Balanitis xerotica obliterans (BXO) is uncommon in children. Diagnosis of the condition is almost always clinical and supported by histology.
Circumcision is a common procedure with minimum risks of complications by trained professional doctors. There are different opinions whether there is a need for a male to be circumcised.The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring), reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis (tight foreskin) and paraphimosis ( foreskin stuck behind the head of penis) When the men later becomes sexually active he has substantial protection by circumcision against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s) is also reduced.
The Pollock Technique for newborn male circumcision
Liquid infant acetaminophen is administered orally 20 minutes before the procedure
The room is heated to 25 °C to help keep the newborn warm
A parent (or guardian) accompanies the child into the procedure room to help calm him, if he is distressed
The newborn is secured onto a soft restraining board wearing a clean diaper
The parent gives a grape-juice-soaked cotton ball to the infant orally to help soothe the newborn during the procedure 2.5 ccs of 0.5% Xylocaine is administered into the dorsal and ventral nerves of the penis eight minutes prior to the circumcision
Hemostats are used to open adhesions from the foreskin to the glans to the level of the corona
Hemostats are placed about two-thirds of the way up the foreskin
The Mogen clamp is applied over the foreskin using the pair of hemostats as a guide
The foreskin is excised with the #23 scalpel T
he glans is liberated Hemostasis is promoted with pressure applied with Coban tape over gauze with petroleum jelly
A blanket is used to help comfort the infant The infant is assessed after 15 minutes.
Reference: Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting. Global Pediatric Health January-December 2015: 1–7 © The Author(s) 2015 DOI: 10.1177/2333794X15589114 gph.sagepub.com
Notes: The Pollock Technique for newborn male circumcision in not different from Mogen clamp circumcision. Mogen clamp is commonly used for Jewish circumcision (brit milah). Other methods for baby circumcision are Gomco clamp circumcision and forceps guided circumcision. In my experience, these methods are not superior to Circumplast or Plastibell circumcision in newborn circumcision.
The complications specific to Mogen clamp circumcision (Pollock Technique) include injury to the glans if it is not below the inferior edge of the clamp, and an asymmetric incomplete circumcision due to malpositioning of the clamp (typically more redundancy ventrally).
Reference: Complications of Circumcision: TheScientificWorldJOURNAL (2011) 11, 2458–2468 ISSN 1537-744X; doi:10.1100/2011/373829)