North Bay Ontario

​A circumcision is a procedure to remove the prepuce (or foreskin) of the penis.  This procedure can be done for either 1) Pathologic causes  or 2) Cosmetic / Religious reasons.  The majority of cosmetic / religious circumcisions are performed in the neonatal age (less than 1 month of age). While the majority of pathologic circumcisions are performed in older children and adults.  

There is significant debate surrounding the risks and benefits of circumcision in the neonatal period.  The most recent reports suggest there can be a small long term benefit to neonatal circumcision and this has been supported by the American Association of Paediatrics (AAP) who recently released their position statement  saying " Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it."

There is no right or wrong decision about neonatal circumcision.  Despite this, the main reasons families choose neonatal circumcision is either for cosmetic or religious reasons.  At Urology North we believe in offering this service to families who wish to have their son circumcised in a safe environment with dedicated surgical care. 

* Please note: Neonatal circumcision is not currently covered under OHIP and as such there is a fee payable for this service.

The Procedure

Pathologic:
Please arrive at the day surgery unit on time. You can expect to be at the hospital for several hours; however the surgery itself will last less than 1 hour.

Neonatal:

Please arrive at the clinic at your scheduled time.  You can expect to be at the clinic for approximately 1 hour.  


Risks

All surgical procedures have inherent risks associated with them.  Despite these risks being very low, we believe it is important that all patients who choose a surgical option are aware of the potential for unwanted outcomes.

Circumcision is a very safe procedure, however there are risks associated with it.  These include significant bleeding, surgical site infection requiring antibiotics, damage to the penis or urethra, damage to the glans penis, including partial penile amputation.  For neonatal circumcision, local anesthetic is used and carries risks of adverse drug reactions.  Pathologic circumcisions are typically performed under a general anesthetic, which include risks of Stroke, cardiovascular issues such as MI, and even death.    


When you arrive

For pathologic circumcisions a general anesthetic or a regional anesthetic (such as a spinal that numbs below the level of the block) will be administered by the Anesthetist. Once frozen or asleep you will be prepped in a sterile manner.  You should not experience any discomfort during the procedure.  

For neonatal circumcisions a local anesthetic will be given prior to the procedure.  Once this has been completed the attachments of the prepuce to the glans will be removed to allow a specialized instrument called a "Mogan Clamp" to be applied to the foreskin. This tool allows for haemostasis and compression while removing the foreskin in a quick and safe manner.  

After circumcision

After the circumcision you will be able to resume normal activities including driving within a few days.  Most patients do not complain of significant pain following the surgery, however discomfort can be expected for a few weeks.  Pain medications are often needed for a few days following the surgery. 

Following neonatal circumcision it is normal for the child to be fussy for a few days.  We recommend comforting the child during this period of time.  There is no evidence to suggest that neonatal circumcision has any positive or negative effect on neonatal development.  If there are any concerns, such as bleeding or infection, please contact the clinic immediately. 


When Should I Call my Doctor?

You should contact our office if significant bleeding or pain persists for more then a few days, if you are having a hard time passing your urine, or if you develop a fever.

Following neonatal circumcision, if the child remains persistently fussy, if there is any ongoing bleeding, or if there are any signs of infection, please contact the clinic immediately.  

Q&A

1. There are many strong opinions on neonatal circumcision.  What is the position of Urology North?

     At Urology North we believe that neonatal circumcision is a personal choice to be made by the family.  We believe in evidence based medicine, and as such, can state that there are likely some small long term benefits to circumcision that must be weighed against the risks of the surgical procedure.  We do believe that circumcision is a surgical procedure and wish to offer this service to families in a safe environment with follow-up specialized surgical care.  

2. Will it hurt?

     The procedure itself should not be uncomfortable and is performed under either a regional or general anesthetic.  It is common to need pain medication for the first few days after surgery and this will be provided to you.  We recommend abstaining from intercourse for 4-6 weeks until the surgical site if completely healed.  

     It is common to have increased sensitivity to the glans penis following circumcision.  This typically resolves and returns to normal within a few weeks.  Loose fitting underwear can help with this.

3.  What about stitches?

     There are no stitches needed for a neonatal circumcision in most cases.  For pathologic circumcisions, we do utilize a series of small stitches around the surgical site.  These are absorbable stitches that will resolve within several weeks.

4. How long will it take?

     The procedure length is determined by the amount of abnormal tissue present and the amount of tissue to be removed.  This can range from 30 minutes to 60 minutes.

     Neonatal circumcision takes 10-15 minutes in most cases, however, a period of time is also given to allow the local anesthetic to take effect. 

Circumcision

Call Us:  +1-705-995-2490

Urology North