Circumcision. Multimedia Health Education. Disclaimer

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Marybeth Carol Kelley
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1 Disclaimer This movie is an educational resource only and should not be used to manage genitourinary health. All decisions about undergoing must be made in conjunction with your Physician or a licensed healthcare provider.

2 MULTIMEDIA HEALTH EDUCATION MANUAL TABLE OF CONTENTS SECTION CONTENT 1. About a. What is? b. Is safe? 2. Health Impact a. Why is it done? b. Is painful for a baby? c. What are the Benefits? 3. The Surgical Procedure a. How is done? b. Things to do after c. Risks and Complications

3 What is? Unit 1: About Male circumcision is the surgical removal of the foreskin of the penis. The foreskin, also called prepuce, is the tissue that covers the glans, or head of the penis. is an elective surgical procedure. Although it is not medically necessary to circumcise a male baby, religious and social influences are often the reason behind a parent s decision to circumcise their baby. is usually done soon after birth before the baby is discharged to home but may also be performed on older children and adults. Is safe? is generally a safe surgical procedure when: The circumcision is performed carefully, using sterile technique The circumcision is performed by a trained, experienced practitioner The circumcision is performed only on a healthy, stable infant

4 Why is it done? is one of the oldest operations performed. is usually done for religious, cultural, or family reasons. Sometimes circumcision is performed because a specific problem with the foreskin (prepuce) exists. Although routine circumcision was once advocated for all newborn males,the current feeling is that it is not medically necessary for all baby boys. Unit 2: Health Impact (Fig. 1) Scientific evidence supports some potential benefits of circumcision but the data is inconclusive in favor of routine circumcision. Most boys will do fine later in life if their foreskins are not removed. Rarely, adult males may eventually need circumcision because of narrowing at the tip (phimosis), infections (posthitis), or irritation. However, teaching young boys proper care of the foreskin can prevent these problems from occurring in the future. The foreskin may increase the risk of urinary tract infections, therefore circumcision may be recommended in boys with any underlying kidney abnormality. (Refer fig. 1) Is painful for a baby? There is strong evidence that circumcision is overwhelmingly painful and traumatic for babies. Some infants do not cry because they go into shock. Infants may exhibit behavioral changes after circumcision. Anesthetics, if used, do not eliminate all circumcision pain What are the Benefits of? There is some scientific research that circumcision benefits can include the following: Protection against urinary tract infections, most importantly in infancy Protection against HIV/AIDS infection and other sexually transmitted diseases (STDs) Protection against cervical cancer in female partners

5 What are the Benefits of? Protection against cancer of the penis Unit 2: Protection against infected/unretractable foreskin and penile skin disease Promotes lifetime ease of cleanliness It is important to understand that the current scientific research available is not sufficient to recommend routine circumcision in male babies and that male circumcision is an elective choice of the parents. Health Impact

The circumcision may be performed using surgical clamp techniques or with a

6 How is done? is usually performed in the hospital before the baby is discharged home with the mother. Sterile technique is maintained to prevent infection after the procedure. The circumcision may be performed using surgical clamp techniques or with a special disposable plastic device called a Plastibell depending on your surgeon s preference. The baby is placed on a table and local and/or topical anesthetic is used to lessen the pain and discomfort. The penis and foreskin are cleaned thoroughly with antiseptic. Unit 3: The Surgical Procedure (Fig. 2) (Fig. 3) (Refer fig. 2 to 9) (Fig. 4) (Fig. 5)

special clamp is applied to the penis or a

7 How is done? Depending on the surgeon s preference, a special clamp is applied to the penis or a Plastibell is used. The foreskin is cut and removed. Pressure is applied to stop bleeding, and the incision is covered with petroleum jelly and sterile gauze. Unit 3: The Surgical Procedure (Fig. 6) (Refer fig. 2 to 9) (Fig. 7) (Fig. 8) (Fig. 9)

Things to do after circumcision Unit 3: The Surgical Procedure It usually takes about

You should follow instructions given to you by your doctor regarding the care of your

Common post operative guidelines may include the following: Generally it is

At each diaper change, you can apply a small amount of unscented petroleum jelly, or

8 Things to do after circumcision Unit 3: The Surgical Procedure It usually takes about 7-10 days for the penis to heal. You should follow instructions given to you by your doctor regarding the care of your infant. Common post operative guidelines may include the following: Generally it is recommended that the area be cleaned several times a day with warm soapy water. At each diaper change, you can apply a small amount of unscented petroleum jelly, or your doctor might recommend application of an antibiotic ointment as well. It may take up to seven to 10 days for the incision scab to slough off. After the scab falls off, no further care is required except for normal hygiene. (Fig. 10)

Unit 3: The Surgical Procedure What are the Risks and Complications? Complications can be medical (general) or specific to your surgery.

Medical Complications that can occur with any surgery include: Allergic reaction to medications Blood loss requiring transfusion with its low risk of disease

11) Complications from nerve blocks such as infection or nerve damage Serious medical problems can lead to ongoing health concerns, prolonged hospitalization, or

It is important that you are informed of possible complications prior to electing to have your child undergo circumcision.

Rarely, stitches may need to be placed or a repeat surgery may be indicated to control bleeding.

9 Unit 3: The Surgical Procedure What are the Risks and Complications? Complications can be medical (general) or specific to your surgery. Medical complications include those of the anesthesia and your child s general well being. Almost any medical condition can occur so this list is not complete. Medical Complications that can occur with any surgery include: Allergic reaction to medications Blood loss requiring transfusion with its low risk of disease transmission Heart attack, strokes, kidney failure, pneumonia, bladder infections (Fig. 11) Complications from nerve blocks such as infection or nerve damage Serious medical problems can lead to ongoing health concerns, prolonged hospitalization, or rarely death. Specific Complications related to surgery are rare but can occur. It is important that you are informed of possible complications prior to electing to have your child undergo circumcision. These can include: Bleeding: Bleeding is controlled with the use of pressure dressings. Rarely, stitches may need to be placed or a repeat surgery may be indicated to control bleeding. It is normal, however, to see a small amount of bleeding for the first several days post-operatively. A few drops of blood or a spot no larger than a quarter on the diaper is acceptable. Infections: Infections are a risk after any surgical procedure but is uncommon after circumcision repair. Your child may be prescribed an oral antibiotic for several days postoperatively to prevent infection. If your child develops a fever or other signs of infection including any increase in redness, swelling, or the presence of pus at the incision site, call your surgeon.

10 Unit 3: The Surgical Procedure What are the Risks and Complications? Long term complications of circumcision are rare but do occur and are usually not noticed until the child is older. These may include the following: Discomfort or pain with erection Penile disfigurement Curvature of the penis Numbness related to scarring

11 Unit 3: Disclaimer Disclaimer Although every effort is made to educate you on and take control, there will be specific information that will not be discussed. Talk to your doctor or health care provider about any concerns you have about. You must not proceed until you are confident that you understand this procedure, particularly, the complications.

12 YOUR SURGERY DATE READ YOUR BOOK AND MATERIAL VIEW YOUR VIDEO /CD / DVD / WEBSITE PRE - HABILITATION ARRANGE FOR BLOOD MEDICAL CHECK UP ADVANCE MEDICAL DIRECTIVE PRE - ADMISSION TESTING FAMILY SUPPORT REVIEW Physician's Name : Physician's Signature: Date : Patient s Name : Patient s Signature: Date :

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