NUMBER: Before circumcision, local anesthesia, that is, regional anesthesia, is applied around the penis (anesthesia is not given). Before this procedure, which is performed with a small needle, the area around the penis is anesthetized with cream or spray so that it cannot feel the needle. There may be redness and color changes on the skin due to this medication.
PAIN: Pain will begin approximately 2.5 hours after circumcision, that is, when the effect of regional anesthesia wears off. Depending on the size of the child, 80% have mild to moderate pain, 15% have very mild pain, and 5% have severe pain. Just because the pain starts suddenly and is severe does not mean that there is a problem with the penis. The cause of severe pain is due to the child's pain threshold being too low, insufficient amount of medication being given, or fear. Post-circumcision pain is a type of pain that results from a skin cut and does not harm the child. Follow the prescription I gave you as described until the next day. On other days, give medication only if the child has pain and at as long intervals as possible. The pain will usually decrease and disappear within 1-2 days. Due to possible side effects, it is beneficial to discontinue painkillers as soon as possible.
BLEEDING: Bleeding occurs as a result of severe straining, impact or external pressure on the penis. and occurs at a rate of less than 0.1%. After circumcision, check your child's penis every 1 hour at the latest. A few drops of blood may come from the tip of the penis or to the gland, this is normal. However, if there is bleeding that does not stop and lasts more than 10 minutes, inform them immediately.
URINATION: During urination, they may feel a slight pain and burning, depending on the movement of their penis. . Especially the first urination is painful and painful. Due to pain or fear, children may rarely feel much pain and may even retain urine for 24 hours. If he retains urine for more than 24 hours, let us know.
ITCHING: Rarely, itching may occur. If it becomes bothersome, they can take a warm shower or hot sitz bath. Additionally, an itching medicine that I recommend can also be used.
PROTECTION: Protect your child from severe blows. on the dick Positions with high cut weight, movements such as crawling and tumbling may damage the penis and cause bleeding. I recommend using a foam cup protection placed inside the diaper, using a diaper one size larger, tying a double diaper, or using circumcision panties.
SLEEP: Position on the back to avoid pressure on the penis. I recommend them to sleep.
MOVEMENTS: I recommend them to rest as much as possible on the first day after circumcision. In the following days, they can play games and do their daily activities. However, activities that require excessive movement such as cycling, wrestling and playing ball are dangerous. In young children or diapered babies, movements such as jumping, jumping, somersaulting, turning sideways can put pressure on the penis and cause bleeding. Therefore, it is necessary to avoid such movements.
CLOTHING: Children can wear their daily clothes that they are comfortable with. Babies can be diapered. Older children can wear specially protected circumcision underpants.
BATH: They can take a bath starting from the second day. Soap or shampoo should not be used in the first bath. Afterwards, you can take a bath as you wish. Taking a shower every day speeds up healing. Especially for children with itching or severe pain, sitting in warm water significantly reduces their complaints. There is no risk of infection in babies, even if they are contaminated with poop. In these cases, you can put the baby in water and wash it.
DRESSING: There is no need for dressing. It is enough to drip St. John's Wort oil for a week.
APPEARANCE: There may be redness on the skin, bruises in some places (especially at the injection sites) and swelling. All color changes are temporary.
FIRE: There is no fever due to circumcision. Even if there is an infection in the penis, it does not cause fever. If there is a fever, it is due to a microbe your child has previously contracted (such as a flu infection or diarrhea). Consult your pediatrician for this.
PAIN: There may be sensitivity in the penis, that is, pain when touched, for 2-3 days. However, it is covered with foreskin for years and after circumcision There may be tenderness and a strange feeling at the tip of the penis (the mushroom part) that rarely lasts for a few weeks. Your child will get used to it completely over time.
WOUND HEALING: Within a week, the active healing process will be completed and wound-related complaints will almost cease. The "aesthetic shaping" period, which will continue from now on and where the crusts and swelling disappear, will last approximately 4-6 weeks, as in all circumcision methods. This process will not cause any complaints and your child will continue his daily activities such as playing games, swimming in the sea or going to school.
Swelling will go down: The swelling will go down for the first 2-3 days. it could be. The shape and amount of swelling will be different for each child. A lot of swelling does not mean that there is a bad development, it just indicates that there is more skin sensitivity than expected. Swellings, regardless of the amount, will disappear completely in 4-6 weeks. Especially in plump babies, after the swelling disappears, the remaining skin appears as a slight fold around the penis. This fold, which gives the impression of a slight swelling, is the skin margin necessary for the penis to harden during urination and for its future development. As your baby grows, these folds will disappear
AESTHETIC APPEARANCE: Aesthetic healing, that is, the stages of the crusts falling off and the swellings subsiding, do not cause any complaints in your child. During this period, your child continues his daily life such as playing games, swimming or going to school. In this method, the most natural healing process occurs. When the crusts fall off and the swelling subsides, a very smooth and aesthetic penis appears. During this process, people or physicians who are not familiar with the method may demoralize you. However, after 30-40 days, your child will have the ideal penis appearance. The appearance of the fungal part of the penis may occasionally be purple in babies and young children. This appearance is the normal color of that area. It is the color given by the tangle of dirty blood vessels underneath, due to the skin being very thin. The purple color becomes more evident during the cold-hot change and when the pipini hardens. Depending on age, this color becomes pink as the skin covering the tip of the penis thickens. It should also not be forgotten that r so that you do not compare your child with others as each child's penis appearance is unique.
FUNCTIONAL DEVELOPMENT: It has been practiced for centuries. In this method, the amount of tissue cut and the way it is cut does not cause any sexual function problems in the future. The vessels and nerves (cavernous artery and nerve) that enable penis erection are deep and pass in the inner part of the penis.
CHECKS: You can bring it for its first checkup after a month has passed.
POSSIBLE RISKS:
1.LOCAL ANESTHESIA: Very rarely ( It has been reported that serious, life-threatening adverse allergic effects have been observed due to local anesthesia (approximately one in 100 thousand).
2. BLEEDING: An average of 10% in the first 24-48 hours. Prolonged bleeding is observed in a rate of 0.4. Post-circumcision bleeding is in the form of leakage and occurs through the skin. Although short-term bleeding does not cause significant blood loss, it can be dangerous if it continues for more than a few hours. Most bleeding stops with a pressure dressing, but a few require stitches. Although bleeding scares the family and the child, it is a condition that can be stopped in a short time and does not cause any permanent damage to the penis if it is intervened in time. For this reason, check your child's penis frequently, especially in the first 24 hours, and inform us if there is bleeding that lasts longer than 10-15 minutes.
3. BURIEDNESS: During the healing process, in some children, the fatty tissue around the penis may develop. It pushes the skin forward to cover the penis. Accordingly, the wound begins to close above the penis level. In this case, the pipe is buried inward and the head of the pipe, that is, the mushroom part, is not visible. Pipi burying usually occurs within the first few weeks of the wound's active healing process. If there is no burial within a month, there is no risk of burial after this period. The risk of impaction is higher in chubby babies or plump children (95th percentile or above). Approximately 3-5% of babies are at this risk. 7-10 days after circumcision, it will be understood whether your baby is at risk. He/she is at risk of being buried during the checks. Pipi massage is recommended for babies with frequent intervals. In the pipi massage, the fatty tissues around the penis are pushed back, allowing the tip of the penis to move forward. Pipi massage, which is a very easy maneuver that will be shown to you by your doctor, does not cause pain or suffering, although it may make your baby a little uneasy. In babies at risk, the risk of burying is eliminated when pipi massage is applied early (in the first few weeks) and regularly. Do not forget that it is very difficult to open the penises that are buried and therefore not massaged even though it is recommended. In addition, it is difficult to open and massage the buried penises, which are noticed 3-4 weeks after circumcision, as they do not come for check-ups. Therefore, come for your check-ups regularly, if you cannot see the mushroom part of your penis, please inform us immediately and follow our recommendations. In the post-circumcision period, especially in plump babies, the penis sometimes gets into the fatty tissues and stays there for a while. This does not mean that the penis is buried. If you can easily see the fungal part of the penis when it hardens or when you push the fatty tissues, this is definitely not a buried penis.
4. INFECTION: The most important findings of the infection: new onset pain, new It is a visible swelling and a new onset of redness. In these cases, please notify us. Do not forget that infections occurring in the penis are superficial skin infections that do not cause fever, are easily treated with antibiotics, and do not cause any permanent damage to the penis.
5.PSYCHOLOGICAL EFFECT: Some psychiatrists recommend that circumcision should be performed between the ages of 3-6. They state that it may cause permanent psychological effects. There is no scientific study on this thesis, which was developed based on the "castration anxiety" theorem put forward by Freud more than a hundred years ago, and it has still not been proven. Circumcision is a serious surgical intervention and can cause more or less permanent or temporary psychological effects in children, regardless of age. Older children may experience complaints such as urinating their pants, biting their nails, having nightmares, and not being able to touch their penis after circumcision. Babies may experience problems such as crying every time their diapers are unwound or when they lie on their backs, and waking up crying at night, even if only temporarily.
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