When circ's go bad... - page 5

Has anyone seen a circ go really bad? I saw one today where the doc took too much foreskin off and the skin on the shaft ended up "degloving" from the fascia underneath. A urologist had to come in... Read More

  1. by   BittyBabyGrower
    Ewwww...we used to have the foreskin collector that came around in the AM's. Ewwww! They use them to help grow grafts and such, but man, gross!!!!

    I have seen more than my share of botched up circs....some looked like Jaws came in and had an appetizer, one was literally skinned, we had one brillant resident that came over for a bleeder and decided to nitric stick (I think that is what they are called...we don't use them on anything) it and burned a hole just below the glans...she did this when no one was around the bed! The attending OB had to come over and the kid had to go for emergency surgery with urology as she made right thru to the urethra! How she did that was so beyond anything I had ever seen. That was the first depo I ever had to give.
  2. by   Q.
    Quote from jwk
    Right - it's a foreign idea, meaning you haven't heard of it and have little knowledge of it, yet you automatically assume it's worthless. What would us men do without you women telling us what to do with our manhood?

    No, it seems that you "automatically assumed" that she assumed it was worthless. She never once stated that. I think you need to go back and re-read her post.
  3. by   SmilingBluEyes
    Quote from BittyBabyGrower
    Ewwww...we used to have the foreskin collector that came around in the AM's. Ewwww! They use them to help grow grafts and such, but man, gross!!!!

    I have seen more than my share of botched up circs....some looked like Jaws came in and had an appetizer, one was literally skinned, we had one brillant resident that came over for a bleeder and decided to nitric stick (I think that is what they are called...we don't use them on anything) it and burned a hole just below the glans...she did this when no one was around the bed! The attending OB had to come over and the kid had to go for emergency surgery with urology as she made right thru to the urethra! How she did that was so beyond anything I had ever seen. That was the first depo I ever had to give.
    that is simply horrible. OMG.
  4. by   nursenickie
    I have seen a couple bad circs. The obstetricians do the circs in my institution. They prefer to use silver nitrate when there is a bleeder. This stuff is really ugly. the last bad one I saw the OB used 4 silver nitrate sticks, never wrote a note in the chart, then hopped an airplane later that day out of the country--literally. I wonder what ever hapened to that little boys penis. One of the obstetricians also uses gelfoam around the circ. As this material 'melts' it really looks like sloughing skin.
    I would venture to say about 95% of the males born at our hospital have circumsision. --nursenickie
  5. by   kc2004
    i have seen silver nitrate used on circs before and they look like
    ugly black burns (actually i think that's what silver nitrate does).
    i've never seen the healed penis afterward though.
  6. by   vermonthiker
    Quote from nursenickie
    I would venture to say about 95% of the males born at our hospital have circumsision. --nursenickie

    WOW!! That's amazing to me!!! I don't work in a hospital yet but I'd be curious to know about our local hospital. I'd say about 90% of my friends and relatives don't circ!! Maybe it's regional?????
  7. by   Gompers
    During my OB rotation, I watched a few circs and one was done by a second-year resident. She had circed a few kids before with supervision so they let her do this one herself. I was comforting the baby while she did the procedure. So she goes ahead and makes the cut, then goes..."Hmmmm.." She tells me she'll be right back. She comes back into the nursery with another resident who agrees, "Hmmmm...that doesn't look right." I might add that each time they look, they're moving the cut foreskin up and down, all around, and the baby is screaming around his pacifier. Finally they get an attending to come in...takes one look...turns out the resident didn't examine baby and he had a hypospadius! The attending sighed and commented that the baby would need extensive surgery later, and because the resident had circed the baby, it would be that much harder to repair the hypospadius.

    I might add that this particular hospital had a policy of putting EMLA cream on the babies an hour before the procedure...if they had insurance. If they didn't, NO ANALGESIA was used. NONE. :angryfire

    In the NICU where I work, about 80% of the boys are circed before discharge. If they have an upcoming surgery (about 50% of the preemie boys end up with hernias) they'll do the circ in the OR while the baby is under anesthesia. If it's done up on the unit, urology does the procedure. We give Tylenol an hour before, then q6h after for at least 24 hours. They also use lidocaine for a local block, thankfully.
  8. by   Spidey's mom
    Quote from vermonthiker
    WOW!! That's amazing to me!!! I don't work in a hospital yet but I'd be curious to know about our local hospital. I'd say about 90% of my friends and relatives don't circ!! Maybe it's regional?????
    I'd have to say 98% of our boys get circ'd. It definitely is regional. I'm in northeastern California but if you head over to the coast to Humboldt County - one of the biggest pot growing areas by the way, the circ rate goes down.

    steph
  9. by   Gompers
    Quote from nursenickie
    One of the obstetricians also uses gelfoam around the circ. As this material 'melts' it really looks like sloughing skin.
    That gelfoam is good stuff. I much prefer it to silver nitrate, hands down. We've never used it on a circ - usually wrap in vaseline gauze and hold a little pressure if bleeding, but since we use lidocaine they usually don't bleed much - but we've used gelfoam on kids with stomas. Usually those kids have bad livers because of the short-gut and TPN dependence, and their stomas bleed sometimes and I've even had some with vericies that just start pumping! Gelfoam worked every time.
  10. by   Ross1
    Referring to the original posting, I'm sure that this baby boy is going to grow up to be an adult male with a dysfunctional penis. I cannot believe that in this day and age, especially with all the concerns about medical liability, routine infant cirucmision is still being performed here in the USA.

    While it is true that in this country, a parent as the legal right to consent to this procedure for his/her infant son, in my opinion, that parent does not have the ethical or legal right to do so. And any MD who performs this unnessessary and permant procedure (or RNs who assist) in my opinion are violating basic medical ethics.

    I am not some radical anti-circumcision activist, an adult male. I am just stating to me what seems so obvious. The only person who has the right to consent to part of his body being surgically removed is the owner of that body....plain and simple. It is not the doctor's penis, the nurse's penis, or the parent's penis.

    When are people going to recognize this.

    I
  11. by   Nursewise
    Quote from Gompers
    During my OB rotation, I watched a few circs and one was done by a second-year resident. She had circed a few kids before with supervision so they let her do this one herself. I was comforting the baby while she did the procedure. So she goes ahead and makes the cut, then goes..."Hmmmm.." She tells me she'll be right back. She comes back into the nursery with another resident who agrees, "Hmmmm...that doesn't look right." I might add that each time they look, they're moving the cut foreskin up and down, all around, and the baby is screaming around his pacifier. Finally they get an attending to come in...takes one look...turns out the resident didn't examine baby and he had a hypospadius! The attending sighed and commented that the baby would need extensive surgery later, and because the resident had circed the baby, it would be that much harder to repair the hypospadius.

    I might add that this particular hospital had a policy of putting EMLA cream on the babies an hour before the procedure...if they had insurance. If they didn't, NO ANALGESIA was used. NONE. :angryfire

    In the NICU where I work, about 80% of the boys are circed before discharge. If they have an upcoming surgery (about 50% of the preemie boys end up with hernias) they'll do the circ in the OR while the baby is under anesthesia. If it's done up on the unit, urology does the procedure. We give Tylenol an hour before, then q6h after for at least 24 hours. They also use lidocaine for a local block, thankfully.
    Maybe someday little boys will acquire the same legal status of little girls, where in the U.S.A., in the absence of any pathology, this kind of procedure is a felony.
  12. by   Ross1
    Quote from Nursewise
    Maybe someday little boys will acquire the same legal status of little girls, where in the U.S.A., in the absence of any pathology, this kind of procedure is a felony.
    Well said! Thank you.

    All surgery has risks and clearly a percentage of circumcisions do go awry and it is the unfortunate boys/males who pay the price, not the doctors, not the nurses, and not the parents. There is no medical reason to be perform routine infant circumcision. In fact, I recently read a quote somewhere (can't remember the source though) that said that more male babies die each year from complications associated with circumcision then adult males who are diagnosed with penile cancer (a very rare cancer for both circumcised and uncirumcised males, but often toted as one of the reasons to perform circumcision....to prevent penile cancer).
  13. by   jwk
    Quote from Ross1
    Well said! Thank you.

    All surgery has risks and clearly a percentage of circumcisions do go awry and it is the unfortunate boys/males who pay the price, not the doctors, not the nurses, and not the parents. There is no medical reason to be perform routine infant circumcision. In fact, I recently read a quote somewhere (can't remember the source though) that said that more male babies die each year from complications associated with circumcision then adult males who are diagnosed with penile cancer (a very rare cancer for both circumcised and uncirumcised males, but often toted as one of the reasons to perform circumcision....to prevent penile cancer).
    You're a medical professional (to be) - quote your sources, otherwise it's called hearsay. You say you're not a "radical anti-circumcision activist", but that kind of statistic is straight out of their playbook.

close