The Rotherham NHS Foundation Trust Parent information for children having a circumcision Anaesthetics patientinformationinformation Your health, your life, your choice, our passion
Bring your medicines when you come into hospital Prescription medicines Medicines you have bought Alternative & herbal medicines Inhalers Hearing about your experience of our services is very important as it means we can pass compliments on to our staff and make improvements where necessary. Tell us what you think by emailing us at: yourexperience@rothgen.nhs.uk If you require this document in another language, large print, braille, audio or easyread format, please ask our healthcare providers * *Note to healthcare providers: Translated / easyread healthcare information can be sourced via the Easyread websites listed at the back of this leaflet or via contacting our translation company Big Word. Big Word can be accessed through the search option on InSite.
Circumcision - Child Please follow these starving instructions. If you do not follow these instructions, your child s operation may be cancelled. Remember: Your child must have nothing to eat after: 2.00am if your operation is in the morning 7.00am if your operation is in the afternoon This includes food, milk, sweets, chewing gum and fizzy drinks. Your child may drink water or dilute squash until: 6.00am if your operation is in the morning 11.00am if you operation is in the afternoon Contact the ward you are expected on if your child becomes unwell within 1 week of their planned operation Please come to On At 3
Circumcision About this leaflet This leaflet is designed to give you information about the operation your child is going to have. Please refer to the leaflet Your child s general anaesthetic for important information about how to prepare your child for coming to hospital, what to bring with them, what to expect when you are at the hospital and information to enable your child to receive a safe general anaesthetic. What is a circumcision? This is an operation to remove the foreskin from the penis. Why does this operation need to be done? Either for religious reasons or abnormalities of the foreskin which are not going to improve with age. What would happen if nothing was done? For a child experiencing problems, those problems would persist and in some cases get worse. If the foreskin becomes too tight and scarred it can lead to difficulty passing urine. 4
Circumcision What does the operation involve? With your child fully asleep (under general anaesthetic), the surgeon will make a cut to remove the skin on the penis. The underlying glans (head of the penis) is exposed completely. The skin is then rejoined beneath the glans with dissolving stitches. How long will the operation take? This operation normally takes about 30 to 60 minutes. When the operation is finished your child will be taken to the recovery area. When they have started to wake up you will be able to see your child. The wound All the stitches are buried under the skin and dissolve so they do not need to be removed later. A gauze dressing will be placed over the operation site. 5
Circumcision What complications can occur from the surgery? The most common are bleeding from the site of operation, infection and narrowing of the hole through which the urine (wee) passes. Rarely too much or too little skin can be removed. Bleeding usually stops but occasionally will require a further operation. Infection is not common but requires treatment with antibiotics. Difficulty passing urine after the operation due to narrowing of the hole is unusual, but is more common when there is a scarring process of the foreskin called BXO (Balanitis Xerotica Obliterans). With BXO some cream is prescribed after the operation to reduce the inflammation. Will my child have any pain? While your child is asleep some local anaesthetic will be injected around the base of your child s penis by the anaesthetist and/or surgeon. This will make the operation site numb so your child will not feel pain when they wake up. Very occasionally this is not effective and your child will be given a strong painkiller (morphine) to stop the pain. The local anaesthetic normally gives good pain relief for up to 6 hours. It is important for your child to start taking painkiller medicine by mouth before the numbness wears off for continued pain relief. 6
Circumcision You will also be given some lignocaine gel that you can put on your child s penis to help ease any discomfort he may feel there. When can my child go home? A nurse will check your child s pulse rate and breathing rate at regular intervals until your child is fully awake and back to their normal self. Once your child is ready then they will be given a drink. If they do not feel sick they will then be given something to eat. If your child has minimal or no pain, their temperature is normal and they do not feel sick they will be allowed to go home. Very occasionally the Surgeon or Anaesthetist may advise that your child needs an overnight stay in hospital. Is there anything special I have to do to look after my child at home? If the wound starts to look more red, feels hot, pain increases, or it starts to smell or discharges pus then please seek advice from either your G.P or from the contact numbers given. Will my child have any pain at home? When you go home it is advisable to give your child regular painkiller medicine for the first 24 to 48 hours even if they do not complain of discomfort. Then you can give it as needed. Paracetamol (Calpol) and/or Ibuprofen (Neurofen) can be used. 7
Circumcision What will happen afterwards/ what will the recovery be like? The penis often swells and bruises a little. A scab will form where the skin has been rejoined. Do not try and clean the scab off. There should be no problem passing urine (wee) afterwards. Nappies can be used as normal but older boys may prefer loose clothing until the area is less sore. Your child can have a bath or shower from the day after surgery. Bathing every day will help your child recover. When can my child go swimming? It is best to wait until the wound is fully healed. This is usually after 7 to 10 days. When can my child go back to school? When they are comfortable, usually after 5 days. Will I need to see the Surgeon again? After a straightforward circumcision this is often not required. However all boys with suspected BXO will usually be seen a few weeks after surgery in outpatients. 8
Circumcision Notes 9
How to contact us Day Surgery Telephone 01709 426500 Children s Ward Telephone 01709 424271 or 424049 Children s Assessment Unit Telephone 01709 424053 Switchboard Telephone 01709 820000 Useful contact numbers If it s not an emergency, please consider using a Pharmacy or call NHS 111 before going to A&E. NHS 111 Service Telephone 111 Health Info Telephone 01709 427190 Stop Smoking Service Telephone 01709 422444 A&E Telephone 01709 424455 For GP out of hours, contact your surgery Useful websites www.therotherhamft.nhs.uk www.nhs.uk www.gov.uk www.patient.co.uk Easyread websites www.easyhealth.org.uk www.friendlyresources.org.uk www.easy-read-online.co.uk We value your comments If you have any comments or concerns about the services we have provided please let us know, or alternatively you can contact the Patient Experience Team. Patient Experience Team The Oldfield Centre The Rotherham NHS Foundation Trust Rotherham Hospital Moorgate Road Rotherham S60 2UD Telephone: 01709 424461 Monday to Friday 9.00am until 4.00pm Email: yourexperience@rothgen.nhs.uk Produced by Dr Kim Russon & Mr JC Cooper, August 2010. Revised October 2014. Revision due October 2016. Version:3.0 The Rotherham NHS Foundation Trust 2015. All rights reserved. 10
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