Introduction
New-born male circumcision is usually performed for religious and cultural reasons. This leaflet will explain what happens and how to organise it.
What is Plastibell Circumcision?
This procedure involves using the Plastibell ring which is a plastic ring inserted between the foreskin and the head of the penis. This causes the foreskin to fall off naturally by blocking blood supply.Assessment
When you attend the clinic, a member of staff will ask you some questions and examine your child. They are checking that there are no reasons that the procedure cannot go ahead, and making sure that you understand what it will involve.
Some babies are born with a condition called hypospadias which means that the hole that your child passes urine from (meatus) is not in the right place. If your child has this condition, we may have to check with the Urologist (a doctor who specialises in the kidneys, bladder and genitals) that the circumcision can go ahead. We will arrange this.
If your child is suitable for a circumcision, we will explain the procedure to you and both parents will have to sign the consent form.

The Procedure

We use the Plastibell(R) technique to perform the circumcision. The procedure takes approximately 10-15 minutes.
Anaesthetic
Once both parents have given their consent, we will apply a local anaesthetic injection around the base of your son’s penis this is to numb the penis. 
The Plastibell
After applying a local anaesthetic, we place the plastibell between the head of the penis (glans) and the foreskin and use surgical string (ligature) to secure it.
We then remove any excess skin to prevent bleeding.Over the next seven to ten days, the surgical string will work its way through the layers of skin to completely remove them and will then fall off along with the Plastibell into your child’s nappy.

Risks

We will remind you of the risks before you give your consent on the day of your child’s procedure. As with all medical procedures, circumcision carries some risks. The most common are bleeding and infection.
Bleeding from the wound happens in around 1 out of 100 procedures. Not all children who experience a bleed will need a further procedure, but around 1 out of 2 will, and they usually need a general anaesthetic.
Infection happens less than 1 out of 100 procedures and we can easily treat this with antibiotics. – You can reduce this risk by following the aftercare instructions.

Aftercare Instructions
  The procedure will take place in the GP Clinic. You will be able to go home shortly after the procedure takes place and your child has passed urine. 
  We will give you a numbing gel to apply to the head of the penis for the first 48 hours.
  Every time you change a nappy, you should apply petroleum jelly (Vaseline) to the Plastibell and the head of the penis to make sure it doesn’t stick to the nappy.
  After 48 hours, you can give your child a bath. Your child should have a bath
every day until the Plastibell falls off.
  There may be some swelling that appears around day five to seven after the
procedure, this is normal.
  The ring of the Plastibell may start to partially separate at this point, that is
normal and it should be allowed to do so on its own.
  After it falls off completely, the wound may look red, or have some white or
yellow discharge, this should settle within two or three days.

Side Effects
It is normal to see a few small drops of blood, or a slight stain in your baby’s nappy after this procedure. If, however, there is a lot of blood, or the small drops do not stop after a few hours, then you should attend the Emergency Department at your local Hospital for Children.
If there is a lot of redness around the skin edges or if there is any discharge, or if you have any other concerns about a side effect of the procedure, then you should speak to your GP or phone 07306381615 or 111.