Before reading this section, please refer to General instructions after surgery in this section of the website.

Your child has just undergone a circumcision, which involves removing the foreskin from the penis. Pain is not usually a big problem after a circumcision. A local anesthetic was administered, so your child should be comfortable immediately after surgery. An appropriate type and amount of pain medication will be recommended or prescribed for your child. If your child is a newborn, the circumcision may have been performed with a clamp that completes the procedure without the need for suturing (stitches). If your child's circumcision was performed in the operating room, there are likely some small, brown stitches around the circumference of the penis along the wound edge just behind the rim of the head of the penis. These usually disappear in a week or two. Baths are very important for healing. In general, it is safe to begin baths two days after surgery, as the wound is usually sealed by then.

Your child's penis will be dressed with either ointment alone (no dressing), or with some type of wrap. If there is no dressing, apply Aquaphor (preferred) or Vaseline to the penis with every diaper change or, for potty-trained children, at least four times per day. The wrap will either be a non-stick gauze or an adherent plastic that looks like Saran Wrap. The non-stick gauze usually falls off with the first diaper change in babies. If so, please begin applying ointment as described above. For older patients, you may remove the dressing after two days. If the dressing is still adherent after two days, begin frequent baths to soak it off. Several baths may be necessary to remove the dressing. If it fails to fall off by the third day after surgery, please notify our office during regular business hours of the next business day. If your child's penis is dressed with a clear plastic dressing (Tegaderm), begin baths on the third day after surgery. If the dressing does not fall off with frequent bathing, please notify us during regular business hours of the next business day. If the dressing appears to be acting like a tourniquet (constricting the base of the penis), please call us immediately. If either dressing falls off ahead of schedule, that's fine- just begin applying ointment as described below. Irrespective of the type of dressing used, or how and when it comes off, once it is off begin applying Aquaphor or Vaseline with each diaper or, for potty-trained children, four times per day for two weeks.

Circumcisions typically heal very quickly. It is normal to see some bruising, swelling, and oozing of blood into the diaper for a day or two. Red spots in the diaper are typically seen. Abnormal bleeding usually occurs on the underside of the penis. Any heavy or persistent bleeding, i.e clots in the diaper, should be brought to our attention immediately. In the meantime, try applying gentle pressure to the site of bleeding using a Kleenex. This technique usually stops the bleeding, but it is sometimes necessary to stitch the wound.

Infections after circumcision are unusual. A thick, adherent yellowish film frequently forms on the head of the penis after penile surgery. The film, called exudate, is a normal part of healing and should not be confused with pus, which is runny.

The most common side effect of circumcision is foreskin adhesion. This occurs when part of the foreskin sticks to a raw area on the head of the penis. To prevent this complication, you need to apply Aquaphor or Vaseline to the ENTIRE head of the penis with each diaper change. For potty-trained boys, ointment should be applied at least four times per day, including after bath and at bedtime. Use a Q-tip if necessary to get under the swollen foreskin. If stitches have been placed, it is OK to gently pull back the penile skin to expose the entire head of the penis. If no sutures were used (i.e. if the procedure was done in the office), do not try to retract the shaft skin, as the wound may separate.

Baths are very important for healing. Once you have begun bathing your child, gently clean the penis with a soft washcloth to remove the build-up of dried blood, exudate, and ointment. It may be very adherent, and it may be sore, but time and persistence usually work. Reapply ointment after the bath.

If you have any questions, or if something doesn't seem right, please call the office during regular business hours (8 am to 5 pm). Don't wait until the afternoon to call, especially if you think your child might need to be seen, as the office closes at 5pm. Again, for bleeding that seems unusually heavy, please call immediately, irrespective of the hour.