For many men, the circumcision that they received as an infant or child had undesirable results. Reasons for a circumcision revision include:. Complications during the healing process can have resulted in a host of other symptoms that can emotionally and physically hinder male well-being.
Skin bridges occur when the circumcision incision adheres to the glans penis, creating an unusual and unappealing path of skin that connects the foreskin to the head of the penis. This can be uncomfortable for the patient and requires surgical intervention. For men whose parents did not choose to circumcise them as an infant, they now have the advantage of being able to make this decision for themselves as an adult.
They know their body, lifestyle, and sexual activity. Adult circumcisions offer a wide range of health and cosmetic benefits and can be customized to achieve specific results. Men who choose to undergo circumcision for cosmetic reasons still reap the health and hygienic benefits that circumcision offers.
Cosmetic Circumcision can be a life-changing confidence boost to men who struggle with shame in the locker room or bedroom. Depending on your anatomy, Dr. Bidair can tailor your circumcision to give you the optimal appearance and sensation. Your results will depend on how much foreskin is removed and where the incision in the foreskin is made in relation to the shaft of the penis.
During your circumcision surgery, the remaining foreskin will be positioned and tightened on the shaft of the penis to your specifications. As Dr. Bidair tailors the foreskin, he can also adjust its tension. While some men are more comfortable with a loose foreskin, other men enjoy the sensation of a tight, supportive foreskin when fully erect.
Modern science has proven the benefits that ancient peoples supposed. Male genitalia is sensitive, with delicate skin whose folds and crevices require caring attention. Unfortunately, the foreskin can trap bacteria and lead to painful infections with embarrassing side effects. Balanitis occurs when the head of the penis becomes inflamed due to either a bacterial infection, a sexually transmitted infection, or irritation from soaps or detergents.
Neither Mogen nor PlastiBell was associated with greater pain per 3-minute time period, but the PlastiBell technique on average took nearly twice as long as the Mogen procedure 20 vs 12 minutes. Residents and interns universally preferred the Mogen technique over the PlastiBell because of the former's simplicity. Circumcision, one of the most commonly performed surgical procedures in the United States, is carried out because of a complex array of medical, sociocultural, and religious factors.
This study was catalyzed by our hospital's obstetric service choice not to carry out circumcisions because of their belief that it was medically unjustified. Pain, discomfort, and behavioral changes are well documented during neonatal circumcision; 9 , 10 , 11 , 12 however, there are few studies comparing methods and procedures used for circumcisions.
Our presumption was that the procedure of shortest duration would be the least painful granted the amount of pain per unit time was similar with each technique. Although circumcision is usually a rapid procedure in the hands of skilled operators, 13 no studies have compared the amount of time required by trainees to perform different techniques.
The sample included term male infants born at San Francisco General Hospital. Inclusion criteria were:. No urological anomalies contraindicating circumcision, such as ambiguous genitalia or hypospadius. The human research committee of the university approved the protocol. To estimate the sample size, we used the data of Benini and coworkers 14 on heart rate changes during circumcision.
We assumed twice the variability that they found with a similar effect size and determined a sample size of 30 in each group for an alpha of 0. A table of random numbers was used to generate the assignments. The assignments were placed in sealed envelopes that were numbered sequentially.
Infants were not fed for 1 to 2 hours before the procedure. After enrollment, the physician performing the circumcision opened the next envelope, and determined the procedure.
A dorsal nerve block was emplaced using 0. Time of dorsal nerve block, time of first clamp on the foreskin, response to skin clamping, and average infant behavior in 3-minute epochs for the duration of the procedure were recorded. Time was measured to the nearest minute. The infants' responses to the application of the first foreskin clamp were graded by cry, with 0 to 1 indicating no or minimal response, 4 indicating a lusty bellow of rage, and 2 and 3 indicating midrange responses.
This response was used to judge the adequacy of the dorsal nerve block. Thereafter, infant behaviors were graded using a scale of 1 to 7 that was adapted and simplified from other neonatal pain scores. Grade 1 was deep sleep indicated by regular breathing, eyes closed, and no eye or extremity movements.
Grade 2 was rapid eye movement sleep defined by rapid eyelid movements, irregular respirations, and frequent limb movements or twitches. Grade 3, a drowsy state, was characterized by eyes mostly open and sparse body movements with some sucking. An infant who was awake and alert, with eyes occasionally fixing on objects, arms and legs moving, no cry, some sucking movements, was assigned grade 4. Grade 5 was defined by the infant being fussy with infrequent soft vocalizations, purposeful extremity movements against restraints, active head motion, and a facial expression of discontent.
Grade 6 was scored for mild or moderate crying. Grade 7 was defined by continuous loud crying indicative of rage. The beginning of the circumcision was recorded as the time the first clamp was placed on the foreskin. The end of the procedure was recorded when sterile drapes were removed. Medical students, interns, and residents were responsible for obtaining two consents from the parents — one consent for the procedure and another for participation in the study.
Consent forms were written in Spanish or English, and where necessary translators were utilized. In cases where parents refused consent for randomization, circumcision was performed after dorsal nerve block using the procedure chosen by the operator. Only procedures in which consent for randomization was obtained were included in this study. We did not track or record data on those who refused circumcision or those who were not asked for enrollment in the study. The method of performing the Mogen procedure followed the description included with the instrument package insert, H Bronstein, Instructions for the use of the Mogen circumcision instrument.
The method of performing the PlastiBell procedure also followed the directions on the package insert. We trained medical students and house staff for the techniques by routine didactic review, by providing videotapes of each procedure, and by direct supervision. All circumcisions were supervised by an attending neonatologist or an experienced senior resident. On rare occasions when the nursery was busy, the circumcision was performed by one of the four neonatologists.
Sixty-one infants were enrolled in this study over a 2-year period from to Two were eliminated, one for insufficient data and one for unclear identification of the procedure, leaving 30 in the Mogen group and 29 in the PlastiBell group included in the analysis.
No difference in the response to placement of the first clamp was found between the two groups an average score of 1 for each group. If poop gets on the penis, soapy water can be used to gently wipe it away. If there is a dressing on the incision, apply a new one with petroleum jelly whenever you change a diaper for the first day or two.
Even after the dressing is no longer needed, you should put a dab of petroleum jelly on the penis or on the front of the diaper for 3 to 5 days.
This can help avoid discomfort from rubbing and sticking to the diaper. It usually takes between 7 to 10 days for a circumcised penis to heal from the procedure. Until it does, the tip might be raw or yellowish. Call your doctor right away if you notice any of the following:. In the first year of life, a circumcised infant is less likely to get a urinary tract infection. It may be easier to keep a circumcised penis clean and uninfected, though boys who don't have circumcisions can be taught to properly clean beneath the foreskin once it becomes retractable usually by puberty.
Later in life, studies show that circumcised men may also be at lower risk for developing cancer of the penis although the disease is rare.
Circumcision may lower the risk of contracting HIV and other sexually transmitted diseases STDs from an infected female partner.
A circumcision is considered a safe procedure with minimal, if any, risks. Most of the time, there are no complications. When your child is having any kind of procedure or surgery, it's understandable to be a little uneasy. But it helps to know that circumcisions are common procedures and complications are rare. A child who has a circumcision typically heals without any difficulty or health problems. If you have any questions about circumcision, talk with your doctor. Surgeries and Procedures: Circumcision.
Reviewed by: Larissa Hirsch, MD. Larger text size Large text size Regular text size. Pain-Control Measures Several safe and effective pain-control methods can lessen a baby's pain during circumcision. In newborns, the three most common circumcision techniques are: 1. The Gomco Clamp A special instrument called a probe is used to separate the foreskin from the head of the penis they are usually joined by a thin membrane. The Mogen Clamp Again, the foreskin is separated from the head of the penis with a probe.
This is uncommon but is not a complication as it does not affect the healing whether the ring comes off automatically or needs manual removal. Forceps Guided traditional method. This method has been used in circumcision for centuries and involves the full removal the foreskin. The foreskin is pulled in front of the glans and a special forceps is applied to hold the foreskin. The foreskin is then removed and often there is minimal, if any, bleeding.
The smooth surface of the forceps provides a guide for a clean smooth cut. If the wound edges are close apart and there is no bleeding, the wound can be left to heal on its own without the need for stitches.
However, if stitches are needed, the absorbable stitches are applied and they usually come off automatically within weeks.
We use this method for adults and older children, usually above 3 years or when the glans is bigger than the ring. The advantages are that you see the circumcised penis immediately and there is no waiting for dead skin to fall off. The disadvantages are that sometimes stitches are needed and the patient cannot wash the area for 3 days, it must be kept dry.
Freehand method.
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