Circumcision of infant boys has been practised for centuries for religious and cultural reasons. It involves the removal of the prepuce of the foreskin, which is the skin that covers the tip of the penis.
Some believe there are benefits such as cleanliness and reduced cancer risk. It also avoids the occasional need for it to be done when the child is older involving a general anaesthetic and significant postoperative discomfort.

Deciding whether to have your newborn son circumcised can be difficult. You will have to consider both the benefits and risks of circumcision. Other factors such as your culture, religion and personal preference will also affect your decision.

As parents you have the right to decide what is in the best interests of your child. The information contained in this pamphlet may help you make your decision. If you have any concerns or questions, talk to one of our doctors before making an appointment for this procedure.
Are there any benefits from circumcision?

Studies have provided conflicting results. Most authorities say that the benefits of circumcision are not significant enough to recommend it as a routine procedure. Urine infection and some sexually transmitted infections are thought to be less common in circumcised boys. Cancer of the penis although rare is also less common in men circumcised as infants.

How is circumcision done?

There are many different methods used, but our research shows that the Plastibell device is one of the safest to use in infants under local anaesthetic. The Plastibell is a plastic ring that is fitted over the head of the penis under the foreskin. It is then firmly secured by a special tie so that no stitches or dressings are required. The remaining foreskin is then removed leaving a consistent length of foreskin. The Plastibell is designed so that the baby can urinate normally.

What after-care is required?

If your son is distressed following the procedure you can give him paracetamol. For babies 2-3 weeks of age, the dose is usually 1-2ml of paracetamol (120Mg/5mI) depending on their weight. The doctor will advise you of any change in dose. Your son can be bathed and changed normally. The Plastibell ring will come off by itself after 3 to 5 days leaving a narrow open area of skin which heals over naturally in about 1 week. You do not need to put any special creams or dressings on the penis but a small amount of vaseline may help if the skin sticks to the nappy. You can use either disposable or cloth nappies.
Is it painful?

The circumcision is done using a local anaesthetic injection and after giving paracetamol by mouth. The procedure is normally relatively quick with minimal discomfort and baby frequently settles quickly after a feed. Occasionally a further dose of paracetamol is required 4 to 6 hours later.

What is the best age for circumcision?
The ideal time is between 1 to 3 weeks of age but it can be done up to 3 months of age.

Are there any complications?
Both Dr Connell and Dr Russell are highly experienced having done over 5000
operations. This method has a very low rate of complications. Parents should notify
the doctor beforehand of any family history of bleeding problems or if your baby has
not had the Vitamin K injection at delivery. Occasionally there can be minor
infection or bleeding. The amount of foreskin removed can vary. Longer term there
occasionally can be narrowing of the urinary outlet or anaesthetic complications."

You should phone if:
There is any significant bleeding
The ring slips back onto the penile shaft
The penis becomes increasingly red or swollen
The baby remains very unsettled
He has not urinated after 6—8 hours
He develops a fever
  More Information:
For a detailed independent review of circumcision, please refer to the RACP postional statement (pdf), and their website
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