During the first 24 hours
- Monitor for: bleeding, urination, feeding, breathing, skin colour, and how easily the child can be awakened.
- If a sedative was used: the child must remain under continuous adult supervision until fully awake and back to normal activity. Do not leave the child alone during this period.
Normal appearance after circumcision
Gomco Method
- Mild redness or swelling around the circumcision site; the head of the penis may be red or pink and more sensitive to touch.
- A few small drops of blood on the gauze or diaper may occur after the procedure.
- Healing layer: a thin white or yellow odourless layer may form over the wound while it heals. It is normal, it is not pus, and it must not be removed.
- Anaesthetic injection site: a light blue tinge at the block injection site is normal and fades within a few days.
Plastibell Method
- Mild redness or slight swelling around the area.
- Skin colour change: the skin held in front of the ring's thread may gradually become dark and dry before it falls off together with the ring. This is normal and expected.
- Colour of the head of the penis: the glans may be red or pink and more sensitive after circumcision. Turning dark blue or black is not normal and needs immediate assessment.
- Swelling: mild swelling may increase between days 2 and 5.
- After the ring falls off: a thin yellow odourless layer is normal. Continue the petroleum jelly and start exposing the head of the penis (see “Exposing the head of the penis” below).
- Anaesthetic injection site: a light blue tinge at the block injection site is normal and fades within a few days.
Wound and diaper care
Gomco Method
- Wash your hands thoroughly before every diaper change.
- Change the diaper regularly and fasten it without placing pressure or tension on the penis.
- Removing the gauze, if present: remove it two days after the procedure. If it sticks to the wound, wet it thoroughly with lukewarm water and let it come away easily, without pulling or forcing it. If the gauze is soiled with stool, remove it and clean the area gently.
- Using petroleum jelly: put a generous amount of petroleum jelly on the diaper itself, where the penis touches it, at every diaper change. Petroleum jelly does not stay well on the penis itself, whereas on the diaper it stops the wound from sticking to it. Keep this up until day 20 after the procedure, then put a small amount when exposing the head of the penis, twice a day, until the end of the sixth week.
- Cleaning: clean the circumcision site using lukewarm water only, then gently pat it dry without rubbing.
Plastibell Method
- Very important warnings: do not pull the ring · do not rotate it · do not cut the thread · do not try to reposition it.
- Wash your hands thoroughly before every diaper change.
- When the ring falls off: the ring usually falls off on its own within 7 to 10 days. If it has not fallen off within 14 days, contact the clinic and do not pull it.
- Diaper and petroleum jelly: put a generous amount of petroleum jelly inside the diaper, where the penis touches it, at every change, and fasten the diaper without tension or pressure. Keep this up until day 20 after the procedure, then put a small amount when exposing the head of the penis, twice a day, until the end of the sixth week.
- Cleaning and drying: clean the area with lukewarm water only if urine or stool is present, then gently pat the area dry without rubbing.
Exposing the head of the penis to prevent narrowing
Gomco Method
from the third day until the end of the sixth week
- Why? The wound heals on the outside in about a week, but the scar keeps contracting over the following weeks, especially from the second to the fourth week. If the skin stays over the head of the penis during this time, it may stick to it and a narrowing may form over it; that is why this care continues after the wound has healed.
- How: place two fingers on either side of the base of the penis and press gently towards the child's body until the whole head of the penis is visible, together with the entire wound line.
- How often and for how long: at least twice a day (morning and evening), from the third day after the procedure until at least the end of the sixth week. The doctor may ask you to continue for longer, especially if there is a lot of fat around the base of the penis.
- Gently, without force: if the child is in pain or the head of the penis does not come fully into view, do not press harder, and send us a photo via WhatsApp.
- If it bleeds while you expose the head, stop and press on the spot for 15 minutes.
Plastibell Method
after the ring falls off, until the end of the sixth week
- Why? After the ring falls off, the wound heals on the outside within days, but the scar keeps contracting over the following weeks. If the skin stays over the head of the penis during this time, it may stick to it and a narrowing may form over it; that is why this care continues after the wound has healed.
- How: place two fingers on either side of the base of the penis and press gently towards the child's body until the whole head of the penis is visible, together with the entire wound line.
- How often and for how long: at least twice a day (morning and evening), from the day after the ring falls off and not before, until at least the end of the sixth week after the day of the procedure. The doctor may ask you to continue for longer, especially if there is a lot of fat around the base of the penis.
- Gently, without force: if the child is in pain or the head of the penis does not come fully into view, do not press harder, and send us a photo via WhatsApp.
- If it bleeds while you expose the head, stop and press on the spot for 15 minutes.
Do not
Gomco Method
- Do not remove or try to lift off the white or yellow healing layer.
- Do not use alcohol, iodine, perfume, creams (except petroleum jelly), or topical antibiotics unless the doctor prescribes them.
- Do not immerse the child in water during the first 48 hours after the procedure. Local cleaning with lukewarm water is allowed when needed.
- Do not stop the petroleum jelly or exposing the head of the penis before the end of the sixth week, even if the wound looks healed.
Plastibell Method
- Do not use alcohol, iodine, perfume, creams (except petroleum jelly), or antibiotics unless prescribed by a doctor.
- No immersion bath until the ring has fallen off.
- Do not stop the petroleum jelly or exposing the head of the penis before the end of the sixth week, even if the wound looks healed.
Bleeding and urination
Bleeding
If a few small drops of blood appear: place clean gauze over the bleeding site and apply direct, constant pressure for 15 uninterrupted minutes without lifting the gauze to check.
If the gauze becomes soaked, place a second one on top and keep pressing without removing the first layer.
If the bleeding continues, soaks the gauze or diaper, or does not stop after 15 minutes: go to the Emergency Department immediately while continuing to apply pressure.
Urination
The child must urinate within 8 hours after the procedure.
If the child has not urinated at all within 8 hours, appears to strain without passing urine, or swelling develops in the lower abdomen: go to the Emergency Department immediately.
Pain and pain relief
Give paracetamol regularly for the first 24 hours, then only as needed, according to the dose on your child’s instruction sheet.
Take the temperature before each dose: at 38.0 °C or more under 3 months, see a doctor at once.
Do not give Ibuprofen to this child without medical advice. Aspirin is not given to children unless the doctor prescribes it for a specific medical reason.
Contact and follow-up via WhatsApp
Attending the follow-up visit at the end of the second week after the procedure is mandatory.
There is no need to send photos every day. Send a clear photo of the circumcision site via WhatsApp only when needed: if you are unsure or worried about how the wound looks, or if the doctor asks for one.
The photo only needs to show the circumcision site clearly; there is no need to show your child's face.
Send a video when the doctor asks for one, or when something in the photo is unclear.
Send a photo within 24 hours if you notice that the skin has come back over the head of the penis and does not slide back easily when you press, a tight ring at the wound line, or that the penis seems to be disappearing into the fat.
We reply on WhatsApp during opening hours; in the evening and at weekends it may take longer.
In urgent situations, do not wait for a reply via WhatsApp; call 112 immediately or go to the nearest Emergency Department.
When to go to the emergency department at once
Go immediately to the Emergency Department if any of the following occurs:
- Persistent bleeding: the bleeding does not stop after 15 minutes of direct, constant pressure, is more than a few drops, or soaks the gauze or diaper.
- Colour change of the head of the penis: turning dark blue or black.
- Severe swelling: the swelling increases rapidly or becomes severe.
- No urination: the child has not urinated at all within 8 hours after the procedure, strains without passing urine, or has swelling in the lower abdomen.
- Breathing disturbance: difficulty breathing or an abnormal change in breathing.
- Deterioration in the child's condition: severe lethargy, difficulty waking, obvious pallor, or an abnormally cold body.
- Fever of 38.0 °C or higher in a child under 3 months: needs immediate medical assessment, do not wait.
- Ring displacement: the ring has moved out of its normal position or slipped onto the shaft of the penis.
- Ring trapped or slipped backwards: if the ring has moved behind the head of the penis or is pressing on the shaft, go to the Emergency Department immediately and do not try to move or remove it.
Call 112 immediately and do not transport your child yourself if he stops breathing or his lips turn blue, is very hard to wake, or bleeds heavily and is pale or cold.
For all warning signs, see the Warning signs page.
When to seek medical advice the same day
Seek urgent medical assessment on the same day if any of the following occurs:
- Fever: a temperature of 38.0 °C or higher in a child aged 3 months or older.
- Abnormal redness: redness extending along the shaft of the penis or continuing to spread.
- Signs of infection: pus discharge or a foul smell from the wound.
- Increasing pain: persistent or worsening pain despite paracetamol at the prescribed dose.
- Poor feeding: refusal to feed or a clear reduction in feeding.
- Unusual crying: persistent crying that cannot be soothed and is unusual for the child.
- The ring has not fallen off within 14 days — contact the clinic and do not pull it.
- Swelling when urinating: the skin over the head of the penis balloons while the child urinates, or the urine stream is clearly weak.
Call your GP or paediatrician; in the evening, at night, at weekends and on public holidays, the doctor on duty on 1733.