London Circumcision Clinic by Paediatric Surgeon/Urologist
Blog - Baby and Adult Circumcision
Parents are usually asked " what is best age for newborn circumcision"
“Baby circumcision remains a widely practiced procedure. Therefore it is important for pediatric surgeons/urologists to perform circumcision safely with minimal trauma to the neonate. This study shows that painless circumcision is possible in almost all newborns if it is performed during the first week after birth.”
This study shows that best age for painless circumcision in newborns is during the first week after birth.
Lignocaine Gel- instillagel 2%
In addition to giving your child/young person painkilling medicine after circumcision, you will be given a tube of local anaesthetic jelly called instillagel to numb the area around the ring near the thread or the stitches. This may be used:
If your child is in pain after circumcision.
If, before passing urine, your child/young person is frightened to do so.
After passing urine.
You will be shown how to apply the jelly in the clinic by Dr. Khan before your child/young person leaves the clinic after circumcision at London Circumcision Clinic. It is very useful for the first 24-48 hours in babies or a few days in children. It can be applied every 4 hours up to a maximum of 5 times a day. It works within 5 - 10 minutes and lasts for up to 45-90 minutes.
If you think your child/young person is in pain after circumcision, please give the painkillers as directed. Please be reassured that you will not overdose him if you follow these instructions, nor will he become addicted to the medicines. It is best to give the painkillers regularly for the first 2 - 3 days after the circumcision and then as needed:
● Paracetamol (Calpol, Disprol)
This can be given to your child/baby regularly 4 times a day for the first 2 days after
going home, and thereafter as needed up to 4 times a day. Give amount as directed on the
bottle or Dr Khan will calculate the dose for babies under 2 months old according to their weight. Paracetamol can be given under 2 months old child.
● Ibuprofen (Junior Nurofen) over 3 months child
Give this to your child/young person after circumcision as needed up to 3 times a day. It is safe to give both
Ibuprofen and Paracetamol together, or alternate Ibuprofen with regular doses of
Paracetamol.
● If your child/young person is asthmatic, it may still be safe to give them Ibuprofen as they may have had it in hospital. If you are worried about this, please talk to the nursing staff or doctors before you leave. If your child’s/young person’s asthma gets worse at home, stop using Ibuprofen, but continue with the Paracetamol as prescribed. Rarely, Ibuprofen can cause indigestion; if this occurs, stop using it but continue with Paracetamol. Follow the instructions on the bottle for drug dosage.
Please ask Dr. Khan if you have any question.
The content on the Our website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice from Dr. Khan regarding any medical questions or conditions developed after circumcision
Please see uptodate about newborn circumcision information for parents.
The penile frenulum, often referred to as the "banjo string," plays a crucial role in male anatomy by connecting the foreskin to the head of the penis. When this small piece of skin is too short, it can lead to a condition known as frenulum breve, causing discomfort during erection and sexual activities.
Adults feel pain during sex due to several reasons. Some men have recurrent pain during sex. This may be due to a short or tight frenulum or a tear to the frenulum. However, pain can occur due to other reasons as well.
Frenulum breve occurs when the penile frenulum is too tight. This small band of skin can cause pain, tears, bleeding, and scarring during sexual activities, making it a concern for many adolescents and men. In some cases, frenulum breve is associated with a skin condition called Balanitis Xerotica Obliterans (BXO), which can result in more severe scarring.
1. Tight/Short Frenulum without Tear or Scar:
- Mild cases with no visible issues.
- Lubricants during sex can help prevent problems.
2. Torn Frenulum with Healing:
- Tear and healing occur, but no lasting scar.
- Considerable discomfort during this stage.
3. Visible Frenulum Scarring with or without BXO:
- Scar tissue becomes visible.
- Associated with a skin condition (BXO) in some cases.
4. Complete Scarring of BXO Beyond the Frenulum:
- Severe scarring extends beyond the frenulum.
- Can result in significant complications.
1. Observation:
- For mild cases, no specific treatment.
- Using a lubricant during sex can help avoid problems.
2. Steroids Cream:
- In the early stages of scarring, applying a steroid cream can be effective.
3. Penile Frenuloplasty or frenulectomy:
- A procedure to release the tight frenulum.
- Dissolvable stitches used for healing.
- Loose bandage applied for a day or two.
4. Circumcision:
- Removal of the foreskin, suitable for more severe cases.
Frenuloplasty or frenulectomy of the penis or release or division of frenulum breve can be cured the pain during sex. Frenulectomy, is simply a foreskin-releasing procedure. An incision is made on the frenulum or excised the ridge underneath the surface, thus allowing full retraction. This will allow you to retain your foreskin but at the same time be able to keep the area underneath clean.
Frenulectomy and circumcision can be done at the same time. Sometimes, adults preferred frenulum removal during the circumcision.
Frenulectomy is the first-line treatment in these cases in which pain or tear to the frenulum is the main complaint.
The benefit is that he retains his foreskin. Frenuloplasty helps to get rid of most of the bending of the penis.
- Done under local or general anaesthesia.
- The frenulum is cut and stitched in a way that lengthens it.
- Wound is sealed with glue
- Dissolvable stitches are used, and a bandage is applied temporarily.
- Expect swelling and bruising, which can last a few weeks.
- Minimal bleeding, usually manageable with pressure.
- Infection is a rare complication treated with antibiotics.
- Changes in sensation over the penis head may occur.
- Some tenderness at the scar site.
- 5-10% chance of foreskin tightness recurrence.
- Swelling and bruising may persist for a few days.
- Stitches dissolve in 3-4 weeks.
- Painkillers can help with discomfort.
- Keep the area dry. Avoid baths for 10 days.
- No swimming or intense exercise for two weeks.
- Maintain wound hygiene after urination.
- Apply Vaseline to the penis tip.
- Wear tight underwear for a couple of days.
- Start withdrawing the foreskin daily after 4 days.
- Sexual abstinence for 4-6 weeks.
Dr. Khan and Our Consultant Urologists, who are fully trained and most experienced in frenuloplasty or frenulectomy (removal of frenulum), will give you professional advice on whether this frenulum removal suits you.
A review of first 1000 circumcisions in boys with a novel disposable ring in a community clinic.
Thornhill Circumcision Clinic, Luton and Leyton Clinic, London
PURPOSE
We evaluated postoperative complications in first 1000 circumcisions with a novel disposable ring, Circumplast, in a community clinic (London and Luton Clinic) for non-therapeutic male circumcision.
MATERIAL AND METHODS
We reviewed the outcome of first 1000 circumcisions performed with Circumplast device in children from May 2014 to October 2016 in a community clinic. Data were collected prospectively and all circumcisions were performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon. Early and late complications were assessed. Complications were further looked for under and over 3 months old. Follow-up consultation/visit were arranged if required.
RESULTS
The mean age of the patients was 11 ± 0.6 months (median 2, range 2 days to 11 years). The overall incidence of minor complications was 10% (n=101).
There is no major complication.
The outcome was significantly better in children under 3 months (7%, 39/554) over than 3 months (14%, 62/446) (p<0.05). Delay in ring separation is significantly lower in children under 3 months (0.3% to 2.9%) (p<0.05). Postoperative use of antibiotics for suspected infection was also significantly lower in children under 3 months (3% vs 7.4% n=17 vs 33) (P<0.05).
Post-operative bleeding (1%), preputial adhesions (1%), buried penis (0.6%), redo operations (0.7%), and urinary retention (0.01%) were recorded, but there was no significant difference in children under 3 months (P>0.05). Mean follow-up consultations were 16 days (range 1 to 373).
CONCLUSIONS
Non-therapeutic baby boys circumcision by the Circumplast device can be safely performed in a community clinic. This novel device decreases the risks of complication especially in children under 3 months of age.
Fisher Exact test, two tailed p value, <0.05 is significant, was done by Graphpad software
I visited your clinic on Monday for a circumcision operation for medical reasons. I am just writing to let you know that I thought the service you offer is excellent.
The doctor was extremely informative and explained everything and the reason behind it.
Clearly explained the procedure and after care information. Kept a relaxed atmosphere.
I am impressed by high standards of professionalism displayed throughout my stay here (Thornhill Circumcision Centre). Good team and God bless.
Very good manner, put me at ease through out the procedure, would definitely recommend.
Excellent service Dr Khan and I will recommend to anyone who needs this services. Thank you.
(Good) Evening Dr (Khan) just wanted to let you know that AP' ring dropped off today (day 10 post op). Thank you for your help and constant check ups. I am so pleased thank you so much.
The doctor was extremely informative and explained everything and the reason behind it.
Dr Khan was very informative and listened to our concerns. So happy with the result
