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Circumcision is a commonly performed procedure in the newborn period, most
often done by the obstetrician before discharge from hospital. However, many
newborns may go uncircumcised for a variety of reasons - newborn illness,
prematurity or voluntarily by parental choice. Although circumcision need not
routinely be done (a position held by the American Academy of Pediatrics),
the parents may opt for circumcision subsequent to the newborn being discharged
from the hospital. The advantages and disadvantages of circumcision may be
discussed, and a rational decision reached regarding the very need for
this procedure.
Newborn circumcision is done by the obstetrician with a variety of clamps.
This so-called clamp circumcision may not attain a decent cosmetic result.
Occasionally an excess amount of foreskin may remain giving the appearance of
still being uncircumcised. Less commonly, the head of the penis may still
remain covered and unable to be exposed (hidden penis). These situations may
also require a revision of circumcision (repair of incomplete circumcision.
Beyond the newborn period both circumcision and repair of incomplete
circumcision are best accomplished via ambulatory or same day surgery under
general anesthesia between six months and one year of age. This allows an
appropriate amount of foreskin to be removed and offers the best functional
and cosmetic result in a pain-free fashion.
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