Phimosis / Tight Foreskin / Circumcision

[tigger88]

Funz:

The appointment for my boy's circumcision is fixed.


I know it is a simple procedure but still worried.

Hi Funz,

did you go through the polyclinic to get an appointment etc?
My DS2 (2.5yrs) has been complaining about pain when he pee and we can see redness at the tip of his penis. PD commented that his foreskin is tight but so far no infection and hence we have some time to consider if we want to go for circumcision.

[Funz]

Hi Tigger88,


No, DS’s PD referred us to a paediatric surgeon. We decided not to go through the polyclinic route as we want to get it done soon. As it is, had to delay for 2 weeks from planned date as DS fell sick. If go through polyclinic route, to reschedule again will be very troublesome.

[tigger88]

Funz:

Hi Tigger88,


No, DS's PD referred us to a paediatric surgeon. We decided not to go through the polyclinic route as we want to get it done soon. As it is, had to delay for 2 weeks from planned date as DS fell sick. If go through polyclinic route, to reschedule again will be very troublesome.

Thanks Funz! Do you mind sharing the cost of the surgery and at which hospital? Thanks again!

[Funz]

I cannot remember what is the cost. Will let you know next week. We were given 3 hospitals. Gleneagles, Mt E and Mt A. The surgeon said in terms of facilities and support staff all the same but Mt A is the cheapest and he suggested going for Mt A as well since it is only a day surgery.

[tigger88]

Funz:

I cannot remember what is the cost. Will let you know next week. We were given 3 hospitals. Gleneagles, Mt E and Mt A. The surgeon said in terms of facilities and support staff all the same but Mt A is the cheapest and he suggested going for Mt A as well since it is only a day surgery.

Great and thanks!

[ken26ksh]

Dear Parents


My DS got irretractable foreskin and was referred to KK to circumcise by polyclinic, however KK’s school holiday appt all full.

Can anyone recommend alternative to me please.

Highly appreciate to all helpful parents.
Thank you!

[Funz]

DS had his circumcision done last week and is still recovering.


Before the Op

The weeks leading to his surgery, we spoke to him about it. We explained why the surgery needs to be done.

We told him what will be happening in the operating theatre. Mummy or Daddy will acccompany him in, there will be a bed, and above it big lights, some equipments all around. There will be the surgeon who will be doing the op and nurses and another doctor who will be administering the anaesthetic. The doctor will ask him to breathe into a mask and that will help him sleep. Thereafter the surgeon will do the op.
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We showed him and let him try on what he was going to wear after the op and the 'protective gear'(which is a cut up styrofoam cup) to prevent the fabric of the clothes from touching his penis. We asked him to pick a few items that he likes, to bring to the hospital to comfort him if he gets scared.
We explained to him that there will be some pain and discomfort but not something that is so unbearable and that the doctors will give him painkillers to help ease the pain.

He took it quite well and at times will say that he is scared. I told him it is natural to be scared and that it is ok to be scared. Just remember that both mummy and daddy will be there with him.

The op is early in the morning. DS's last food intake must be before 2am and fluids, before 4am.

The day of the op

We woke up early that day as DS had to be admitted by 7am and the op to be done at 8am.

DS was still in a chirpy mood all morning. Only when we said it is time to go that he resisted a little. We made it to the hospital. Took a while to get admitted and was shown to the day ward and DS’s bed. DS was getting nervous and refused to walk, we had to carry him to the bed. He refused to sit on the bed and did not want to put on the hospital gown. Took a little coaxing before he allowed us to change him out but he remained on my lap. We distracted him with his favourite shows on his iPod touch and time passed really quickly. Soon we were asked follow the nurse to the operating theatre. Again DS refused to walk so we had to carry him there. Only 1 person can accompany DS into the op theatre. DS wanted mummy so I went and changed out into their surgical gown as well. DS giggled when he saw me.

The anaesthetist came by to check on DS and chatted with him for a while. She told us what to expect as well. Then we were shown the way to the op theatre. DS was pensive and the moment he saw the bed, with the lights and all, he started saying he is very scared and clung on even tighter to me. He refused to get onto the bed, even though it had some colourful kids’ blankie on it. So the doc had me sit on the chair with DS. The doc then demonstrated putting the mask on me to show DS what will happen. Initially DS was fine but when the gas started coming out of the mask, DS panicked and started screaming and struggling. Took 3 of us to hold him and get the mask onto him. DS just kept screaming and calling me but I had to hold him down. The moment we managed to get the mask on him the gas worked real fast and he went under. I left the operating theatre crying.

The op was pretty fast. We saw the surgeon coming out within like 20mins but it was about 45mins before they wheeled DS out. According the anaesthetist, DS woke up shortly after the op but he woke up really angry and upset and was struggling so she sedated him and hopefully he will be calmer when he wakes up with us around. Back at his bed, we took a peek at his penis. It doesn’t look bloody or bruised at all. It actually looked rather neat and clean. DS slept for another hour or so. He stirred and I was prepared for an upset and angry boy. But he just opened his eyes and asked me if it’s over. Told him yes all done. That was when he felt the pain and started crying. He pushed away the blanket and saw a little blood oozing from the wound and howled even louder. The nurse came to check on him and he scolded her. Shouted at her to go away and not touch him. The nurse had to back off while we calmed him down. After a while he calmed down, I guess the initial pain subsided, and he asked for his lamb and his iPod. That was about 10+am. DS was kept there for observation, to ensure that there is no excessive bleeding. He managed to drink some water and when the water stayed down, he was offered, fish/chicken porridge or milo and biscuits. He chose the latter. At about 12+pm, the nurse came around again, this time to clean DS and check on him. He refused to let her touch him but she handled him well. Talking to him, joking with him and praising him as well. DS was discharged at about 1+pm. He was asked if he would like to walk out on his own, be carried or sit in a wheel chair. DS chose to be wheeled out. He found sitting in a wheelchair a novelty.

After the op and home

DS has a very low threshold for pain so we anticipated we will have a challenge getting him to pee and shower the next few days. The nurses and doctors told us there is no need to rush all these things. They did not know DS ability to hold his urine. :roll: DS did not pass urine at all on the day of the op, through the night until the next morning. His bladder was so full that his belly looked swollen. We were hoping that he will wet himself in the middle of the night but that did not happen. I think in the end the discomfort of having such a full bladder surpassed his fear of pain and he peed. And lo and behold, there was no pain. :rahrah: We were warned that over the next few days, the penis will look worse, bruises will appear and scabs will be forming on the head of the penis. There is no need to do much cleaning, just let some water flow over the penis. If DS feels any pain of discomfort, he is to be given paracetamol. As it turned out, there was no need to give him any meds after the first day. Throughout the penis kept oozing some blood and we had to keep cleaning it off his scrotum to prevent it penis from sticking to the scrotum when the blood dries.

DS is still recovering and his penis is still oozing blood now and then but he is up and about, even managed to play a little soccer yesterday. The doc said it takes about 7 days to fully recover but looking at DS I think it will take up to 10 or 11 days before he is willing to put on his pants again. Nope he hasn’t showered since the day of the op, been giving him only sponge bath and he is still reluctant to pee and will hold till he is really uncomfortable before attempting to pee. After the first night, he is sleeping through the nights without any major discomfort. So, the worse is over I guess.
DS will recover and eventually, this will become a foggy memory as he grows. For me however, that moment in the op theatre where he was struggling and screaming for me to help him but yet I had to hold him down and watching him succumb to the anaesthetics against his will, will be indelibly etched in my mind.

[Funz]

@Tigger, the total bill came up to $1518. Think medisave will cover 30%. The rest, depends on your insurance.


@ken26ksh, DS was referred to Dr SL Cheah from Children & Babies Surgery. Tel 6735 3886. Located at #07-06 Gleneagles Medical Centre.

[hquek]

hi funz,


Glad all went well for your DS. surgery is over and he can only look forward to recovery. For my DS case, the scabs in fact looked really really scary and fierce…until i started wondering if he was ever going to recover. Fortunately, after that thought, his body started to heal beautifully.

For a while after full healing, his organ was still super sensitive. We had to be extra careful we were bathing DS still then. He’s built up tolerance to it now.

[Funz]

Thanks hquek.


Yah the scabs do look nasty. B4 the op, I was of the impression that the only wound will be on the foreskin, did not know that the head of the penis will be affected. If ever (quite impossible lah) I have another boy, circumcision will be done at infancy.