Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) because the clamp crushes the edge of the foreskin. Parents should be told to bring the child back to the clinic if: • the child appears to be distressed or in pain; • the child has fever; • the child does not wake for feeding as per his usual pattern; • there is any separation of the skin edges; • there is any unusual swelling or bleeding; • the child has any difficulties with urination; • the parents have any other concern about healing. REFERENCES 1 Taddio A, Stevens B, Craig K et al. Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. N Engl J Med 1997;336:1197-1201. Infant and paediatric circumcision Chapter 6 - 24
Male circumcision under local anaesthesia Version 3.1 (Dec09) Appendix 6.1 INFORMATION FOR PARENTS CONSIDERING CIRCUMCISION FOR THEIR CHILD Parents should be given information about circumcision so that they can give informed consent to the procedure. The information should be given verbally in the local language using non-technical terms. In addition, the clinic should have printed information sheets that the parents can take home. Information given needs to be specific to the clinic, and should include the following topics. • What circumcision is. Circumcision is removal of the foreskin. This means that the head of the penis is exposed all the time. It does not affect the ability to pass urine normally and does not affect the ability to father children in adult life. • The benefits of circumcision. The main benefits of circumcision are improved penile hygiene, reduced risk of sexually transmitted infections, including HIV, and reduced risk of cancer of the penis. • How circumcision is done. The technique to be used should be described, i.e. dorsal slit with sutures, Plastibell, Mogen or Gomco clamp methods. • The risks of circumcision. It should be explained that complications from male circumcision are extremely rare but can include poor cosmetic outcome, bleeding, infection, or injury to surrounding structures. • What to do before circumcision. No special precautions are needed before the operation. If the child becomes ill before the planned operation date, the parents should contact the clinic to postpone the procedure until after the child recovers. • What to do after circumcision. The instructions will depend on the procedure that has been used (see descriptions of techniques in Chapter 6). • What to do if there are any complications or problems after circumcision, in particular bleeding, infection or other concerns. This will usually be for the family to bring the baby back to the clinic, but if distance makes a return visit difficult then an alternative health facility should be identified. • An emergency contact number or information about where to go in an emergency. Infant and paediatric circumcision Chapter 6 - 25
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Manual for Male Circumcision under Local Anaesthesia

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