What should be done after circumcision?
(Update: ) - Skin and soft tissue diseases
It is a question that every mother and father asks themselves once or more than once in their life. My child was circumcised, what should we pay attention to afterwards?
According to my observations, mothers and fathers are very worried about this issue and do not know what to do.
Of course they are right, because how many times they have encountered such a situation 🙂 1, 2, sometimes 3, rarely 4 or more.
When the parents are inexperienced, anxious, the child is tense and painful, a voice is heard to help relatives, friends and family, and many other factors come together, it becomes inconvenient.
Since the topic of post-circumcision care is important, I decided to write this article to help mothers and fathers whose children have just been circumcised.
I hope it helps a lot of families. Get well soon already 🙂 Op.Dr. Ertan BEYATLI
Here are those questions
Will it be pain?
Today, in all circumcision methods performed under local, sedation or general anesthesia, the circumcision area is numbed with some needles.
The effect of these drugs is an average of 1-2 hours. After this period, mild aches begin and if medication is not used, the pain may gradually increase.
These pains become more severe and more frequent in the first 24 hours following circumcision.
The first night after circumcision can be sleepless 🙂
This is quite normal because the child is very sensitive and may show a crying and tingling attitude in order to attract attention and attention to himself.
It is sufficient to use the drugs during this period. After 24 hours, the pain decreases significantly (50-75%) and at 48 hours there is almost no pain.
Think about it when you cut your finger with a knife, the first hours will be painful, but the next day it will only be pain when you touch the wound.
Here, the mechanism and the situation are the same. Even if the pain disappears, medication should be continued regularly!
Local anesthesia Eating and drinking can be started immediately in circumcisions performed with (LA).
In procedures performed under general anesthesia (GA), nothing should be given orally until the child regains consciousness.
Because in these cases, because the vomiting reflex is in an uncontrolled process, some of the removed food and beverages may escape to the lungs through the respiratory tract and cause an undesirable unpleasant picture. This period is 1-2 hours on average.
Most of the time, children urinate before the circumcision procedure. Some children prefer to urinate during the procedure for some reason 🙂
For these reasons, and especially the pain that starts after the procedure causes involuntary spasm of the muscles in the region, the first urination event may be delayed for a few hours. This is normal.
When there is a feeling of urine, the child cannot hold back too much and expresses it. Sometimes the first attempts to urinate may fail due to excessive spasm. In such cases, warm water can be applied to the bladder area.
The first urination situation can be watched with a little burning and there may be interruptions in between. This is a very normal situation. Don't worry right away.
However, if the first urination lasts longer than necessary (24 hours), if the pain gradually increases excessively, if blood is seen with the urine, you should contact your doctor. For example, the bandage may be tightly wrapped and these problems can be solved by loosening it.
Swelling of the penis after circumcision
As with any surgical intervention, some swelling and redness may occur from the incision site and may gradually increase in the first 24 hours. Swelling and redness may gradually decrease after 24 hours. Sometimes there may be sensitivity to the stitches used during circumcision. This situation causes excessive edema and swelling at the tip of the penis. You don't have to worry too much about this situation because it is temporary.
Under normal conditions, the dressing (circumcision dressing) can be removed at home after the first 24 hours. This period can sometimes be extended up to 48 hours and sometimes up to 72 hours.
First, the dressing cloth is thoroughly soaked in warm water and then dissolved. The areas that remain dry during thawing are wetted again with plenty of warm water. Do not be nervous or anxious while performing this procedure because it is completely painless.
It is very normal for a few drops of blood to come out while the dressing is being thawed. It is sufficient to apply open dressing 2-3 times a day with the cream or olive oil given after the dressing is opened.
First, stretch the skin of the penis (pipi) with the left hand thumb and forefinger until you see the tip of the penis (glanz penis), then apply the cream with the right hand thumb and index finger, especially on the suture area and the tip of the penis. It is beneficial to continue the cream application for at least two weeks.
Once a day, the circumcision area should be soaked with warm water or bathed. After drying, the cream should be applied.
Daily wetting of the wound ensures that the area is kept clean, the scabs are removed, the edema is dissolved, and the stitches removed during the procedure are absorbed and fallen off as soon as possible.
Related article: What is edema?
In some overweight children, the penis may get inside and the dressing may fall off in the early period. In these cases, don't worry. If the penis escapes after circumcision, mothers and fathers have a very important duty.
The penis and especially the tip of the penis should be removed manually for at least 7-10 days (until the wound heals), otherwise there will be adhesions and strictures in the area, which may require a second and unnecessary intervention. Also, swelling may occur at the tip of the penis for up to 10 days after circumcision, and this is normal and improves over time.
Pain relieving and antipyretic syrups are usually given as medicine, sometimes antibiotics and sometimes suppositories can be given to babies. There are various creams and ointments to be applied to the circumcision area. Those who do not want to use medication can apply olive oil.
Under normal conditions, 24 hours after circumcision, the first bath can be done with the opening of the dressing. If there is a risk of bleeding, infection or similar situations 48 hours after the first bath It is useful to do. For adult children, it is sufficient to take a bath once a day for up to 10 days. In babies, instead of bathing, the circumcision area can be cleaned with plenty of warm water.
Time to move
After circumcision critical first 24 hours It is a process and it is best not to act as much as possible. It is especially appropriate for the child to spend the first 6 hours lying down. In cases where there is no risk of bleeding and infection, they can move after 24 hours and leave the house.
How many days does the circumcised child's penis heal?
This situation may vary depending on the age of the child and the method of circumcision. This period is a little shorter in babies. It may take 5-10 days for the foreskin to heal.
Time to call the doctor
In the following cases, you may need to contact the physician or healthcare provider performing the procedure:
- The dressing is completely bloody or there is visible bleeding.
- Excessive darkening of the glans, especially 6 hours after circumcision. Under normal conditions, bruising is seen on the tip of the penis and this may continue for a few weeks.
- No urine output 24 hours after circumcision and increased pain despite medications
- blood in the urine
- extreme nausea, vomiting, and fever
What are the mistakes of circumcision?
Although the circumcision procedure is seen as a simple and short procedure in the society, it actually has a very important status in surgery because when it is performed by experienced and unqualified people, some mistakes made during the procedure may be irreversible and cause pain throughout life, for example:
- BLEEDING: It is observed during circumcisions performed with inappropriate techniques or following trauma after circumcision in children with normal or blood diseases. While a second surgical procedure is sufficient for normal children, sometimes it may be too late for children with blood disease.
- SHAPE DISORDER: Irregular and misshapen cutting of the foreskin. If the deformity is within acceptable limits or at levels that will not disturb the family and the child, it is expected until the age of puberty (adolescence). If the deformity has not decreased or disappeared after puberty, circumcision is required again.
- PERMANENT DISABILITY: It is observed if there is excessive tissue loss or excessive burns with cautery. Although it can be partially corrected with various plastic surgery, loss of function does not improve.
- BAD CAUSE TISSUE: It is observed in children whose wound ends are left to heal and not be sutured.
- INFECTION, INFECTIOUS YELLOW: Especially in mass circumcisions, asepsis is observed after circumcisions performed by people who do not know the rules of antisepsis.
- LOSS OF PENISCutting the tip of the penis during the circumcision or complete penile loss.
- excessive cutting of the foreskin and shortening of the penis length
- drug made into the penile veins causing the penis to rot
As can be seen above, this list can go on. Circumcision is an operation and should be done like surgery. It should never be taken lightly, because it is terrifying and can pose problems for your child's life. Circumcision cannot be performed at home, on the street or in a wedding hall. First, the child should be psychologically prepared before the surgical intervention.
After communicating with the child, the foreskin should be carefully removed, the veins tied, and the wound should be closed with self-absorbing stitches. In this way, wound healing is smooth and faster. Our society has gradually grasped the seriousness of circumcision, especially with the increase in media and communication tools in recent years. However, it is not an acceptable justification for some families to have the circumcision wedding in the most beautiful place, but the surgical procedure, which should be essential, under unsuitable conditions by unqualified persons.
When and How is Circumcision Performed?
Circumcision is a surgical procedure that is widely used in various societies, which is called circumcision in the Islamic religion because the Prophet wants it to be done.
It is applied as a cut in a certain shape and size of the skin covering the glans of the penis in boys. Although the benefits of circumcision are still controversial, the ones that have been definitely determined:
- Urinary tract inflammation is less common in circumcised boys.
- Penile cancer is observed only in men who are not circumcised.
- Infectious diseases are more common in men who are not circumcised.
- It reduces the risk of uterine cancer in women.
In our country, circumcision is a religious and social demand and is widely applied in all boys. Having a circumcision ceremony for the family is considered a pleasurable and proud event and a spiritual happiness. For the child, circumcision is an important event in terms of gaining status among his friends.
The best time for circumcision?
Circumcision is usually done before puberty. Recently, it has been accepted as the most ideal age because of the ease of the surgical procedure in newborn (first 2 weeks) babies, the rapid wound healing in the baby, ease of post-circumcision care and no psychological trauma. However, according to my observations, circumcision after the first month is a more correct option due to anatomical reasons and unless there is a very important problem.
Although circumcision can be performed at any age, circumcision should not be performed in children between the ages of 2 and 4, unless it is necessary due to the development of identity, being self-centered and incompatible.
Every child should be informed about the action to be taken and should have the right to accept or not. What is important in circumcision is that the surgical procedure to be performed on the child is performed without causing psychological trauma, in accordance with hygienic conditions and without any problems. Today, there is no acceptable justification for circumcision performed in unsuitable places and conditions by people who have no anatomical, physiological and psychological knowledge. Although circumcision seems simple, it is an important surgical procedure. For this reason, it is necessary to provide a microbe-free environment such as sterilization, asepsis, and antisepsis in the places and instruments where circumcision is performed.
What is the Prophet's Sunnah?
Commonly known as "Prophet circumcision" or "Half circumcision" in medical language "HypospadiasIt is called ”. Surgical intervention must be performed for children born with this problem (especially up to the age of 1) and before the surgical procedure Certainly circumcision should not be done. Children with hypospadias may face infertility problems in the future, so early diagnosis and correct treatment should be applied. Hypospadias is a congenital anomaly (disease) and its most important symptoms are as follows:
- The urinary tract is in the lower part of the penis and further back.
- Curved head of the penis.
- The foreskin is not formed on the lower face of the glans.
- Downward curvature of the penis during erection.
- Children with hypospadias have to sit while urinating, as they cannot urinate forward.
Op.Dr.Ertan BEYATLI / General surgery specialist - Information / Appointment
Circumcision care for babies with diapers
There may be fluid discharge from the wound area after circumcision. When this liquid dries, it can stick to the cloth. therefore, the tip of the penis should be released in babies with diapers. Special apparatus or plastic cups can be used for this. In addition, creams to be applied to the tip of the penis can prevent this sticking. In addition, care should be taken not to contaminate the penis area with poop in babies with diapers. This situation can take an average of a week.