An older baby may be able to receive a circumcision using a plastibell device, a method usually reserved for infants. The Plastibell circumcision device is a clear lightweight plastic in the shape of a bell with an attached handle (see photo). It comes in various sizes to fit newborns, infants, and toddlers. The bell portion is designed to cover the glans while the foreskin is pulled over it and secured with a string (ligature). The ligature sits in a groove at the top of the bell so that when tied, the ligature will compress the excess foreskin, cutting off its circulation.The unwanted foreskin can now be removed by cutting around the bell while it protects the glans from injury.
The key is choosing the correct size device since too large a bell will cause excessive tension on the remaining foreskin and pull the bell over the glans onto the penile shaft. On the other hand, too small bell size could result in either an inadequate amount of foreskin removed; also a small bell can put excessive pressure on the glans, causing a visible deformity. An experienced provider will chose the appropriate size device and perform the procedure in 5-10 minutes. Healing time is slightly longer than infant’s healing time, lasting up to 2 weeks.
Pain Management for Older Babies
Older babies feel pain just like older children and adults. Unfortunately, a study published by the American Academy of Pediatrics shows that many parents under treat their child’s pain following procedures like tonsillectomies and circumcisions.
In our practice, pain control is our first priority for ALL patients. To help your child manage discomfort and pain following the procedure, we choose between several options, depending on your babies age and weight:
- Both acetaminophen (Tylenol®) and ibuprofen (Motrin®) can provide relief from mild to moderate pain. They may be taken alone or you may alternate the two types of medications as per your doctors instructions.
- Tylenol® with codeine has a much better pain-relieving effect that “plain” Tylenol® and is especially helpful with the more significant pain experienced in the first day following circumcision. A better understanding of how these medications work in children has resulted in safer dosing to allow your child to feel pain relief without suffering side effects.
Notify our office if:
- Temperature is greater than 101F
- Your child refuses to eat
- He has difficulty urinating
- There is uncontrollable bleeding
- Thick, yellow discharge with swelling is present