London Circumcision Clinic by Paediatric Surgeon/Urologist
Blog - Baby and Adult Circumcision
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They have treatments like adult circumcision, infants and children circumcision and other procedures under care of Mr. (Dr.) A R Khan
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Parents are usually asked, "What is the best age for newborn circumcision?"
What is the best age for newborn male circumcision?
Newburn male circumcision has been a topic of discussion for many years. The goal of modern medicine is to achieve the best possible balance between the benefits and risks of neonatal circumcision. Like many medical procedures, this practice carries certain risks or complications; however, the benefits often far outweigh these risks.
First, it is essential to acknowledge that any medical procedure carries a degree of risk. This is a universal truth in medicine, where the most effective treatments often have potential complications. Nevertheless, the overwhelming consensus from various studies is that the risks associated with newborn male circumcision are minimal at modern CQC-registered clinics conducted by trained medical professionals.
One significant point that opponents of neonatal male circumcision (NMC) often raise is the risk of procedural complications. While it is true that minor complications like bleeding, infection, narrowing of the urethra, scarring, inadequate or too much skin removal, and buried penis may occur, serious complications are extremely rare. For instance, serious penile injuries and threats to life are exceptionally uncommon in NMC. According to research by the USA Centres for Disease Control and Prevention (CDC), the rate of penile amputation among uncircumcised newborns was 4 per million, whereas it was zero among circumcised newborns. Medical research demonstrates that the risk of severe complications is exceedingly low for those undergoing NMC.
Moreover, the American Academy of Paediatrics (AAP) has noted that the frequency of minor adverse events associated with NMC is only 1 in 200 (0.5%), with most of these complications being easily treatable and fully resolvable. Serious complications requiring hospital admission affect just 2 in 10000 (0.02%) of cases. These statistics highlight the rarity of severe complications in NMC procedures.
A 2014 study by the CDC further supports the notion that NMC has a low incidence of adverse events. The study examined 41 possible adverse events in a large administrative claims dataset for 1.4 million NMC procedures performed in the United States. The frequency of adverse events was 4 in 1000 cases (0.4%), consistent with earlier studies from 1989. The research reinforces the idea that NMC is a low-risk procedure.
Additionally, the timing of the circumcision is crucial. The risk of serious complications is significantly higher when the procedure is performed on older children or adults. The frequency of complications is 20 times higher for children aged 1 to 10 and 10 times higher for patients over 10 years. This study underscores the importance of performing circumcision in the neonatal period when the risk of complications is lowest.
Another compelling piece of evidence comes from a 2014 analysis in the Mayo Clinic Proceedings. The CDC cited this analysis, which concluded that the benefits of NMC far exceed the risks, with a benefit-to-risk ratio of 100:1. This means that for every potential risk, there are 100 benefits, highlighting the substantial advantage of undergoing NMC.
In summary, while neonatal male circumcision does carry some risks, they are minimal and manageable compared to the potential benefits. The procedure has been shown to have a low incidence of severe complications, primarily when performed in the neonatal period in clinic settings and by trained medical professionals.
The overwhelming evidence supports that the benefits of newborn male circumcision far outweigh the risks, making it a recommended practice in modern medicine today. As with any medical procedure, parents need to consult with a specialist surgeon to make an informed decision that is best for their child’s health and well-being for medical, religious, or cultural reasons.
In conclusion, the optimal time for newborn circumcision is within 1 to 8 weeks of age. Please get in touch with us for further details.
“Baby circumcision remains a widely practiced procedure. Therefore it is important for pediatric surgeons/urologists to perform circumcision safely with minimal trauma to the neonate. This study shows that painless circumcision is possible in almost all newborns if it is performed during the first week after birth.”
This study shows that the best age for painless circumcision in newborns is during the first week after birth.
Reference: Cureus. 2024 Feb 23;16(2):e54772. doi: 10.7759/cureus.54772
Neonatal Male Circumcision: Clearly Beneficial for Public Health or an Ethical Dilemma? A Systematic Review
Lignocaine Gel- instillagel 2%
In addition to giving your child/young person painkilling medicine after circumcision, you will be given a tube of local anaesthetic jelly called instillagel to numb the area around the ring near the thread or the stitches. This may be used:
If your child is in pain after circumcision.
If, before passing urine, your child/young person is frightened to do so.
After passing urine.
You will be shown how to apply the jelly in the clinic by Dr. Khan before your child/young person leaves the clinic after circumcision at London Circumcision Clinic. It is very useful for the first 24-48 hours in babies or a few days in children. It can be applied every 4 hours up to a maximum of 5 times a day. It works within 5 - 10 minutes and lasts for up to 45-90 minutes.
If you think your child/young person is in pain after circumcision, please give the painkillers as directed. Please be reassured that you will not overdose him if you follow these instructions, nor will he become addicted to the medicines. It is best to give the painkillers regularly for the first 2 - 3 days after the circumcision and then as needed:
● Paracetamol (Calpol, Disprol)
This can be given to your child/baby regularly 4 times a day for the first 2 days after
going home, and thereafter as needed up to 4 times a day. Give amount as directed on the
bottle or Dr Khan will calculate the dose for babies under 2 months old according to their weight. Paracetamol can be given under 2 months old child.
● Ibuprofen (Junior Nurofen) over 3 months child
Give this to your child/young person after circumcision as needed up to 3 times a day. It is safe to give both
Ibuprofen and Paracetamol together, or alternate Ibuprofen with regular doses of
Paracetamol.
● If your child/young person is asthmatic, it may still be safe to give them Ibuprofen as they may have had it in hospital. If you are worried about this, please talk to the nursing staff or doctors before you leave. If your child’s/young person’s asthma gets worse at home, stop using Ibuprofen, but continue with the Paracetamol as prescribed. Rarely, Ibuprofen can cause indigestion; if this occurs, stop using it but continue with Paracetamol. Follow the instructions on the bottle for drug dosage.
Please ask Dr. Khan if you have any question.
The content on the Our website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice from Dr. Khan regarding any medical questions or conditions developed after circumcision
Please see uptodate about newborn circumcision information for parents.
A review of first 1000 circumcisions in boys with a novel disposable ring in a community clinic.
Thornhill Circumcision Clinic, Luton and Leyton Clinic, London
PURPOSE
We evaluated postoperative complications in first 1000 circumcisions with a novel disposable ring, Circumplast, in a community clinic (London and Luton Clinic) for non-therapeutic male circumcision.
MATERIAL AND METHODS
We reviewed the outcome of first 1000 circumcisions performed with Circumplast device in children from May 2014 to October 2016 in a community clinic. Data were collected prospectively and all circumcisions were performed under local anaesthesia, by trained doctors with the backup of a trained paediatric surgeon. Early and late complications were assessed. Complications were further looked for under and over 3 months old. Follow-up consultation/visit were arranged if required.
RESULTS
The mean age of the patients was 11 ± 0.6 months (median 2, range 2 days to 11 years). The overall incidence of minor complications was 10% (n=101).
There is no major complication.
The outcome was significantly better in children under 3 months (7%, 39/554) over than 3 months (14%, 62/446) (p<0.05). Delay in ring separation is significantly lower in children under 3 months (0.3% to 2.9%) (p<0.05). Postoperative use of antibiotics for suspected infection was also significantly lower in children under 3 months (3% vs 7.4% n=17 vs 33) (P<0.05).
Post-operative bleeding (1%), preputial adhesions (1%), buried penis (0.6%), redo operations (0.7%), and urinary retention (0.01%) were recorded, but there was no significant difference in children under 3 months (P>0.05). Mean follow-up consultations were 16 days (range 1 to 373).
CONCLUSIONS
Non-therapeutic baby boys circumcision by the Circumplast device can be safely performed in a community clinic. This novel device decreases the risks of complication especially in children under 3 months of age.
Fisher Exact test, two tailed p value, <0.05 is significant, was done by Graphpad software
I visited your clinic on Monday for a circumcision operation for medical reasons. I am just writing to let you know that I thought the service you offer is excellent.
The doctor was extremely informative and explained everything and the reason behind it.
Clearly explained the procedure and after care information. Kept a relaxed atmosphere.
I am impressed by high standards of professionalism displayed throughout my stay here (Thornhill Circumcision Centre). Good team and God bless.
Very good manner, put me at ease through out the procedure, would definitely recommend.
Excellent service Dr Khan and I will recommend to anyone who needs this services. Thank you.
(Good) Evening Dr (Khan) just wanted to let you know that AP' ring dropped off today (day 10 post op). Thank you for your help and constant check ups. I am so pleased thank you so much.
The doctor was extremely informative and explained everything and the reason behind it.
Dr Khan was very informative and listened to our concerns. So happy with the result
