Circumcision in Ottawa with the Pollock Technique™
Circumcision in Ottawa with the Pollock Technique™Jack Roberts2017-05-02T09:08:20+00:00
At Reddoch Clinics we use the Pollock Technique™ for circumcision.
Our doctor has trained with the renowned Dr. Neil Pollock at his clinics in Vancouver, and has been certified in the use of this superior circumcision method.
For newborns and babies, extensive pain control methods are employed like Tylenol, oral sugar solution (which has been shown to reduce pain perception), soothing music, topical freezing cream, padded baby holders, and a long acting local anesthetic.
Is Pollock Technique™ Circumcision Like Plastibell?
The Pollock Technique™ can be used for babies and infants of all ages, and consists of using a Mogen shield under long-acting local anesthetic. This method is quite different from the Plastibell procedure in that it is faster and there is no device left attached to the baby’s penis.
Reddoch Clinics locations in Ottawa and Cornwall currently offer Pollock Technique™ circumcisions for infants and babies younger than toddlers (aged 12 – 15 months). The Pollock Technique™ circumcision operation takes only 30-60 seconds for newborns (10 times quicker than most hospital circumcisions).
This is different from the Plastibell circumcision procedure where an infant circumcision requires 10 minutes to affix the Plastibell device to the baby’s penis and it remains in place for up to 7 days. Dr. Reddoch chose to train with Dr. Pollock in order to bring this gentle and comfortable circumcision method to Ontario.
We feel the Pollock Technique™ circumcision can be considered the most innovative procedure practiced in Ontario today for infants, older children, teens, and men. Only local anesthetic is needed and recovery time is relatively fast. Reddoch Clincs in Ottawa and Cornwall focus on baby and child circumcision (boys up to 12) only.
Our method is faster than other procedures, and has proven safe over the past 20 years. This is one of the reasons why so many physicians refer their patients to our clinic. Our focus and expertise make us the leading circumcision provider in Ottawa.
The three images below show the change in your baby boy’s penis brought about by circumcision.
1. A profile of the uncircumcised penis with the foreskin covering the glans (head of the penis).
2. The same penis as in Figure 1 but drawn as if the foreskin was transparent. Here you can see the foreskin in relation to the inner side of the foreskin and the glans. Notice the adhesions along the inner side of the glans. These are present at birth in almost all babies and must be released before the actual circumcision.
3. The same penis following the circumcision. Notice that the cut edge of the skin retracts to just behind the back rim of the glans. This is the site of healing.
Potential Benefits of Infant Circumcision
Ontario parents undertake a circumcision procedure for their son in order to fulfill cultural and religious traditions, as well as to seek improved health outcomes for their children. There are many potential benefits from baby circumcision.
Improved genital hygiene
It is well known that microorganisms accumulate under the foreskin which fosters inflammation which can lead to conditions such as balanitis/balanoposthitis (inflammation of the head of the penis).
The incidence of balanitis is twice as high as those who are uncircumcised. Smegma, which is a cheesy like secretion, can also accumulate under the foreskin combining with bacteria to produce an offensive odor.
Reduced risk of urinary tract infections
Because microorganisms can accumulate under and adhere to the foreskin, bacteria has a greater chance of migrating up the urethra causing urinary tract infections (UTIs) especially in infancy. Studies suggest an over 10-fold decrease in risk of urinary tract infection in circumcised infants. UTIs are a potentially painful and dangerous condition as it can result in kidney inflammation and scarring. Studies suggest that the protective effect of circumcision against UTIs when done as a newborn continues into adulthood.
Reduced risk of phimosis
Phimosis is a condition where the foreskin becomes so tight that it cannot be pulled back fully, resulting in UTIs, local skin infection, pain when passing urine, retention of urine, kidney stones, and sexual dysfunction.
Circumcision eliminates the risk of phimosis, which affects 1 in 10 older boys and men. Phimosis treatments, if required, can include creams and potentially a circumcision surgery later in life.
Reduced risk of penile cancer
Studies have shown an over 20-fold reduction in the risk of invasive penile cancer which is thought to arise from adherence of high-risk human papillomavirus to the foreskin and smegma causing chronic inflammation and recurrent infections resulting in phimosis. Invasive penile carcinoma is highly associated with a history of phimosis.
Reduced risk of prostate cancer
Uncircumcised men have a 1.6-2.0- fold higher incidence of prostate cancer, which is thought to correspond with a higher chance of sexually transmitted infections resulting in a chronic state of inflammation.
Circumcision reduced the risk of getting HIV/AIDS by 3-fold during sex with an infected woman. This is because the HIV virus enters through the inner lining of the foreskin which is thin and vulnerable. Ulceration and tearing are also more common in uncircumcised men, adding to the risk of HIV entry.
Reduced cervical cancer in women
Circumcision reduced cervical cancer risk of a man’s female partner by 5.6 times as there is less risk of adherence and colonization of human papillomavirus.
While the procedure performed at our Ottawa and Cornwall clinics can be considered routine and low risk, there is always some degree of risk with any surgery. Potential problems include:
Bleeding after circumcision – In 1 in 500 circumcisions there may be some bleeding that is usually stopped with pressure or less commonly with stitches. If a bleeding disorder such as hemophilia is present, then our doctors will need advice from a pediatric hematologist prior to proceeding.
Infection – There is always a possibility that there could be a generalized infection requiring antibiotics after the surgery (1/4000). Serious infections are rare (1/5000).
Concealed penis – When there is a good amount of fat around the penis (pubic fat), the penis may retract inward and increase the chances the penis gets partially buried and requiring medical intervention (1/800).
Meatal stenosis – This is a narrowing of the urethra that may occur after the procedure requiring medical intervention (1/1000).
Phimosis from circumcision – This is a narrowing of the shaft skin opening over the head of the penis requiring medical intervention (1/500)
Trauma resulting in permanent damage to the head of the penis (never in our practice)
Suboptimal cosmetic result (1/500)
More serious complications including death (never in our practice).
Potential Complications After a Baby Circumcision
Circumcision is associated with few and infrequent complications, although with any surgical procedure there are occasional problems. For example, bleeding. In almost all cases bleeding is controlled by direct pressure. The frequency of complications after infant circumcision varies with the skill and experience of the physician amongst other factors.
Even though complications are rare, do not hesitate to consult Dr. Reddoch if you have any questions about the appearance of the penis. Remember, early treatment (if any is needed) is always best.
Please check your baby’s diaper for any bleeding every hour or so for the first 24 hours after circumcision. If the baby is sleeping, you can just look at the front edges of the diaper from the outside. If it is not discolored, he is likely not bleeding abnormally. When you open the diaper, it is normal for the covering gauze to be a little red from bleeding. You need to remove the gauze to check for active bleeding only if the whole gauze has become soaked with fresh, red blood. You treat active bleeding from the penis the same as you would for the tip of a finger:
Apply pressure to the penis for 3-5 minutes; no less. Do this by grasping the penis between your thumbs and two fingers using a piece of gauze with some Vaseline to prevent sticking.
After applying pressure, inspect the area for continued bleeding and repeat step one if necessary.
Once the bleeding has stopped, apply a fresh gauze square with Vaseline and close the diaper. Recheck the diaper after 10 minutes for any signs of more blood on the gauze.
It is reasonable for you to try the pressure technique twice, for 3-5 minutes at a time, before calling Dr. Reddoch as most bleeding will stop with this.
If the penis is dripping any blood, and you cannot stop the bleeding with the pressure technique that we have demonstrated to you, call Dr. Reddoch immediately on his cell (613) 362-2837. If there is no answer, page him at (613) 930-8523 and leave your call-back phone number.
When the length of the penile shaft is no greater than its diameter or when there is a good amount of pubic fat, the penis will tend to retract inward. This is normal. This characteristic is only a concern for the first month or two since the healing circumcision can adhere to the surrounding skin resulting in a “concealed penis”.
If your son fits this profile, you can reduce the chance of concealed penis by applying a very thin layer of Vaseline to the entire glans, once a day, until the glans takes on a healed appearance (about 1-2 months). To expose a glans that has retracted inward, place gentle downward pressure on either side of the base of the penis.
Consult Dr. Reddoch if the penis cannot be fully exposed, or if any connecting skin bridges form between the shaft skin and the head of the penis.
Although rare, there have been reported cases of infection. Common signs of infection include: a pus like discharge, a foul smell, excessive swelling or redness, local warmth, a fever, or a rash anywhere in the area of the penis.
With any of these signs, or if your son has not urinated in over 12 hours, consult Dr. Reddoch immediately.
There will be a long gauze strip (1/2×8 inches) wrapped around your son’s penis. This strip may fall off within the first 24 hours. If it falls off early, do not worry, this is normal, just leave it off. You can place the small gauze given to you at our office (with some Vaseline on it) on the penis for the remainder of the 24 hour period. If after 24 hours the gauze strip is still in place, it will have to be removed.
To remove the gauze strip:
Apply Vaseline liberally and completely over the stuck surface.
Close the diaper and allow 10-15 minutes for the bandage to soften.
Gently peel away surfaces that are no longer stuck. Repeat the process as necessary. It is okay to do this a little at a time over the course of the day – it always comes off.
Additional Concerns Post Circumcision
Keep in mind the following things:
If your child has any medical problems or significant jaundice, discuss this with Dr. Reddoch before giving him more Tylenol.
If you want, you can sponge bathe your baby following the circumcision, but do not totally submerse him in water for 2 days after his surgery.
If you have any other comments or questions, do not hesitate to call the office.
In case of an emergency, call Dr. Reddoch on this cell at (613) 362-2837.