What is circumcision?
Circumcision is the surgical removal of the foreskin that covers the head of the penis. In Azerbaijan, circumcision is mostly done for religious and traditional reasons, and some children have a medical indication.
Medical indications
- scarred phimosis that does not respond to cream treatment,
- lichen sclerosus (narrowing of the foreskin by white, hard scar tissue),
- recurrent balanoposthitis,
- recurrent infections in children with urinary tract anomalies,
- recurrent paraphimosis.
Who should not be circumcised (or should be assessed first)?
- Hypospadias, a “born circumcised” or “half circumcised” appearance,
- buried penis and webbed penis,
- penile curvature or twisting,
- a balloon-like, very large foreskin (megaprepuce),
- children with a bleeding tendency (testing is needed first),
- a child whose general condition is not suitable for anesthesia.
In these cases, the foreskin may be needed for corrective surgery. That is why an examination by a pediatric urologist before circumcision is important.
How is the operation done?
- Anesthesia. Children usually receive a short general anesthetic together with local anesthesia. This means the child does not remember the operation and does not feel pain for hours after waking up. More: anesthesia in children.
- Surgical technique. The outer and inner layers of the foreskin are measured and cut, bleeding is controlled with bipolar cautery, and the incision line is neatly closed with fine, absorbable stitches. Caution: monopolar cautery and burning devices sold as “laser” must not be used on the penis, because the current can spread along the penis and damage the head of the penis and its blood vessels.
- Dressing. A light dressing is applied, or the area is left with ointment only.
The child goes home 2–3 hours after waking up, once he has passed urine.
Home care
- For the first 1–2 days, acetaminophen (paracetamol) or ibuprofen for pain, dosed for age and weight.
- After 24–48 hours, a short bath in warm water 1–2 times a day, without soap.
- Ointment on the head of the penis at every diaper change or after passing urine.
- Loose, soft underwear; no cycling, horse riding or strenuous sports for 1–2 weeks.
- In the first days, a yellowish coating and swelling on the head of the penis are normal.
- The stitches fall out on their own within 1–3 weeks.
More: care at home after surgery.
Possible problems
Complications are rare when circumcision is done by an experienced surgeon under sterile conditions. The most common are bleeding, infection and, later on, meatal stenosis. More: circumcision complications.
When to seek urgent care
If any of the following is present, do not wait for a routine appointment: call the doctor or go to the nearest emergency department.
- Bleeding that soaks the dressing and does not stop after 10 minutes of pressure
- Unable to pass urine for 8–12 hours after surgery
- Fever above 38.5°C, spreading redness, foul-smelling pus
Note for pediatricians and family doctors
Before circumcision, hypospadias, buried and webbed penis, megaprepuce, penile curvature and torsion must be excluded; in these cases the prepuce should be preserved for reconstruction. Ask about a family history of bleeding disorders. Hemostasis is performed with bipolar cautery only; monopolar cautery and “laser” devices are contraindicated on the penis. Medical indications: pathological (scarred) phimosis, lichen sclerosus, recurrent balanoposthitis, recurrent infection in a urinary tract with anomalies.
What happens at the visit?
- Before surgery, the penis, foreskin and urinary opening are examined to check for any condition that rules out circumcision.
- The anesthesiologist assesses the child, and the fasting rules are explained.
- The operation is done in an operating room under sterile conditions, and the incision line is closed with absorbable stitches.
- Before going home, care, pain relief and bathing rules are explained, and a follow-up visit is scheduled.
Frequently asked questions
What is the best age for circumcision?
Medically, there is no single exact age. Circumcision can be done from the newborn period through adolescence. Many specialists prefer an early age, when the child will not remember the operation, or school age, when the child can understand the process and cooperate. The choice is made together with the family.
Is laser circumcision better?
No. 'Laser circumcision' usually refers to a monopolar electrocautery (burning) device. Monopolar cautery must not be used on the penis: the current spreads along the penis and can damage the head of the penis and its blood vessels. Bleeding is controlled with bipolar cautery only. The result depends on the surgeon's experience and sterile conditions.
What about the ring (clamp) method?
In the ring method, the foreskin is clamped over a plastic ring, and the ring falls off a few days later. It is used in some babies, but problems such as the ring slipping or falling off late can occur.
Related topics
- PhimosisTight foreskinCondition
- Circumcision complicationsCircumcision errors, revision circumcisionCondition
- Meatal stenosisMeatal stenosis, narrowing of the urinary opening after circumcisionCondition
- Buried penisConcealed penis, penis that looks smallCondition
- HypospadiasBorn circumcised, half circumcised, “prophet’s circumcision”Condition
- Anesthesia in childrenAnesthesia, fasting rules, preparing for surgeryOperation
- Care after surgeryWound care, bathing, pain relief, activityOperation
Sources
- EAU Guidelines on Paediatric Urology, 2025: Phimosis and circumcision.
- American Academy of Pediatrics Task Force on Circumcision. Circumcision policy statement. Pediatrics, 2012.
This page is for education. Decisions about your child’s treatment are made together with the doctor after an examination.