From the Research
Re-circumcision in a 10-month-old should only be considered for specific medical indications, not for cosmetic reasons. The primary indications include incomplete initial circumcision with redundant foreskin causing problems, adhesions leading to inflammation or infection, or true phimosis that developed after the initial procedure 1. Before pursuing re-circumcision, conservative management should be attempted first, including gentle retraction with proper hygiene and topical steroid cream for minor adhesions or mild phimosis.
Key Considerations
- Parents should understand that some redundant foreskin is normal in infants and often resolves with growth.
- If surgery is deemed necessary, it should be performed by a pediatric urologist or surgeon experienced in infant circumcision, typically under general anesthesia.
- The procedure carries risks including bleeding, infection, pain, and potential for excessive skin removal.
- The timing at 10 months is acceptable if medically indicated, but parents should be counseled that the child will have memory of the procedure and appropriate pain management is essential 2.
Recommendations
- A second opinion is advisable before proceeding with re-circumcision to ensure it's truly necessary, as many apparent problems with initial circumcisions resolve naturally with time and growth.
- The conventional sleeve technique is a recommended surgical procedure for circumcision revision, as it produces a satisfactory cosmetic result and is easy to teach to residents and fellows 1.
- Appropriate diagnosis codes have been available, and a new and more specific procedure code has been introduced for circumcision revision 1.
Medical Indications
- Incomplete initial circumcision with redundant foreskin causing problems
- Adhesions leading to inflammation or infection
- True phimosis that developed after the initial procedure It is essential to weigh the potential benefits and risks of re-circumcision and consider the child's individual needs and circumstances before making a decision 3.