Dr. Ismaïl ZARROU - Médecin généraliste à Casablanca :
bernoussi et ain sebaa
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Circumcisions
since August 2015
0 complications
>4500
All the interventions are filmed and the video is available to parents on demand
New FREE transport service to get to the office with your child and return home safely (in Casablanca)
prices
1560 DHS
Child under 3 years old
WHAT is CIRCUMCISION (POSTHECTOMY)?
Circumcision (posthectomy) is a simple and quick operation which consists of removing part of the
skin: the foreskin, which covers the tip of the penis: the glans.
The ideal age for circumcision is 5 to 12 days.
However, our doctor performs circumcisions on older babies, young boys, adolescents and
adults.
HOW?
Before the intervention the doctor carries out a complete clinical examination of the child
and ultrasound if necessary
Then the nurse takes a drop of blood from the child's toe to perform the analysis,
sixty seconds later we obtain the result and we begin the intervention.
4-Step Pain Control Protocol
Pain is minimized with paracetamol
+ a sweet lollipop (to reduce the feeling of pain),
+ a topical numbing cream/spray
+ and local anesthesia by injection: Using a fine needle, an anesthetic product is injected
in the part already desensitized by the topical cream / spray = a technique called nerve block
dorsal of the penis.
After the first minute, the penis is frozen.
IMPORTANT NOTE:
Before starting we test by pinching part of the foreskin,
and we watch if the child jumps up / reacts
so we're sure he's 100% anesthetized
The doctor then proceeds to:
A toilet of the glans after decapping: discovery of the entire base of the glans.
And then at the circumcision = the foreskin is cut: skin and mucous membrane with the help of an electric bistoury.
and finally: mucocutaneous suture for improved aesthetic results.
THE DAY OF THE APPOINTMENT:
Plan to be in the office for one hour.
Feed your son before you leave home, so he won't be hungry in the office.
Arrive at the office 15 minutes before the appointment time and bring two blankets and baby diapers.
If you arrive late, your appointment may be rescheduled.
Thirty minutes before the appointment time, give your baby paracetamol.
DO NOT GIVE aspirin or ibuprofen to avoid causing heavy bleeding.
CARE AFTER CIRCUMCISION?
Keep the treated area clean and dry.
Change diapers more often during the first week to keep the area drier and cleaner.
Gently clean the area around the penis with warm water and a cotton ball or soft cloth.
DO NOT USE wet wipes, alcohol, powders or lotions, which may irritate the wound.
Avoid unnecessary car trips, which can irritate the newly circumcised penis.
In the event of such a move, place a folded diaper between your baby and the tether straps to
prevent pressure on the penis.
DURING THE FIRST 24 HOURS:
It's normal for your baby to be a little fussy for the first 24 hours.
Make sure he is comfortably wrapped: the less he bumps into his legs, the better he will feel.
While sleeping, your baby should be more comfortable lying on his side.
Above all, avoid laying him on his stomach.
Most babies sleep well after circumcision.
Give care in a quiet environment.
A baby who cries for more than a few minutes may have swallowed air during the operation.
You have to make him burp, but avoid putting pressure on his penis.
During the three days following the surgery, limit the toilet of the child to sponge baths.
Check your baby's diaper every hour for signs of active bleeding.
If he is sleeping, just look at the front of the diaper.
If there is no trace of blood, his penis is probably not actively bleeding.
Each changed diaper might have coin-sized blood stains, and the gauze
will be a little red from the bleeding. This is normal.
After 24 hours, remove all dressings and bandages.
They are likely to peel off earlier: smear a thin layer of ointment on one of the compresses and
cover the penis with it for the rest of the 24 hours.
When you remove the bandage, it is normal for the penis to be discolored, there are drops of blood and
patches of skin at the tip of the penis.
The yellowish membrane that appears at the tip or around the penis is part of the normal healing process and does not represent a sign of infection.
Keep the child's legs swaddled in a blanket as much as possible.
AFTER 1 day:
At each diaper change, apply the eosin spray gently from a distance
without touching the bandage or the penis with your hand, you have to wait for it to dry
completely before putting the diaper back on.
AFTER 2 days:
If the skin covers the tip of the penis a little, push it back just behind the tip to ensure
The normal healing.
DO NOT press on the skin for the first 48 hours to avoid swelling.
Only give your baby sponge baths.
From the 3rd days:
After the control
and from the 3rd day it is necessary to start applying the ointment on
the incision area as well as the entire tip of the penis
AFTER 2 weeks:
You can give your son a bath.
Stop applying ointment to the penis.
If you have any questions or concerns about appearance
of your child's penis, do not hesitate to call us.
RECOVERY IS GENERALLY QUICK
AND IT'S DONE IN SEVERAL STEPS:
24 hours:
surgical wound is healing and le bleeding stops during the day.
1-2 days:
The glans may appear off-white, yellowish or spotted: these spots are comparable to bedsores
and are part of the normal healing process.
3-7 days:
Some parents notice swelling mucosal tissue behind or under the tip of the penis, the
comparing to a light bulb. This type of swelling is normal and eventually disappears.
1-2 weeks:
The area just behind the glans (especially the underside) becomes swollen, then swells.
Up to 2 weeks:
After a few days, the area of the incision looks green and yellow.
This does not mean that there is pus, but the tissue is healing.
The color returns to normal within 14 days.
After about 1 month:
The tassel also appears bright red and sometimes purple.
This is because the skin covering the glans of an uncircumcised penis is a mucous membrane.
Once exposed, this membrane hardens (keratinization).
It takes about 30 days for the penis to take on the normal appearance qui testifies to healing.
General aspect:
After circumcision, all parents worry about the appearance of their son's penis.
Remember that penises can have shapes and very different sizes.
Most Penis appear “normal” a few days after circumcision, but some do not seem
completely "normal" only after they have started to grow.
Also, the penis may look smaller after la circumcision.
It's because of sagging skin that surrounds the penis.
Before circumcision, this skin keeps the penis more erect.