In the U.S., the majority of circumcisions are performed during infancy, but a recently released U.S. Census Bureau report shows that during the past several decades, the rate of infant circumcisions has fluctuated, ranging from a low of about 55 percent to a high of about 65 percent. Interestingly, a recent Mayo Clinic Proceedings publication indicates that during the same period of time, the rate of circumcisions among teens and men from 14 to 59 years of age increased to just over 80 percent. These data underscore one of the unique challenges surrounding the circumcision procedure: how to achieve postoperative pain management across a broad span of ages.
Fortunately, advances in our understanding of pain at all ages have enabled healthcare providers to develop pain management techniques and options that can minimize discomfort no matter how old the patient may be. Newborns/Infants/Children Newborns, young infants and children feel pain just like older individuals. Unfortunately, a study published by the American Academy of Pediatrics shows that many parents under treat their child’s pain following outpatient procedures like tonsillectomies and circumcisions under the mistaken belief that pain medications are addictive, are more effective when given in smaller doses or have potentially dangerous side effects. The result: Your child feels more discomfort than is necessary.
At Gentle Circumcision, pain control is our first priority for all patients. According to the American Academy of Pediatrics’ guidelines on circumcision, pain relief “is safe and effective in reducing the procedural pain associated with newborn circumcision; thus, adequate analgesia (pain relieving medications) should be provided whenever newborn circumcision is performed.”
To help your child manage discomfort and pain following the procedure, you have several options:
Both acetaminophen (Tylenol®) and ibuprofen (Motrin®) can provide some degree of relief from mild to moderate pain. They may be taken alone or you may alternate the two types of medications. Let your doctor know if your child has any bleeding disorders or asthma, which can be exacerbated by certain medications.
Tylenol® with codeine prescribed to children 12 years and older, has a much better pain-relieving effect than “plain” Tylenol® and is especially helpful with the more significant pain experienced in the day following
circumcision. A better understanding of how these medications work in children has resulted in safer dosing strategies to allow your child to feel relief without suffering side effects. Be aware that multiple doses may cause nausea or vomiting in some children.
Teens/Adults
Pain management begins with oral medication taken about a half hour before circumcision to allow it to be immediately effective following the procedure. Next, a local numbing anesthetic will be injected into the fat at the base of the penis – not into the penis itself. The anesthetic is similar to what you receive at the dentist. The procedure does not begin until the area is completely numb.
After the procedure, your doctor will prescribe one or more pain medications such as Vicodin® or extra- strength versions of Tylenol® or Motrin® with specific dosing instructions to help ensure pain-free healing. Finally, most patients can resume their normal activities within 24 hours, return to work within 48 hours and resume fitness activities including weight-lifting in seven days.
If you have questions about the circumcision procedure or pain management, call our office at 310-559-8000. We’ll be glad to help.