These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.
 

• What is the problem?
  
  
• What happens before the operation?
  
  
• What happens after the operation?
  
  
• General advice

WHAT IS THE PROBLEM?

The delicate bulb end of the penis is protected by a sleeve of skin called the foreskin. Usually the front of the sleeve of skin gradually frees itself from the bulb and will pull back over the bulb by the age of 3 or 4 years. Sometimes the cuff of this sleeve is too long or too tight to allow the sleeve to pull back. This may cause ballooning and pain in the foreskin when your child passes water, or it may cause infection which makes the foreskin red, swollen and painful.

What does a circumcision consist of?

The narrow cuff of the foreskin sleeve is taken away. The remainder of the foreskin is stitched to the base of the bulb end of the penis as if the foreskin is pulled back.

WHAT HAPPENS BEFORE THE OPERATION?

Reception

When registering at reception your medical aid details will be required. Your medical aid may require that you obtain an authority number from them for the hospital. Please check this. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission.

Welcome to the ward

You and your child will be welcomed to the ward by the nurses or the receptionist. Your child's details will be checked. You will be shown to a bed and your child be changed into an operating gown. Please hand in any medicines the child may be taking, so that the drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings.

Visit by the anaesthetist

The anaesthetist who will be giving the anaesthetic will interview and examine your child. He will be especially interested in chest troubles, runny noses, colds, wheezing, dental treatment and any previous anaesthetics.

Diet

Your child may have a usual diet until 6 hours before the operation after which nothing must be taken by mouth. This is to let the stomach empty to prevent vomiting during the operation.

Timing of the operation

The timing of the operation is usually arranged the day before so that the nurses will tell you when to expect your child to go to the operating theatre. Do not be surprised, however, if there are changes to the exact timing.

Premedication

Usually a liquid sedative or tablet is given about 1 hour before the operation.

Transfer to theatre

Your child will be taken on a trolley to the operating suite by the staff wearing a cotton gown. There will be several checks of the details on the way to the operating theatre. You may accompany your child into the theatre complex if necessary, after which you will be asked to leave.

The operation is then performed.

WHAT HAPPENS AFTER THE OPERATION?

Coming round after the anaesthetic

Your child will be sleepy after the operation and may sleep for an hour or more.

Will it hurt?

Your child may have some discomfort rather than any severe pain. If necessary a painkiller will be given. By the end of one week the wound should be virtually painfree.

Drinking and eating

Fluids can be taken straight after the operation and a normal diet the next day.

The wound and stitches

The wound is stitched with absorbing stitches. A special dressing is used which will come off slowly on its own when the child baths.

There may be some swelling of the surrounding skin which improves in 2 to 3 days. It is not important. After 7 to 10 days slight crusts on the wound will fall off. Occasionally minor matchhead sized blebs form on the wound line but these settle down after discharging a blob of yellow fluid for a day or so.

If the foreskin has to be freed from the bulb of the penis at the time of the operation, there is usually some grazing of the bulb. This scabs over and may take 10 days or so to flake off.

Washing

You can give your child a bath each day. Salt water is not necessary. There is no need to try to wash the crusts off.

How long in hospital?

Usually you can take your child home the same day and make an appointment to see the surgeon about 10 days after the operation.

After you leave hospital

Your child may need frequent sleeps for a day or two. There is no need to limit what he does and in any event you will probably find it impossible to do so. It is better not to put dressings on the wound since they can be painful. Let your child go about without pants if clothing is uncomfortable.

School

If your child goes to school he can return to lessons in 10 days or so. He can restart any sport in one month.

Complications

Complications are rare and seldom serious. Occasionally there is swelling or bleeding where the stitches are. The nurses or doctors will attend to this. Occasionally the stitches stay in for more than 10 days. This is not important. As long as the stitches are comfortable leave them until they do drop out. Infection is occasionally seen. This settles down with appropriate treatment. The wound may look a little lumpy at first with some bunching of the skin. This settles down in a month or so. If you think that all is not well, please ask the nurses or doctors.

GENERAL ADVICE

If you have any problems or queries, please ask the nurses or doctors.