Circumcising older boys

Circumcision in older children can be quite challenging under local Anesthesia in community circumcision clinic .  

Our practice is to apply EMLA local Anesthetic cream 45-60 minutes before the procedure. We give mild sedation (midazolam) 20 minutes before the circumcision in older children. 

Procedure will be performed under local anaesthesia (short acting - Lignocaine and long acting - Chirocaine). We wait 5-10 minutes after local anesthesia to maker sure the procedure will be pain free. Parents will accompany the child during the procedure. There is screen between surgeon and child in the designated theatre so that child will not get upset by seeing the procedure or equipment. 

Children watch cartoon or film on phone or iPad during the procedure. child will get lolly pop and bravery sticker at the end of the procedure. Our staff attends and reassure the parents and child during the procedure. 

Please see the feedback from the mother: 

27th August 2016

Written by a mother at Thornhill Circumcision Centre

"I would like to thank Dr Khan and his wonderful team for the amazing service we received today. My son was circumcised by Dr. Khan who has gone above and beyond to help my son calm down before he operated on him. Dr. Khan and his staff were so caring and attentive to all our needs that makes this surgery stand out from the rest. I will be forever eternally grateful to Dr. Khan.  Thank you!"

Thornhill Circumcision Centre, main theatre

Before Operation Preperation Room

Where I can get circumcised

Your baby can be circumcised at London circumcision clinic, Leyton Healthcare, Leyton London. 

Circumplast device is mainly used, however in some case, I used Plastibell. Getting circumcised for infants and children is at near Leytonstone and Leyton tube station.  

Parents asked " how and where to get circumcised " Circumcision for children is done by a trained paediatric surgeon who has 22 years experience. Ideal age of circumcision is around one month of age.  

Oliver Road Polyclinic, Leyton Healthcare, 4th Floor,  London

Lenthening of frenulum or frenuloplasty

Dr Khan  will cut across the bridge of skin under your penis and repair it lengthwise to lengthen it and this is called frenuloplasty. V-Y or Z pasty may require if frenulum is short. 

Report

Penile frenuloplasty: a simple and effective treatment for frenular pain or scarring

Doctors from King Hospital, London published the report in 2011

“Frenuloplasty, using common plastic surgical techniques for scar lengthening, is a commonly performed operation amongst urologists for isolated frenular pathology. However, there is very little data in the urological literature regarding either technique or assessment. The only other published study was a questionnaire follow-up with a 23% response rate and the technique used was not clarified. Other studies describe expensive, rarely used procedures and are hampered by small patient numbers or short-term follow-up only. Our study validates the common practice of using plastic surgical techniques for scar lengthening. We have 100% clinical short-term follow-up (3 months) and 91% long-term follow-up (up to 10 years) showing high patient satisfaction scores and low complication and re-operation rates. This provides an evidence base from which to counsel patients who are keen for foreskin sparing surgery for frenular pathology. The extra addition of our grading system allows patients to be risk-stratified as to the risk of re-operation depending on their status at presentation and underlying pathology.”

Ref: 2011 BJU INTERNATIONAL | 109, 1546–1550 | doi:10.1111/j.1464-410X.2011.10678.