Circumcision Problems

Symptoms

DEFINITION

  • Recent circumcision, questions or concerns about
  • Mainly addresses circumcision of newborns

Normal Circumcision Healing

  • A circumcision is the removal of most of the male foreskin.
  • The incision is initially red and tender; the tenderness should be minimal by the third day.
  • The scab at the incision line comes off in 7 to 10 days.
  • If a Plastibell (plastic ring) was used, it should fall off by 14 days (10 days on the average). While it cannot fall off too early, pulling it off can cause bleeding.
  • Complications: Wound infections occur in less than 1 out of 200 circumcised boys. 

FIRST AID Advice for Bleeding: Apply direct pressure to the area with a clean cloth.

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

  • Large blood loss and baby is pale or cold
  • Not moving or very weak

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Age under 1 month old and looks or acts abnormal in any way (e.g., poor suck, poor color)
  • Bleeding is more than a few drops
  • Head of penis is dark blue or black
  • Severe swelling of penis
  • Can't pass urine or only can pass a few drops
  • No urine for over 8 hours
  • Crying and your child can't be comforted after trying this advice for over 2 hours
  • Age under 12 weeks with fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen)
  • Circumcision looks infected (shaft of the penis become red)
  • Tiny water blisters occur on skin
  • Plastibell has moved onto shaft of penis
  • You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently 
  • Bleeding is few drops BUT occurs 3 or more times

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Plastibell present over 14 days
  • Penis looks abnormal (e.g., looks strange or has an extra tag of tissue)

Parent Care at Home If

  • Normal circumcision and you don't think your child needs to be seen

Care at Home

HOME CARE ADVICE FOR CIRCUMCISION PROBLEMS

  1. Reassurance:
    • The tip (head) of the penis is normally very red after the foreskin is removed.
    • The shaft of the penis should not be red.
    • Most circumcisions heal easily.
    • Infections are rare.
  2. Plastibell Ring: Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.
  3. Incision (No Plastic Ring is Present):
    • Remove the dressing (which is usually gauze with petroleum jelly) with a warm wet washcloth 24 hours after the circumcision was done. Often the gauze has already fallen off on its own.
    • Gently cleanse the area with warm water twice a day and whenever it becomes soiled with poop.
  4. Ointment for Pain:
    • Apply a layer of ointment to the incision line. This should reduce any pain and crying.
    • To prevent pain, also apply petroleum jelly or an antibiotic ointment (no prescription needed) to the incision line and head of the penis after each cleansing for the first 4 days.
    • Reason: to keep it soft and prevent the diaper from sticking during healing.
  5. Bleeding:
    • The circumcision wound can normally bleed a few drops.
    • Cause: usually friction from a diaper
    • Will stop on its own or with a few minutes of direct pressure
    • Can prevent by keeping the area soft with an ointment
  6. Expected Course For Plastibell Ring:
    • The plastic ring will normally fall off between 7 and 14 days (average 10).
    • It often hangs by a small piece of tissue for a few days.
    • It will come off on its own.
    • Pulling it off can cause bleeding.
    • It can't fall off too early.
  7. Prevention of Infections: Fasten the diaper loosely to prevent friction against the penis.
  8. Call Your Doctor If:
    • Looks infected
    • Large bleeding occurs
    • Minor bleeding recurs 3 or more times
    • Plastibell ring moves onto shaft of penis
    • Plastibell ring does not fall off by day 14

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.

Last Review Date: 6/1/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Version Year: 2012

Copyright 1994-2012 Barton D. Schmitt, M.D.

Is Your Child Sick?

Pediatric HouseCalls Symptom Checker is a parent guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at Children's Hospital Colorado. Dr. Schmitt has developed other health tools for parents, including the 3rd edition of Your Child’s Health (available in bookstores) and KidsDoc, a new iPhone and Android app for parents (available online).

Are You Sick?

David A Thompson, MD is the author of Adult HouseCalls Symptom Checker. He is a board-certified emergency medicine physician at Northwestern Memorial Hospital in Chicago. He has a national reputation in telephone triage, decision support tools, medical information technology and quality improvement. Adult HouseCalls Symptom Checker is a decision support tool for adults that has been reviewed and approved by adult physicians.

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