What is circumcision in older boys?

Circumcision is surgery to remove the skin that covers the head of the penis. This skin is called the foreskin.

Your child will likely be asleep during the surgery. The doctor may use pain medicine to numb the nerves in the surgery area. This is called a nerve block. It helps control pain for several hours after surgery.

You will probably be able to take your child home 2 to 4 hours after the surgery. You can expect your child to fully recover in several weeks. But in some cases it may take a little longer.

Activity

• Let your child rest for a few days. Sleeping will help with recovery.
• Have your child avoid doing any tumbling for a few days. Have your child avoid doing straddling activities, such as riding a tricycle or using a sit-on toy, for 3 to 4 weeks.
• Do not let your child do intense exercise, such as sports, running, or physical education at school, for 3 to 4 weeks.
• Your child may shower or have a sponge bath the day after surgery. Ask your doctor when it is okay for your child to swim or take a bath.
• Your child should be able to go back to school or day care in about 2 or 3 days.

Diet

• Have your child drink plenty of fluids for the first 24 hours to avoid becoming dehydrated. Use clear fluids, such as water, apple juice, and flavored ice pops.
• You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call your doctor.

Medicines

• Your doctor will tell you if and when your child can restart any medicines. The doctor will also give you instructions about your child taking any new medicines.
• Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with a medicine.
  • If the doctor gave your child a prescription medicine for pain, see that your child takes it as prescribed.
  • Talk to your doctor about over-the-counter medicine. Do not use naproxen (Aleve) without your doctor's okay. Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness. Read and follow all instructions on the label.
  • Do not give your child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• If you think the pain medicine is making your child sick to the stomach:
  • Give the medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, be sure your child takes them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.

Incision care

If your doctor told you how to care for your child's incision, follow your doctor's instructions. If you did not get instructions, follow this general advice:

• Always wash your hands before touching the incision area.
• Wash the area daily with warm water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing.
• You may cover the area with a thin layer of petroleum jelly, such as Vaseline, and gauze bandage if it weeps or rubs against clothing.
• Change the bandage every day. And change it more often if the bandage becomes wet, bloody, or dirty.
• Keep the area clean and dry.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that the surgery will remove the skin on the head of the penis. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.
• Your child will probably be able to go back to school or day care in 2 or 3 days.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

After surgery, your child's penis may be painful, swollen, and bruised. In an older baby or child, there may be some blood coming from the wound edge. The penis may have petroleum jelly and gauze on it from surgery. If gauze is used, follow your doctor's directions about when to remove it. When you remove the gauze, first soak it in warm water, and then gently loosen it.

Your child may not sleep as well and may seem fussy while the circumcision site heals. Let your child return to normal activities when your child seems ready or when your doctor says it's okay. This is usually in 2 or 3 days.

If your child wears diapers, use petroleum jelly on the stitches with each diaper change. Fasten the diapers loosely. If your child wears underpants, make sure that the pants aren't rubbing on the penis.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take any medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by an anesthesia provider. Your child will be asleep during the surgery.
• The surgery will take about 1 hour.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor your child's condition. The doctor will talk to you about the surgery.
• You will probably be able to take your child home 2 to 4 hours after the surgery.