Earlier is the better. If possible, get your son circumcised as a baby, but we can circumcise older boys when they missed out an infant circumcision – better late than never.

This can be a difficult age group, as they often are scared and may cry after a local anaesthetic injection. It is wise to prepare your child before the procedure and reassure him. However, pain from the injection using a tiny needle lasts only for 10 seconds.

• Child has to be willing and cooperative to have the procedure done. He cannot be forced and ‘child safeguarding and best interest’ is always the priority.
• Occasionally procedure may have to be abandoned where child is frightened and non-cooperative or withdraws his consent and child safety is compromised.
• Child has to be medically fit and well.

• Reassurance:these are rather difficult ages as children of this age group often get scared and frightened, and tend to cry from injection for local anaesthetic.
• Please prepare the child beforehand and create rapport and be honest by re-emphasizing to them that pain from a tiny needle injection lasts only for 10 to 15 seconds. Although cleaning of the glans can be uncomfortable, there is no pain after initial injection.
• Please do not feed 2 hours beforehand, and child should wear loose trousers preferably without any underwear.
• Please bring all necessary medical records and medications if any.
• Please have Paracetamol and ibuprofen available at home as painkillers.

Under local anaesthetic injection, using sterile single-use disposable instruments and plastibell ring for younger children and suturing for older children.

Plastibell ring technique

• Plastibell ring applies only to younger children.
• Ring has the advantage of being quick and less involvement of sharp instruments, hence less intimidating for restless frightened children, possibly less pain, rounded clean cut, early mobility; but may take up to 2 weeks to fall off and can have issue with “ring intolerance “ causing pain after the procedure, urinary difficulty and stuck ruing etc.

  Surgical cutting (sutures):

  • It involves cutting foreskin using a diathermy cautery, stopping bleeding and stitching up the cut edges. This is mostly for bigger boys those who are not restless after 20 seconds injection pain. It has advantage of quick recovery, less pain and complications afterwards.

Although traditional cutting and suturing can have some advantages for them, it is regarded less safe with potential harm to a restless child and more time consuming than the ring system.

Young children tend to take longer than infants to recover after the procedure, as their skin is more mature and tougher to fall off after ring procedure. It takes 1 to 2 weeks for ring to fall off and 1 week to heal for ‘cutting and stitching’ technique.

We provide the best after-care for all our patients. All the relevant information and medicines are provided by our chief doctor and surgeon after the surgical procedure.

Complications are uncommon. However, bleeding, urinary difficulty, infection, stuck ring, swelling, redness and cosmetic deformity etc. can happen. We manage those expediently.

During consultation and examination, doctor will notify you if this is the case. This is not an abnormality and no need to panic and this will have no bearing on his future wellbeing. However, you may have to perform pushing back exercise, one week after the ring falls of completely, for a couple of months. Cosmetic look may not be good for some time and penis may not come out unless you push it out. This usually gets better as the child grows out, loses weight and pubic fat etc. You may be required to come for follow up visits for us to open it up, if you have not done the exercise appropriately.