Circumsion and Newborn Circumsion

Liv Hospital Pediatric Surgery and Pediatric Urology Specialist Prof. Dr. Selami Sözübir, answered the questions you wonder about circumcision.




 

Which period is the most appropriate for circumcision?

The most suitable period is before 18 months and after 6 years. Before 18 months , children do not remember the operation for being unconscious. Therefore, pediatric surgeons and pediatric urologists prefer this period for surgery most. This period is divided into two groups as newborn period and outside. If circumcision is considered before 18 months, newborn period should be preferred. 6 years and older is the period when the child is conscious. Although the child does not accept it or fear it, it can understand what is circumcision. Especially between 2 and a half and 4 and a half years of circumcision should definitely stay away. This is the semi-conscious period. The child remembers things but doesn't remember why. Because it does not know what it is and does not share, it can cause many psychological backgrounds to cause sexual problems. In addition, circumcision should be carried out in hospitals where all kinds of emergency interventions can be carried out.
 

What should be paid attention to before circumsion?

In the preliminary period, duties fall on the family and the environment. The child should be told about the circumcision and the circumcision should be explained. Families should forget that today's children are developing very fast due to communication tools such as TV, internet and newspapers. The child should not be lied to in any way about the operation; It's enough to say, "Doctor will tell you." In preparation for pre-circumcision, a doctor interview should be made. The doctor should be consulted with the child, eye and contact with the child if necessary.
 

Surgery or laser?

In circumcision surgery, the technique should be safe, classical surgery. The circumcision performed using the laser is not recommended because there is no return when any problems arise. Operation should be performed by a pediatric surgeon or child urologist.
 

What should be paid attention to after circumcision?

Circumcision is a one-day surgical procedure. The child enters the surgery in the morning and is discharged in the afternoon. When you are discharged, you should listen to the doctor's instructions very well and make a note of it. After circumcision, bleeding and microbes are the most common. There may be bleeding in the trauma, such as excessive movement of the child, a blood disease that has not been determined before, or direct hit on that area. In such cases, the physician should be contacted immediately to avoid bleeding due to bleeding. As long as the precautions mentioned by the doctor are taken into account, there won't be a microbic infection.
 

What is the risk of infection?

In operation room conditions, circumcision, which is performed in a sterile environment and where the correct dressing is applied, does not carry the risk of infection under normal conditions. There is no need for protection antibiotics. There is nothing special to be done at home. But if the swelling, pain and fever coexist, the doctor should urgently apply.
 

Do you have to limit the child's movements?

No. With special anesthetic applications, the area anesthetized for 8 hours. As the pain disappeared after 3 hours, the children laugh and leave the hospital. Therefore, no special restriction is required. Only the first day should move a little less. Also blood and bleeding are not the same thing. Circumcision is an open operation. After a few days of surgery, it is normal to see blood, light pinkness or bleeding. The point to be aware of the family is that, if after 8 hours of circumcision, the patient has a hemorrhagic bleeding.
 

How long for a full recovery?

Full recovery after 4 days. The child comes to the dressing on the 4th day. They can bathe the next day. In the circumcision period, three things should be considered; children should not be put into the pool for a week due to hygiene and should be kept away from the germ. Also, they should not be sent to school for at least one week to remove them from the uncontrolled inhalation environment.
 

How should anesthesia be?

With the exception of neonatal circumcision, children should be circumcised with general anesthesia. The right team and equipment are important for anesthesia. There should be a team that knows child anesthesia and all kinds of infrastructure (such as intensive care unit) of the hospital should be ready. Families who want to circumcise their child before they should wait for the circumcision of the age of 6 years and over. Young children should not be circumcised with local anesthesia. The biggest complications are experienced in the circumcision performed during this period. This is because it is not possible to keep that child in place once a single needle has been shot for local anesthesia in an 18-month-old child. There is no sterilization of such a circumcision. No bleeding, accurate cutting, stitches in the right places are not possible. It is a great risk for both the surgeon and the child.

Is anything done pre-anesthetic to the child?

Children are given a "happiness syrup" in their room. The child feels comfortable and good. The most important feature is forgetfulness; Once the drug has started to effect the child does not remember the ones. He'il be back in his room when he's all over. In the past, children were slept on their adult devices; Now we have special tools for children. There have been very important developments in the drugs applied to children. They wake up very comfortably as if they never had anesthesia.
 

What are the health conditions that necessitate circumcision?

The most important health problem necessitating circumcision is the anomalies of the foreskin. The second is that the foreskin is longer than normal. This prevents both urination and sperm excretion. Apart from these, the circumcision of the prophets can be half circumcised. The circumcision necessitates circumcision in cases such as adhesion or curvature. Also, there are situations in which we recommend circumcision. If the baby has a congenital kidney, urinary or bladder-related anomaly, we recommend circumcision.
 

What are the advantages of neonatal circumcision?

• In the circumcision before 18 months, the first 30-day period is called the newborn period. Newborn circumcision has three important advantages:
• The baby is not anesthetized.
• As it is done with the bell method to prevent cuts, the wound healing in the newborn baby becomes faster and appears more aesthetically pleasing.
• The baby does not remember anything; it in no way leads to psychological problems.

 

Is there an ideal time for neonatal circumcision?

The baby's 5-21 day period is ideal for circumcision. Because the baby is born with edema. She needs to get the edema out of her body and get her skin back to her normal state. Latter; The baby may have an anomaly. In particular, discharge related anomalies may occur a few days after birth. Therefore, it is useful to have 5 days to be fully understood. The third is; the mother should know her baby and ensure that the infant is in harmony with the environment. If the mother understands when her baby is happy or unhappy, she can decide whether or not to cry.
 

In which cases can the newborn circumcision not be performed?

Newborn circumcision is not performed in three cases: 

1. Babies below 2500 grams should be expected to grow more. 
2. He may have congenital blood disease. Bleeding, clotting time should be examined.
3. The baby should be examined by a pediatric surgeon or specialist pediatrician. Because in the future if there is an anomaly that requires to use the foreskin, it is known that circumcision should not be performed in the newborn period.