Circumcision for Children: Key Questions and Answers

Q: Circumcision for Children: Key Questions and Answers

Hello： 1. <br>Is circumcision for a 10-year-old performed under general or local anesthesia? --> General anesthesia. <br>2. <br>There seem to be traditional circumcision and circumcision with a device; which one is more suitable for children? --> Both are acceptable, but the cost

Pediatric circumcision surgery

Hello, Director Du.
My son is 10 years old and in the fourth grade.
He has a condition of phimosis.
In the morning, during an erection, his foreskin is still quite long.
Although I can pull it back to expose the glans, the corona and the foreskin tend to stick together, and he experiences pain during the process.
When he was in second grade, we took him to a urologist for treatment (where they manually retracted the foreskin and applied medication).
However, recently, while bathing with him, I noticed that the foreskin is still very tight and there are areas where the corona and foreskin are sticking together again.
He often avoids cleaning the glans due to discomfort, which has led to an unpleasant odor.
Based on my own experience, I am considering taking him for a circumcision.
May I ask you a few questions?
1.
For a 10-year-old boy, is circumcision performed under general or regional anesthesia?
2.
I understand there are different methods for circumcision, such as traditional circumcision and the use of a circumcision device.
Which method is more suitable for children?
3.
It seems that the areas where the corona and foreskin are sticking together have become tightly adhered.
When he was treated in second grade, the doctor was able to separate them, but I am unsure why there is adhesion again.
Is it still possible to separate these adhesions?
4.
Will the circumcision require my son to take time off from school for recovery? Generally, how many days does it take for him to be able to return to class?
I would greatly appreciate your responses to these questions.
Thank you very much!

Mr. Lin, 10~19 year old female. Ask Date: 2022/06/15

Dr. Du Shixi reply Urology

Hello: 1.
Is circumcision for a 10-year-old performed under general or local anesthesia? --> General anesthesia.
2.
There seem to be traditional circumcision and circumcision with a device; which one is more suitable for children? --> Both are acceptable, but the costs differ; the device method is more expensive, typically around 20,000 to 30,000 TWD.
3.
It seems that part of the corona and the area where the foreskin is adhered has become tightly bound again? When my son was in second grade, the doctor managed to separate it, but I don't know why there is adhesion again now.
Can this adhesion still be separated? --> It can be gradually pushed apart on its own, but it may cause some pain, bleeding, and wounds.
I personally recommend pushing a little bit each day after soaking in warm water for a few minutes to make it less uncomfortable.
If it feels like it's glued together and pushing apart feels like tearing, then it would be best to consult a physician for evaluation.
4.
Does the circumcision surgery require the child to take time off from school for care? How many days does it generally take to recover enough to return to class? --> It depends on the individual; it's recommended to take a longer break to avoid pain at the wound site that could affect learning.
Wishing you good health.

Reply Date: 2022/06/15

More Info

Understanding circumcision for children, especially in cases of phimosis or tight foreskin, is an important topic for many parents. Your concerns regarding your 10-year-old son’s condition are valid, and I will address your questions one by one.

1. Anesthesia for Circumcision: For a 10-year-old undergoing circumcision, the procedure is typically performed under general anesthesia, but in some cases, local anesthesia may be used. The choice depends on the child's health, the surgeon's preference, and the specific circumstances of the case. General anesthesia allows the child to be completely unconscious during the procedure, which can be beneficial for both the child and the surgeon, especially if the child is anxious or if the procedure is expected to be more complicated.

2. Types of Circumcision Techniques: There are various techniques for circumcision, including traditional circumcision and the use of devices like the Gomco clamp or the Plastibell device. The choice of technique often depends on the surgeon's experience and the specific needs of the child. Traditional circumcision is widely used and involves the surgical removal of the foreskin. The Plastibell method is less invasive and may be preferred in certain cases, but it is more commonly used in infants. For a child of your son’s age, a traditional circumcision is often recommended as it allows for better control and precision.

3. Adhesions Between the Foreskin and Glans: It is not uncommon for the foreskin to become adherent to the glans (the head of the penis) in cases of phimosis. This can happen even after previous attempts to separate the two. The adhesions can sometimes resolve on their own as the child grows, but if they are causing pain or hygiene issues, surgical intervention may be necessary. During the circumcision, the surgeon will be able to address these adhesions effectively. If the adhesions are tight, they may not be able to be separated manually without causing pain, which is why surgical options are often considered.

4. Recovery and School Absence: After circumcision, children typically require some time to recover. Most children can return to school within a week, but this can vary depending on the individual child and the specifics of the surgery. It is advisable to allow for at least a few days of rest at home, especially in the first few days post-surgery when discomfort may be more pronounced. Pain management will be important during this time, and your doctor will likely prescribe pain relief medication to help your child feel more comfortable.

In conclusion, it is essential to consult with a pediatric urologist who can provide a thorough evaluation and discuss the best options for your son. They will be able to assess the degree of phimosis, the presence of adhesions, and recommend the most appropriate surgical technique. It is also crucial to discuss any concerns you have regarding anesthesia, recovery, and post-operative care during your consultation. This will ensure that you are well-informed and prepared for the procedure, ultimately leading to a smoother experience for both you and your child.

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