The Circumcision Procedure – Pollock Technique Now in Calgary
The Circumcision Procedure – Pollock Technique Now in CalgaryJack Roberts2017-04-27T10:38:05+00:00
Circumcision is regarded as one of the safest routine operations today. Each year there are over a million circumcisions performed in North America.
Here at Intramed Medical Centre in Calgary, Dr. Crouse performs Pollock Technique circumcision, including use of a Mogen clamp and adequate local anaesthetic methods.
For newborns and babies up to six months old, extensive pain control methods are employed, including Tylenol before the procedure, an oral sugar solution (which has been shown to reduce pain perception), topical freezing spray, and a quick & long acting local anesthetic.
Is Pollock Technique Circumcision Like Plastibell?
The Pollock Technique can be used for babies, teens and adult men, and consists of using a Mogen clamp 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.
Intramed currently offers Pollock Technique circumcisions for infants up to 6 months of age, for teens age 13 and up, and any adult male. The Pollock Technique circumcision operation takes only a minute 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.
We feel that Pollock Technique circumcision is the most effective and gentle procedure available in Alberta (or anywhere in the world) today for infants, teens, and men. Only local anesthetic is needed and recovery time is relatively fast.
Our method is faster than other procedures, and has proven safe over the past 25 years. This is one of the reasons why so many physicians refer their patients to our clinic. Please call us anytime at 403-255-6196 with questions or to schedule an appointment.
Our Circumcision Method and Pain Control Approach
The Pollock Technique used here at Intramed by Dr. Crouse is based on the Mogen technique. This technique is known for its quickness and safety. In conjunction with this technique, Dr. Crouse uses the most complete and extensive pain control methods available. This ensures that your son will feel little or no pain at all.
The entire circumcision (including bandaging) takes under 60 seconds. To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, as well as sufficient local anaesthetic.
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.
Why do Alberta Parents Choose to Circumcise Their Sons?
An infant circumcision is often undertaken for cultural and religious reasons, and there can be health benefits as well:
It reduces the risk of urinary tract infection.
It reduces the risk of penile infection also called balanoposthitis.
It eliminates the need to do it later in life when up to 6% of boys will require a circumcision because of various problems, like phimosis – an overly tight foreskin.
When an adult circumcsion is done later in life, it is a more costly, difficult, and riskier procedure that may require a general anesthetic; and it is more painful.
It reduces the risk of getting some sexually transmitted diseases including Human Papilloma Virus (HPV) and AIDS (HIV).
It reduces the risk of penile cancer and cervical cancer in partners.
Circumcised men have less risk of sexual dysfunction later in life.
In some Alberta families circumcision is simply a family tradition, with sons following the lead of the father.
Some mothers prefer circumcision to reduce the risk of infection in their baby and over the life of their sons.
Why do some parents choose not to circumcise their sons?
They are concerned that they may be doing a procedure on an otherwise healthy baby that may cause pain or complications.
They wonder whether their child will wish that he had not been circumcised at a later time.
Some parents can be less interested in following cultural and religious traditions.
They are unsure of the medical reasons in favor of a circumcision.
Circumcision is a simple operation that involves removal of the foreskin that sheaths the head of the penis. There are a number of very different methods used in Alberta today for circumcision and the application of anesthesia.
The Pollock Technique for infant circumcision allows for a virtually painless and bloodless procedure to be safely performed in under 60 seconds. This technique was developed by Dr. Pollock and is used exclusively by Dr. Crouse, who has trained extensively with Dr. Pollock and has mastered the Pollock circumcision procedure.
Potential Complications After Circumcision Surgery
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. Crouse if you have any questions about the appearance of the penis. Remember, early treatment (if any is needed) is always the optimal solution. We safely perform over a thousand circumcisions every year and are familiar with all potential issues and we will be pleased to speak with you anytime about any concerns you have.
Please read on below for detail on potential (but unlikely) issues and how to react should they occur.
Please check your baby’s diaper for any bleeding every hour 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 treat bleeding from the penis the same as you would for the tip of a finger:
Apply pressure to the penis for 2-3 minutes: no less. Do this by grasping the penis between your thumb and two fingers (over the 3×3 gauze square).
Without removing the 3×3 gauze square, inspect the area for continued bleeding and repeat step one if necessary.
Leave the 3×3 gauze square in place and close the diaper as removing it may lead to renewed bleeding.
It is reasonable for you to try the pressure technique twice, for 2-3 minutes at a time, before calling Dr. Crouse as most bleeding will stop with this.
TIP: Never wipe a wound with gauze, cloth, etc. This may only dislodge a clot on the wound surface causing renewed oozing or bleeding.
It is better to gently dab or apply gentle pressure on the healing wound surface. If the penis is dripping any blood and you cannot stop the bleeding with the pressure technique, call Dr. Crouse immediately. If after hours, contact the Primary Care Network who will give you directions or contact Dr. Crouse.
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 what is called 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. Crouse 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. Crouse 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. When it does, do not attempt to replace it. If it falls off early, do not worry, 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 hours period. If after 24 hours the gauze bandage 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 15 minutes for the bandage to soften.
Gently peel away surfaces that are no longer stuck. Repeat the process as necessary.
If the bandages won’t come off, call our office to book an appointment ASAP so Dr. Crouse can remove it for you.
Additional Concerns Post Circumcision
Keep in mind the following things:
If your child has any medical problems or significant jaundice, discuss this with Dr. Crouse 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 5 days after his surgery.
If you have any other comments or questions, do not hesitate to call the office.
What are the Risks of Circumcision?
While the circumcision procedure performed at our Calgary clinic can be considered routine and low risk, there is always some degree of risk with any surgery.
Frequency of circumcision complications:
Complications are very rare.
Significant post-operation bleeding requiring medical attention of any kind 1/400.
Phimosis or narrowing of the shaft skin opening over the head of the penis requiring medical intervention 1/500.
Buried or trapped penis ie. penis gets partially buried in the abdomen and requires medical intervention 1/800.
Infection requiring antibiotics 1/1000.
Meatal stenosis – This is a narrowing of the urethra that may occur after the procedure requiring medical intervention (never in our practice).
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).