You and your child will meet the anaesthetist prior to the procedure. After talking to you and briefly examining your child, they will take you through to the operating theatre. One parent is welcome to accompany your child until they are asleep. The anaesthetist puts your child to sleep via a face mask (with children 5 years and over there is the option of either a face mask or a needle with numbing cream). You will then be shown the waiting room where there is tea, coffee or water available to drink.

Once your child is asleep, the anaesthetist will insert a ‘drip’ to allow fluids to be given directly into a vein. Usually this is located in the hand or arm, but occasionally may need to be sited in the leg or scalp. The anaesthetist will then inject some local anaesthetic to numb the penis. Usually this is injected around the base of the penis, but occasionally it may be given near the base of the spine near the ‘tail’ bone, termed a ‘Caudal’. Please inform the anaesthetist if you wish to discuss the relative risks and benefits of these two options.

The penis is cleaned with an antiseptic solution. The foreskin is removed and any bleeding stopped with an electrical cautery instrument. The wound is then closed using a pale yellow stitch material that will dissolve slowly over the next 2 to 6 weeks. No dressing is used, but an antibiotic ointment is applied to the wound to help prevent infection.

Once the operation has finished, your child will be taken to the recovery area. When they are awake, you will be called into the recovery ward. Often children appear distressed and a little confused initially – there may be several reasons for this including residual effects of the anaesthetic, hunger, and some discomfort. Generally they will settle quite quickly, especially if offered a drink or feed. The recovery and ward staff are also able to give pain relief medication once your child is awake, and this is sometimes required. The nursing staff will check the wound and make sure you are happy before you go home. Usually this will be about 2 hours after the surgery.

As a result of the local anaesthetic nerve block, your child may complain of a numb sensation in the groin and in some cases some weakness in the leg on the side of the surgery. This is temporary and will generally settle within a day or so of the operation.

There may be a small amount of blood that oozes from the wound, enough to lightly stain a nappy or pair of under pants. Any further bleeding should be discussed with your local doctor or myself. Paracetamol (‘Panadol’) should be given on the afternoon and evening of surgery, and in the morning of the following day. After that time, assess your child’s pain to see if further doses are required. Children over 12 months of age may require stronger analgesia such as ‘Painstop Day-time’ (or ‘Painstop Night-time’ if over one year of age) for the first day or so. For either Panadol or Painstop Day-time, follow the manufacturer’s dose instruction but never give more than 4 doses in a 24-hour period and never both at the same time.

Your child can begin eating when he gets home. Start with clear liquids (apple juice, iceblocks) and add solid food slowly and in small amounts. Your child may vomit from the anaesthesia on the day of surgery. This should stop by the morning after surgery.

Your child may return to day care or school when comfortable, usually within 3-5 days. He should not participate in sports or swimming for 3 weeks after the surgery and should not ride straddle toys (bikes, walkers) for 2 full weeks after surgery. You should continue to use your car seat.