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Frequently Asked Questions (FAQ)
What age is best?
85% of circumcisions involve boys under 6 months of age, but in general the younger the boy, the better.
What are the risks?
The risks of any surgical procedure are:
- Risk of bleeding
- Risk of infection
- Surgical mishap
- Anaesthetic complications
The Plastibell technique has proven effective at minimising all these problems.
If my child is circumcised, will he be the odd one out?
Approximately 50% of all boys born in the greater Brisbane district are being circumcised. Queensland-wide, about 15% of boys generate a claim against Medicare which is only for medically necessary procedures and does not include those done for preventative health, those done in public hospitals or traditional or ceremonial procedures.
How many have you done and have you had any complications?
Russell Medical centre was the first group of doctor in Australia to research the use of anaesthetic cream in combination with the Plastibell for childhood circumcisions. The results of the research were published in 1996.The circumcision Australia group of doctors have now performed over 47,000 circumcisions for boys of all ages using topical anaesthetic and the Plastibell.
Results after 47,000 (plus) circumcisions:
- There has never been a significant bleed
- There has never been a transfusion
- There has never been a systemic infection
- There has never been a major cosmetic problem
- There has been one minor anaesthetic problem, which resolved spontaneously overnight
- Minor bleeds (drops, not mls) affect about 0.5 % of all boys and are easily treated in house
- Minor infections (purely localised) affect less than 2% of all circumcisions and are always treated in-house and often don’t need antibiotics
Should I be present in the room when my son is being circumcised?
No, this is not required or even a good idea. Having a parent present is a distraction for the doctor, and we minimise distractions so as to focus totally on “doing a good job”. Parents have a big part to play in applying and reapplying the anaesthetic cream prior to the procedure, and again immediately post-op in comforting and feeding.
Some people suggest we should wait until he’s older and have surgery under general anaesthesia?
As discussed by Dr Terry Russell (MedicineToday May 2002, Vol 3, Number 5) modified Plastibell procedure with prior application of anaesthetic cream has many advantages over a ‘cut-and-stitch’ procedure under general anaesthesia.
The modified procedure:
- Is virtually a closed procedure
- Reduces the risk of bleeding
- Reduces the risk of systemic infection
- Accurately defines the level at which the circumcision occurs
- Can be performed out of hospital
- Is less traumatic to parents and child than a hospital admission
- Avoids exposure to hospital bugs
- Avoids the costs of an anaesthetist and theatre and day-bed fees
- Is less costly to the health system
- Frees beds for other cases
- Last but not least, when a general anaesthetic wears off, the pain is there. By comparison, the anaesthetic effect of the cream lasts for about four hours after the procedure, and by that time, the tissue beyond the ligature is dead, so that even afterwards there shouldn’t be any period during which the boy experiences pain.
What is the best method?
In Australia, 75 to 80% of all circumcisions are by the Plastibell technique. Most of those circumcisions Australia-wide are performed using some form of anaesthesia or analgesia. We will only perform a circumcision if it can be done with the Plastibell, and these are only made up to a size that will fit a boy at about puberty.
Is it painful for older boys?
Each year, we perform more circumcisions on boys aged 6 months to 10 years than any other practice in Australia, and a follow-up study, rated by parents, has shown that most boys have little or no pain either at the time of the procedure or post-operatively.
What if shaft skin is still over or adherent to the head of his penis when it has healed?
Please bring him back for a review. If that skin is adherent, we will separate it off. Do give him a salt bath/sponge followed by air drying when you get home from your follow up appointment and daily for two weeks. Add a handful of salt to a shallow bath, clean the newly-exposed area using a face washer if necessary. Air dry for another two or three days, while it’s a bit raw looking to make sure it doesn’t get infected. Then after that it is simply a matter of keeping it clean and dry.