After effects of circumcision in a 11 month old baby?

May 17, 2007 10:26 AM

My 11 month old son needs to be circumcised soon due to extreme phimosis which has led to repeated urinary tract infections. (See this question for some background, actually.) Are there other Mefi parents who have had their older infants/children circumcised? Our urologist seems to think that he'll only be in discomfort for a day or two, and that the aftercare will be fairly minimal, but I'm not sure I believe him. Please lets not debate circumcision, ok? We chose not to have him circumcised at birth, but repeated serious UTIs are a whole other kettle of fish. Thanks!

Just so you know -- we've tried the creme and it hasn't worked. We've had him on preventative antibiotics for over four months to stave off the UTIs, and continuing that can't be good in the long term. Its not unusual for his foreskin to balloon to the size of a golf ball when he urinates (which is clearly uncomfortable and he complains until we do something about it), and gentle pressure is needed to release the urine. This is a procedure that needs to be done, but I a bit concerned that the medical folks are underplaying the aftercare.

Also, he'll be undergoing general anesthesia for the procedure.

posted by anastasiav to Health & Fitness (34 answers total)

I had my adopted son circumcised when he was about 18 months old. Aftercare was not a big deal -- maybe a week of keeping it clean.
posted by indigo4963 at 10:33 AM on May 17, 2007

I was circumsized at age 15 years due to constant irritation despite cleaning several times a day and creams and every other damn thing my doctors could think of. I got stitched up, and the wound actually healed very, very quickly with minimum pain or discomfort. The only part that really sucked was trying to go to the bathroom when I was all bandaged up.

Given how fast babies heal in general, I think you can take your doctor at their word. In my case, it solved all my problems, but at the same time, I wonder how things would be different if I had all those nerve endings back...
posted by AaRdVarK at 10:38 AM on May 17, 2007

Poor little guy. Sorry, no advice (my 5 year old gets irritated under there, but no serious probs), but I wanted to wish you good luck!
posted by serazin at 10:41 AM on May 17, 2007

This isn't the answer you are looking for since it is based only on hearsay, but Penn Jillette did a segment about circumcision on his radio show (for some reason, I can't link to the podcast, but if you look it up, the date is 4-28-06). He was totally against it but a lot of people called in to talk about their experience with phimosis-related circumcision in adulthood. None of them had horror stories or mentioned crippling pain. As I said, this is hardly a scientific response and it isn't first hand. However, if you can find the podcast, it might make you feel a bit more comfortable.
posted by necessitas at 10:57 AM on May 17, 2007

The son of a friend of mine got trimmed this past year (I think he's 10ish). His mom said that it was entertaining seeing him on the pain killers because he was effectively drunk. The son's biggest complaint was scantily clad women on TV, as he would get an erection and that hurt. I imagine that will be less of a problem with an 11 month old.
posted by plinth at 10:59 AM on May 17, 2007 [1 favorite]

Speaking as a girl who did a long stint with preventive antibiotics to stop her recurring UTIs, anything you can do to make them go away is probably worth it in the long run.
posted by crinklebat at 11:06 AM on May 17, 2007

Your doctor's right, and since probably a billion (or more) men have been circumcised over a period of thousands of years, there's pretty good historical evidence to back this up.
posted by Dee Xtrovert at 11:06 AM on May 17, 2007

Mr. Oflinkey had this done when he was in his 20's, and promptly took a train ride from Buffalo, NY to Las Cruces, NM. He sais the care and healing happened quickly, with minimal pain when he urinated for about 2-3 days.
posted by oflinkey at 11:12 AM on May 17, 2007

Uh, he did not urinate for 2-3 days. Geez! I am in a fog...
posted by oflinkey at 11:13 AM on May 17, 2007

You're being a good mommy by worrying like this, but you can relax! Ask for pain meds for your little guy and try to remember: it's just one little slice wound, what, an inch and a half long? It won't hurt too crazy bad, and it's necessary. Babies and genitals are both know for especially swift healing. Stock up on his favorite treats and spoil him rotten if it makes you feel better!
posted by Ambrosia Voyeur at 11:20 AM on May 17, 2007

Wow, he didn't urinate for 2-3 days? Amazing.

(sorry, couldn't resist.)

To the OP: Good luck! Sounds like it'll be fine.
posted by alms at 11:21 AM on May 17, 2007

Per the Bible, it takes at least three days. But they were probably using cruder instruments back then with no good antibiotics or painkillers. I imagine your little guy will be fine.

Plus, he's going to be under GA. Newborns who get circumcised only get topical anestheia or a nerve blocker at best. So as far as the actual procedure goes, he's going to be in much less pain than most kids. Of course, he'll probably want a big teary hug from mom after waking up from GA though.

UTIs really do suck, so the circumcision is definitely a good thing.
posted by bluenausea at 11:30 AM on May 17, 2007

If you're not happy with the advice given by your doctor then get a second opinion. I'd also look for a second and third opinion on the circumcision - its a touchy subject for some people and your doctor may have his/her own agenda in suggesting the procedure - this is something that will affect your child for the rest of his life - I would want to be 100% sure first.
But if you have already decided that circumcision is necessary, whether they are underplaying the aftercare aspect is surely irrelevant? If the child needs the operation then he has to have it.

From what I've heard, (though this is only second hand, I've no first hand experience of circumcision at any age) they're pretty much telling the truth. In *most* cases, the discomfort is minimal but as with any surgery there is the risk of infection, not to mention the risk of giving general anesthetic to an infant. I would ask if its possible to use a local anesthetic, newborns are frequently circumcised without any anesthetic at all, its a big leap to go in only 11 months of life.
posted by missmagenta at 11:34 AM on May 17, 2007

General for circumcision? That doesn't sound right. Are you sure that's what your doctor told you?
posted by damn dirty ape at 11:41 AM on May 17, 2007 [1 favorite]

Response by poster: General for circumcision? That doesn't sound right. Are you sure that's what your doctor told you?

Its what the hospital and the MD both told me. The phrase they actually used was "fully anesthetized".
posted by anastasiav at 11:59 AM on May 17, 2007

Fully may not mean general, tho....god, the general would worry me way more than the circ! Please double check.
posted by tristeza at 12:10 PM on May 17, 2007

There seems to be no reason for general anesthesia for this particular procedure, and it's a good thing to avoid if it's not necessary.

The ill effects from that could be (much, much) worse than the pain from circumcision.
posted by that girl at 12:25 PM on May 17, 2007

Be sure that there isn't another cause for the UTI's. I've been through this. My child had kidney reflux and that can cause serious kidney damage if not treated. We were on antibiotics for a year. Lots of Dr's don't like to test for it because the test is invasive. This is a serious illness that is often missed. Google kidney refux and if you see any symptoms that are similar, please get a second opinion.
posted by pearlybob at 12:29 PM on May 17, 2007

Response by poster: My child had kidney reflux and that can cause serious kidney damage if not treated.

Kidney reflux is out. We had the VCUG and a couple of different ultrasounds to confirm this. My doctor's first thought, actually.
posted by anastasiav at 12:43 PM on May 17, 2007

Was preputioplasty considered unsuitable? It's basically, a small nick to relieve the tension. It has a quicker recovery than full circumscision.
posted by meehawl at 1:36 PM on May 17, 2007

Best answer: Yes, at one year. Had a general. It healed in a few days. It was simple and he didn't not appear to have pain there. Keeping it clean was the only issue and that wasn't hard. What was hard was leaving him with the docs and waiting until it was over, which was only a few minutes in reality. The longest part was because we had two doctors, one for the willy and another to put tubes in his ears. That way he only needed to go under once. I would not fret too much over this one. Make sure you have a good anesthesiologist though.
posted by caddis at 1:38 PM on May 17, 2007

Best answer: There seems to be no reason for general anesthesia for this particular procedure, and it's a good thing to avoid if it's not necessary.

I strongly disagree. Circumcision is a painful procedure, period. Trust me. I've done them. Trying to sew up a small chin laceration on an 18 month old under local anesthetic is a nightmare. Imagine manually taking down the adhesions between the foreskin and the glans of the penis, cutting the foreskin, using electrocautery to stop the bleeding, and then suturing the edges. Under local? Forget it.

General anesthesia for children > 1 year of age who were full-term and who have no significant medical problems is extremely safe (mortality rate of less than 0.01%). The advice given by that girl is not accurate or correct.

Your child will likely recover in a few days with good wound care and some analgesics.
posted by scblackman at 2:49 PM on May 17, 2007

General for circumcision? That doesn't sound right.

I think it's general for babies, more than the particular procedure. You can't really ask a baby to keep still.
posted by mdn at 3:21 PM on May 17, 2007

My views are certainly colored by my interactions. My mother, a medical professional who generally strikes me as non-paranoid would avoid having a procedure done under general anesthesia if it were at all possible.

However, if scblackman thinks that general has greater benefits than risks, his knowledge is most certainly a better indicator than my ideas.
posted by that girl at 5:29 PM on May 17, 2007

I was circumcised at 32 for a similar reason. They sedated me heavily (can't remember if it was an actual general or not) and it bled a lot for a day and hurt like a bastard every time I got an erection for a month.

If you're going to do it, it looks to me like the way these guys do it is probably about the least horrid method, and doesn't need a general.
posted by flabdablet at 7:18 PM on May 17, 2007

even if he is slow to recover, the aftercare cannot be worse than a lifetime of urinary tract infections.

but definitely get a second opinion if it will put your mind at ease.
posted by thinkingwoman at 7:27 PM on May 17, 2007

So anastasiav, can I be a bit selfish for a second? I know you have the new baby and all, but see he is now about a year old. Do you see yourself coming back with some of those just awesomely creative posts? You were one of the top of the top posters, most interesting posts and consistent. I know I am being selfish here, but man I miss that. I still think that any noob who wants to know how to make a post should just peruse your posting history.
posted by caddis at 8:08 PM on May 17, 2007

Response by poster: Caddis, you make me blush. Really blush a lot. I emailed you. Suffice to say that I hope to, I read MeFi every single day, but there isn't a lot of web-facing time in my life right now.

Wow. I'm going to float on that compliment for days. Thank you.
posted by anastasiav at 8:43 PM on May 17, 2007

If you want the foreskin to move free of the glans so his glans can get dry and tough, then the surgical means to do that is NOT circumcision, but DORSAL SLIT (aka Preputial Plasty). It removes no erotic tissue which is good since the foreskin is the best part of the penis.

Generally, the foreskin is self-cleaning and needs no special attention. It sounds like caregiers have been interfering with the ballooning and possibly retracting the skin. These would be the cause of the recurrant infections. Urine is sterile leaving the body and in the normal penis flushes the area within the skin clean. Most males do not naturally retract until some time between age 3 and 18. About 2% of males never do. It's not abnormal, any more than having red hair or living past 100 is abnormal.

YOU SHOULD get the opinion of a doctor WITH A FORESKIN before permitting any surgery. This doctor shouldn't be hard to find since 80% of the wolrd is intact.

-Ron
posted by TLCTugger at 9:57 PM on May 17, 2007

I was offered the slit thing as an option, but decided against it because I thought it wouldn't end up looking normal. But I probably would have been better off going that way.
posted by flabdablet at 10:38 PM on May 17, 2007

anastasiav, I understand a parent's concern, you're very very sweet. but allow me to remind you that this is not open-heart surgery or kidney replacement, thank God: it's a tiny little teeny flap of skin.

let's repeat that: a tiny little teeny flap of skin. in a richly vascularised area of the body, yes, but this is 2007, and I'm sure the procedure will take place in a nice hospital, not in your garden shed with rusty garden tools.

it's a little piece of skin. and unless your baby is a Rocco Siffredi-like monster, I seriously doubt that he has erections at 11 months, so the little tiny stitches will be OK, too (I don't even know if he'll need stitches) -- better do it now than when he's an adult, just ask anybody who underwent the procedure after puberty.

as you know, millions of Muslim kids get circumcised at 12 years old, often with a straight razor at their local barbershop. and they're doing just fine.

if I may respectfully point this out, first Victorian America decides -- a baffling choice, yes -- to circumcise all the newborn babies -- well, most of them -- without apparent reason, unlike the rest of the non-Jewish, non-Muslim world. then circumcision suddendly becomes OMFG THE MOST HORRIBLE THING EVER OMFG -- it's just too extreme, both positions are just too extreme. it isn't necessary for all kids as people thought it was, it isn't a tragedy if it's medically required -- just don't do it if it's not needed; but if it's needed, and your baby does need the procedure, do it. and don't worry.

your son will have many more problems in about 20 years if he has to have his wisdom teeth extracted, believe me. this is nothing. give a scratch on the head to the little guy from me, he'll be fine.

and who cares if you're not posting anymore, you kicked everybody's ass -- but, possibly, madamejujujive's, and just because her booty is unkickable -- for years, you don't have to keep that up forever. thanks for all the good stuff you posted, now you have better things to do -- your family needs you more than some strangers on the Internet do.
posted by matteo at 2:39 AM on May 18, 2007

Whatever you do, make absolutely certain as little cutting is done as possible. I had it done at age 8, due to whatever (pain is all I remember). The doctor botched the "simple procedure", I ended up with a bloody little peepee, 1 week in hospital (was supposed to have been 2 days) followed by a 3-week erection (due to blood coagulated inside my dick). Ultimately, I discovered an opening that was supposed to be closed, and the doctor squeezed my member HARD (more pain) and got the old blood out. Then, finally, it healed quickly.

I suppose the doc was an incompetant fool, I don't know. He was smart enough to be practicing where he was. Why did I have to find the damn opening? (I'm not squimish, so had no issue examining myself). More recently I've learned that my circumcision was probably more radical than was needed. The equipment works just fine, thanks, but I did go through some difficulty and pain for those few weeks (had to stay indoors, in summer, in jammies, the entire time. Had to urinate sitting down, with a damn coffee can over the permanent erection, to direct flow back down).

You are so right to double-check on whatever the doctor says. Someimes they coach their words to sooth you, regardless of reality.
posted by Goofyy at 4:02 AM on May 18, 2007

Unless your baby is a Rocco Siffredi-like monster, I seriously doubt that he has erections at 11 months.

Wrong.

As the father of a 13-month old boy who does not appear to be a Rocco Siffredi-like monster, I can personally attest to the fact that baby boners begin at a very early age, much younger than 11 months.
posted by alms at 11:42 AM on May 18, 2007

My two boys were pointing their little baby boners at me continuously from a very early age, and it's interesting to note the difference in their willies (both uncircumcised). Oldest boy's foreskin is quite closely wrapped around the glans, whilst youngest has a much longer and open foreskin (hi boys, googling (or whatever) in the future!). Little ones heal quickly, with the added bonus of short attention spans. Quick anecdote: housekeeper's son had a circumcision at the age of 12 for the same reasons as your son. He'd been constantly plagued with willy problems all the the years leading up to it, it sucked for a few days, and then he got better. Looking after your little fellow's penis after the procedure shouldn't be a problem as you're already down there changing nappies and applying lotions and wotnot as necessary throughout the day anyway.
posted by h00py at 6:22 AM on May 19, 2007