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Plastibell technique

Here's all you need to know about this technique of neonatal circumcision.

The cost associated to the procedure for infants from 0-3 months* is 400$ for the Plastibell technique and 500$ for the Gomco technique**.

The procedure for babies between 3-6 months will be offered soon. 

*This service is offered to children between 10 days to 3 months. Please note that parental consent is necessary to carry out this procedure.

**A $75 deposit is required, and it will not be refunded if the patient reschedules or cancels their appointment more than once.

Technique and benefits

Here's some information about the circumcision technique used at Circoncision Mieux-Être and the potential benefits for your child. This information is essential for parents seeking a better understanding of the procedure.

  • At Circoncision Mieux-Être, we use the techniques: Plastibell™ and Gomco.

    The Gomco technique is a method of neonatal circumcision that uses a tool called a "Gomco clamp" to remove the foreskin from the penis. The process begins with the placement of a metal cone under the foreskin, which serves to protect the glans. The foreskin is then secured to the cone using a circular component of the Gomco clamp. Once the foreskin is in place, a blade is used to cut it by following the contour of the cone, allowing for a clean and precise cut. The Gomco technique is known for offering good visibility and greater control during the procedure, thereby reducing the risk of complications. Although it might take a bit longer than other methods, it is often chosen for its tidy results and higher level of safety. This method reduces the risk of excessive bleeding and typically does not require stitches.

  • The Gomco technique for neonatal circumcision uses a metal cone to protect the glans, ensuring excellent visibility and better control during the procedure. The foreskin is secured to the cone with a special clamp, ensuring it stays in place for a clean and precise cut.

    This method is known for its tidy results, low risk of complications, and high level of safety. It reduces the risk of excessive bleeding and generally does not require stitches.

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Process

We are here to guide you through each step and ensure your child receives top-notch care. Your trust is invaluable, and we are dedicated to earning it at every moment.

After circumcision, it's common for parents to be concerned about the appearance of their son's penis. It's important to note that penises can vary considerably in shape and size.


While most may appear "normal" a few days after circumcision, some may only look completely "normal" after the child grows. Additionally, it may appear smaller after circumcision due to the loosening of the skin surrounding the penis. Before circumcision, this skin keeps the penis more taut.

  • BEFORE COMING TO THE CLINIC, PLEASE FOLLOW THESE STEPS:

    • Plan for about 2 hours for your visit to the clinic.

    • Arrive at the clinic 15 minutes before your appointment time and bring two baby blankets. If you are late, your appointment may be rescheduled.

    • Plan to feed your child before the clinic visit to avoid them getting hungry during the appointment.

    • Avoid giving liquids 1 hour before the appointment.

    • Administer the recommended dose of infant Tylenol or Tempra 30 minutes before the appointment. DO NOT use baby Motrin or Advil to prevent excessive bleeding.


    AT THE CLINIC:

    • Local anesthesia: Lidocaine injection around the penis to numb the area. This usually takes 3 to 5 minutes to take effect.

    • Foreskin separation: Once the anesthesia has taken effect, the foreskin is separated from the glans using a surgical probe.

    • Gomco clamp: A small incision is made on the foreskin to insert the Gomco clamp's bell. The metal clamp is secured to hold everything in place.

    • Foreskin removal: With the clamp in place, the doctor uses a scalpel or scissors to remove the foreskin.

    • Clamp removal: After the foreskin is cut, the Gomco clamp is removed, leaving the glans of the penis exposed. The area is then cleaned and treated to minimize the risk of infection.

  • ​After circumcision, you will need to return to the waiting area and remain on-site for 1 to 2 hours. We will then call you back to the room to check that the circumcision site and the dressing are dry.

    • During the first 24 hours, it is normal to see blood spots about 1 to 2 centimeters in size when changing diapers.

    • If there is blood flow, apply pressure for 5 minutes and repeat up to 3 times if necessary. If bleeding persists, call the clinic. If the clinic is closed, go to the emergency room (Children's Hospital or Sainte-Justine).

    • Your baby might be fussy, which is normal. Up to two doses of infant Tylenol or Tempra can be given within the first 24 hours following the procedure.

    • If the mother is breastfeeding, she should consider stopping blood thinners for 3 days after the procedure, and she may need to consult her doctor about this.

    AT HOME:

    • The Vaseline gauze should remain in place for 24 hours. After 24 hours, you can remove it.

    • If it is stuck to the incision site, do not worry. You can wet a wipe with warm water, place it in the baby's diaper, close the diaper, and wait for 15 minutes before trying to remove the dressing again. If it is still stuck, repeat this process until you can remove the Vaseline gauze without any issues.

    • Apply a generous amount of Vaseline to your baby's circumcision site and cover it with a 2x2 cm gauze pad at each diaper change.

    • If the initial Vaseline dressing falls off before 24 hours, simply start applying Vaseline with a 2x2 cm gauze pad at each diaper change. Healing will still occur regardless.

    • If the circumcision site gets soiled with feces or urine, simply clean it with a baby wipe and warm water.

    • Gently pull back the skin on the penis at each diaper change, as demonstrated by the doctor.

    • Apply Cytoderm or Stratamed cream twice a day. A prescription will be provided.

    • You might see yellow scar tissue around the circumcision site and slight swelling (not a blister) under the penis, as well as a dark blue or red discoloration on the glans. This is a normal part of the healing process, and it should fully resolve after 1 month, sometimes 2 months.

  • ​You will receive a follow-up appointment in 1 to 2 weeks to confirm that healing is progressing well. If complications related to healing are suspected, we will address them during this visit and schedule another follow-up appointment in about 2 weeks.

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Identification of the patient

Circoncision Mieux-Être handles a large volume of follow-up emails daily. When sending photos of their son, parents should include minimal information to ensure our team can accurately identify the patient, convey relevant details to the doctor, and record the information in the appropriate medical file.

    • Child's name

    • Child's RAMQ number

    • Your phone number

    • 4 photos (top, each side (left/right), and underside of the penis)

    IMPORTANT: Avoid sending repetitive or similar-angle photos. Blurry or distant images can lead to incorrect conclusions and increase health risks. For an accurate diagnosis from the doctor, ensure clear visibility of details in the sensitive area (skin, mucous membrane, etc.).

  • Emails not meeting identification requirements or containing an excessive number of photos may be returned without a doctor's diagnosis. Limit your submissions to four clear photos taken from different angles, as this will streamline the process.

    IMPORTANT: Our team typically responds within 24 hours. If you do not receive a response, please wait at least 48 hours before reaching out to us via email or phone at (514) 360-3975.

Details of the service
  • This service is currently available for babies aged 0 to 3 months*. To be eligible for neonatal circumcision, the child must be between 10 days and 3 months old and must not weigh more than 6 kg**.

     

    The rates for children aged 0-3 months are:

    • 400$ for the Plastibell technique

    • 500$ for the Gomco technique

    Please fill out the form to request an appointment, and a member of our team will contact you to schedule it.

    *The service is available for children between 10 days and 6 months (The service for babies aged 3 to 6 months will be available soon). Please note that parental consent is required to perform this procedure.

    **A deposit of $75 is required, which will not be refunded if the patient changes or postpones their appointment more than once.

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FAQ

Here are the answers to frequently asked questions:

  • It is common for a baby to sleep for 6 to 8 hours after circumcision, possibly missing a feeding. Some babies may be slightly irritable, but most settle down within 48 hours of the procedure.

  • Your baby may feel slight tingling when urinating in the first 24 hours, but this sensation should quickly fade away.

  • In case of feces, try to clean the area as thoroughly as possible using a cotton ball soaked in soap or a soft cloth, and rinse gently.

  • It is recommended not to give your son a bath in the first 24 hours after the procedure. After this period, one bath per day, with regular soap and water, is generally acceptable.

  • It is important to note that complications are rare, but may include:

    • Heavy bleeding or wound infection

    • Excessive skin removal during the procedure

    • Side effects from medical measures taken to relieve pain

    • Maintain the treated area clean and dry. Use disposable diapers during the first week as they tend to be less irritating and help keep the area drier and cleaner.

    • Gently clean the area around the penis with warm water, a cotton ball, or a soft cloth. Avoid the use of wet wipes, alcohol, powders, or lotions, as these may irritate the wound.

    • Limit car rides that could irritate the newly circumcised penis. If necessary, place a folded diaper between your baby and the seatbelt to avoid pressure on the penis.

    • We recommend using Tylenol as needed to facilitate quick healing and manage pain.

  • Active bleeding - Stopping active bleeding

    • During the first 24 hours, it is normal to see blood spots about 1 to 2 centimeters in size when changing diapers.

    • If there is blood flow, apply pressure for 5 minutes and repeat up to 3 times if necessary. If bleeding persists, call the clinic. If the clinic is closed, go to the emergency room (Children's Hospital or Sainte-Justine).

    • If you have concerns, feel free to call us at (514) 360-3975; a member of our team will be happy to assist you.

     

    Infection

    Infections are rare but possible. Common symptoms include:

    • Purulent discharge

    • Bad odor

    • Excessive sweating or redness

    • Local warmth

    • Fever

    • Itching around the penis

     

    IMPORTANT: If your son experiences these symptoms or hasn't urinated for more than 12 hours, call immediately at (514) 360-3975 (during business hours) or go to the emergency room outside business hours. If your baby has a fever, we recommend going directly to the emergency room.

Other resources

Circumcision of baby boys: Information for parents

Newborn male circumcision

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