Potential Complications After CircumcisionMarwan Nasr2016-09-08T13:09:17-05:00
Circumcision is associated with few and infrequent complications, although with any surgical procedure there are occasional problems. For example, bleeding. In almost all cases bleeding is controlled by direct pressure.
Even though complications are rare, do not hesitate to consult Dr. Pollock if you have any questions about the appearance of the penis. Remember, early treatment (if any is needed) is always best.
Post Circumcision Bleeding
Please check your baby’s diaper for any bleeding every 1-3 hours for the first 36 hours after circumcision. If the baby is sleeping, you can just look at the front of the diaper from the outside. If it is not discolored, he is likely not bleeding abnormally. When you open the diaper, it is normal for the covering gauze to be a little red from bleeding.
You treat bleeding from the penis the same as you would for the tip of a finger:
1) Apply pressure to the penis for 2-3 minutes; no less. Do this by grasping the penis between your thumb and two fingers (over the 3×3-inch gauze square).
2) Without removing the 3×3-inch gauze square, inspect the area for continued bleeding and repeat step one if necessary.
3) Leave the 3×3-inch gauze square in place and close the diaper as removing it may lead to renewed bleeding.
It is reasonable for you to try the pressure technique twice, for 2-3 minutes at a time, before calling Dr. Pollock as most bleeding will stop with this. If the penis is dripping any blood, and you cannot stop the bleeding with the pressure technique that our staff has demonstrated to you, call Dr. Pollock immediately on his cell (604) 644-5775. If there is no response within three minutes, call him again every three minutes until he answers.
Concealed Infant Penis
When the length of the penile shaft is no greater than its diameter or when there is a good amount of pubic fat, the penis will tend to retract inward. This is normal. This characteristic is only a concern for the first month or two since the healing circumcision can adhere to the surrounding skin resulting in a “concealed penis”.
If your son fits this profile, you can reduce the chance of concealed penis by applying a very thin layer of Vaseline to the entire glans, once a day, until the glans takes on a healed appearance (about 1-2 months). To expose a glans that has retracted inward, place gentle downward pressure on either side of the base of the penis.
Consult Dr. Pollock if the penis cannot be fully exposed, or if any connecting skin bridges form between the shaft skin and the head of the penis.
Although rare, there have been reported cases of infection. Common signs of infection include: a pus like discharge, a foul smell, excessive swelling or redness, local warmth, a fever, or a rash anywhere in the area of the penis. If you think your child has an infection, call us.
With any of these signs, or if your son has not urinated in over 12 hours, consult Dr. Pollock immediately. In the unlikely event that intervention is required, it is certainly better that we take action quickly.
There will be a long gauze bandage (1/2×8 inches) wrapped around your son’s penis. This bandage should fall off within the first 24 hours (when it does, do not attempt to replace it). If it falls off early, do not worry, this is normal, just leave it off.
You can place the small gauze given to you at our office (with some Vaseline on it) on the penis for the remainder of the 24 hour period. If after 24 hours the gauze bandage is still in place, it will have to be removed.
To remove the gauze bandage:
1) Apply Vaseline liberally and completely over the stuck surface.
2) Close the diaper and allow 10-15 minutes for the bandage to soften.
3) Gently peel away surfaces that are no longer stuck. Repeat the process as necessary.
4) If the bandage won’t come off, call our office to book an appointment ASAP so Dr. Pollock can remove it for you.
Keep in mind the following things:
1) If your child has any medical problems or significant jaundice, discuss this with Dr. Pollock before giving him more Tylenol.
2) If you want, you can sponge bathe your baby following the circumcision, but do not totally submerse him in water for four days after his surgery.
If you have any other comments or questions, do not hesitate to call the office. In case of an emergency, call Dr. Pollock on this cell at 604-644- 5775.
Frequency of complications at the Pollock Clinics:
The frequency of complications after circumcision varies with the skill and experience of the physician amongst other factors. In Dr. Pollock’s hands complications have been infrequent. For example:
• Bleeding – in 1 in 500 circumcisions there may be some bleeding that is usually stopped with pressure or less commonly with stitches. If a bleeding disorder such as hemophilia, then our doctors will need advice from a pediatric hematologist prior to proceeding.
• Infection – there is always a possibility that there could be a generalized infection requiring antibiotics after the surgery (1/4000). Serious infections are rare (1/5000).
• Concealed penis – when there is a good amount of fat around the penis (pubic fat), the penis may retract inward and increase the chances the penis gets partially buried and requiring medical intervention (1/800).
• Meatal stenosis – this is a narrowing of the urethra that may occur after the procedure requiring medical intervention (1/1000).
• Phimosis – this is a narrowing of the shaft skin opening over the head of the penis requiring medical intervention (1/500)
• Trauma resulting in permanent damage to the head of the penis (never in our practice)
• Suboptimal cosmetic result (1/500)
• Skin Bridge (requiring surgical correction)- 1/1000 will have a skin bridge (fine bridge of skin that has grown to connect the shaft skin to the head of the penis) that requires surgical correction. Experienced circumcision physicians will often be able to pickup formation of skin bridges on the follow up visit after circumcision and at that time they are extremely simple to separate with a simple easing back of the skin.
• More serious complications including death (never in our practice).