 Post Procedure
You may notice a greenish-yellow mucousy area around the surgical site. This is a perfectly normal part of the healing process. The small cauterized area on the underside of the penis will form a scab with a greyish-blue tone which will slowly dissolve and disappear in about a week. Mild swelling can occur off and on for up to a month.
Potential Complications
Complications during male circumcision are very rare when performed by well-trained, adequately equipped and experienced providers. If your baby has an excessive amount of bleeding once at home he should be taken directly to the closest Emergency Department for further assessment.
There is always a chance of an adverse reaction to local anesthetic. Reactions are rare and usually seen soon after the injection. Symptoms could include rolling back of the infants eyes and/or difficulty breathing. If symptoms like this were to occur once you are home please go directly to the closest Emergency Department or call 911.
There is a small possibility that residual foreskin may get “stuck” to the head of the penis during the healing process. This happens more frequently with chubbier baby’s or those who experience a sudden growth spurt. The penis may appear to disappear or “turtle in”. If this occurs, place a finger on either side of the base of the penis (best done after a warm bath) and press down gently to expose the head of the penis and then reapply vaseline .
Follow up visits
Although follow up appointments are not usually needed, if you have any concerns with the cosmetic appearance of the penis please do not hesitate to call our office and book an appointment. These such follow up visits are covered by OHIP.