When circ's go bad...

One of the obstetricians also uses gelfoam around the circ. As this material 'melts' it really looks like sloughing skin.

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.

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.

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.

Studies conclude that the risk of an uncircumcised man developing penile cancer is more than three-fold that of a circumcised man. However, the AAP policy notes that in the United States only 9 to 10 cases of this rare disease are diagnosed per year per 1 million men, indicating that while the risk is higher for uncircumcised men, their overall risk is extremely low.

Why would anyone impose a surgical procedure on a healthy patient for which there is no medical reason for that surgery?

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.

Close but no cigar - your original stat was regarding the mortality rate from infant circs compared to penile cancer. This statement from the AAP doesn't address that.


That would leave out about 98% of the work that plastic surgeons do every day.

I think the main point is that it's up to the parents to decide what is or is not appropriate in this situation - not you, not the RN in the nursery, not me. Whether you agree with it or not, it's a perfectly legal procedure nationwide, and I'd guess you'd have a hard time restricting it.


And this is amazingly unethical. The standard of care is the same, insurance or no insurance. Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.