Complications of this procedure are rare and usually very mild. The only complications of concern for which the parents need to be vigilant are the following:
Slight loss of a few drops of blood in the hours after the procedure or after removal of the dressing in the first bath, are common and of no significance. Significant bleeding is from an artery that has not been sealed and will cause dramatic blood loss filling the nappy. This is rare, less than 1: 1000 procedures. It will be very obvious at the nappy change, and when it has occurred in the past, it has been within several hours of the procedure. It is easily corrected by the doctor with a simple suture of the bleeding vessel. Therefore, if you are worried about blood loss, please call the clinic or Dr Levitt immediately and if necessary he will arrange to tie that vessel.
The most important sign of a significant wound infection is a high temperature. If your child is unwell, not feeding, lethargic or very hot in the week after the procedure, please check the child’s temperature and if it is high (>37.5 degrees), then please call the clinic or Dr Levitt immediately. On most occasions this temperature is due to other infections like colds, but true wound infection requiring antibiotics, although very rare, can occur (at a rate of less than 1:5000).
Yellow slough or crusting over the head of the penis in patches is usual and does not reflect infection. A thick discharge onto the nappy could however, be a sign of an infected wound and should be reported.
- Unsatisfactory appearances of the penis
If you are not happy about the appearance of the wound at any time, then call the clinic and arrange for one of the staff to discuss or review the wound as necessary.
In particular, if at any time in the next year or more, the wound appears as though the doctor has not removed enough skin, then bring the child in for a review. In these circumstances there is usually a simple explanation, and an important dressing for you to apply. Therefore, please call the clinic and be reviewed.
- The distressed child
Pain is retained by the neonatal infant for a very short time. The child at this age retains no memory, living only in the instant. Once the early distress has settled...(i.e. of the pain during the procedure and the distress of swallowed air, wind, and being hot and bothered from the crying ) then the child will usually fall asleep. This usually takes between 1 and 15 minutes, On waking, he has no memory of the events prior to his sleep and shows no distress when passing urine or being handled normally. Ongoing distress without fever (fever would suggest possible infection and must be reported) is unlikely to be related to the procedure even if on that day, and should be treated as one would usually manage a restless or irritable infant. If the distress persists, check the temperature again and report a fever.