Baby

Circumcision

It can do more harm than good… harm that could be fatal when the person performing the surgery is not competent.

No, it is not always useful and yes, it has some benefits. When performed on children older than two years old, circumcision (foreskin removal) may be relevant for two medical reasons. First, says Dr. Dickens Saint-Vil, paediatric surgeon and Director of the Paediatric Surgery Program at Sainte-Justine hospital, “It can be relevant for children who have a foreskin problem, such as phimosis (a narrow foreskin opening due to recurrent infections) or for those who suffer from repeated urinary tract infections.”

In infants less than eight weeks of age, circumcision is only performed for personal and religious motives, and under local anaesthesia. In children’s hospitals, children between eight weeks and two years of age are not circumcised because it would have to be under general anaesthesia and it is two risky for children under two years old, says Dr. Saint-Vil.

When parents want their child to undergo this surgery for personal motives, it usually is for religious reasons. “It happens a lot in Muslim families who believe it will make hygiene easier or simply because the father was circumcised”, explains Dr. Saint-Vil. This intervention, which is not covered by Quebec’s Health Insurance, can cost up to $1,800. When circumcision is performed for medical reasons, it costs $250.

Since the province of Quebec – and more specifically the metropolitan area – welcomes more and more families of different cultural communities, the number of circumcised babies, boys and young men rose considerably in the past few years. 

The operation and postoperative care

Performed in infants, circumcision is an operation lasting around twenty minutes. After restraining the baby and injecting an anaesthetic substance in the periphery of his penis, we place a bell-shaped plastic ring around the glans, under the foreskin, before cutting the foreskin. For boys over two years of age, the “bell” is not used; the surgeon removes the foreskin instead and stops the bleeding with stitches. This operation lasts about an hour. 

The foreskin is a mucous membrane that protects the glans, a very sensitive part of the male anatomy. Deprived of its natural protection during circumcision, the glans eventually becomes thicker and changes color to build a new form of protection.

Newborns, just as much as young children, experience pain after circumcision. Acetaminophen (Tempra and Tylenol for example) as well as EMLA cream can ease the pain but not completely, at least during the first 48 hours after surgery. The friction of the glans on the diaper or the underwear can obviously amplify the pain. You can apply Polysporin or Vaseline to ease the pain, recommends Dr. Saint-Vil.

« Do not wet the glans on the first day after surgery, he adds. It is best not to practice sports for at least two weeks to avoid possible hits“.

Risks

In Quebec, circumcision is mainly performed in paediatric hospitals or by paediatricians in regional hospitals for medical reasons.

Parents can have their newborn circumcised in private clinics where some paediatricians have a training certificate to perform the bell method. Because clinics are only allowed to perform medical treatments under local anaesthesia, they cannot perform circumcision in children over two years of age.


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