2 to 15 years of Age
The procedures have been quick and seamless. Great service!
|2 to 15 Years||£550|
Further Information about older Children Circumcision
Circumcision is a simple operation which removes the foreskin. The foreskin is the sleeve of skin around the tip of the penis.
Circumcisions are carried out for religious, cultural, personal hygienic, medical and cosmetic reasons. The world Health Organisation estimates that approximately one third of males worldwide are circumcised. The rates vary by country, from 20% in the United Kingdom to 75% in the United Sates, to over 90% in Muslim-majority and Jewish countries.
At the Modality Circumcision Clinic, we carry out between fifty to one hundred circumcisions a week and to date have operated on more than ten thousand patients in all age groups and for all reasons.
Circumcision can have various health benefits, including:
- Easier hygiene. Circumcision makes it simpler to wash the penis. However, boys with uncircumcised penises can be taught to wash regularly beneath the foreskin.
- Decreased risk of urinary tract infections. The risk of urinary tract infections in males is low, but these infections are more common in uncircumcised males. Severe infections early in life can lead to kidney problems later.
- Decreased risk of sexually transmitted infections. Circumcised men might have a lower risk of certain sexually transmitted infections, including HIV.
- Prevention of penile problems. Occasionally, the foreskin on an uncircumcised penis can be difficult or impossible to retract (phimosis). This can lead to inflammation of the foreskin or head of the penis. Other problems that can occur in uncircumcised men include Balanitis Xerotica Obliterans (BXO), recurrent paraphimosis (i.e. where the foreskin becomes painfully stuck behind the glans); recurrent balanitis (infection of the glans). Traumatic (zipper) injury may also be an indication for foreskin removal.
- Decreased risk of penile cancer. Although cancer of the penis is rare, it’s less common in circumcised men. In addition, cervical cancer is less common in the female sexual partners of circumcised men.
Before booking an appointment, we advise that you read our restraining and refund policy. We operate a very strict policy to ensure the safety of our patients. Although the vast majority of children in this age group are circumcised without any problems, a small minority of cases are cancelled on the day in accordance with our policies and protocols.
The doctor is only permitted to restrain the legs of the child during the administration of the local anaesthetic. Where a child shows signs of distress or resistance and the doctor feels it would be harmful to restrain and administer the anaesthetic, the procedure will be cancelled.
Once the anaesthetic has been injected, we will not allow any form of restraint, either by the doctor or parents. Following the administration of the anaesthetic, if the child refuses to lie still on the operating bed, shows any signs of resistance or distress, it will be harmful and dangerous to continue with the procedure and thus the circumcision will be cancelled.
In certain situations where there is a clinical contra-indication (such as anatomical abnormalities or the child is unwell), lack of parental consent or the failure to provide the required documents, the procedure will be cancelled.
The Modality Circumcision Service has an excellent reputation for providing safe and high standards of care. While the overwhelming majority of procedures in older children and young teenagers go ahead without any problems, in a small minority of cases children do become distressed and the procedure has to be cancelled.
In all of the above circumstances where the procedure has to be cancelled, the booking deposit will be considered a consultation fee and is therefore non-refundable.
All deposits are fully refundable only if we are given a minimum of three working days’ notice.
Some conditions and circumstances where a circumcision will be contra-indicated include:
- Acute illness. (Patients with chronic medical conditions may be fit to have a circumcision. Please contact the clinic for further advice).
- Known bleeding disorders (e.g. haemophilia or thrombocytopenia).
- Webbed penis.
- Buried penis.
- Lack of informed parental consent.
If you are unsure whether it is safe for a circumcision to be carried out, please contact us or see your own doctor.
With regards to older children and young teenagers, consent to carry out the procedure may come from:
• All parents with parental responsibility or other persons or agencies with parental responsibility;
• A court.
The BMA and GMC recommend that consent should be sought from both parents. If parents disagree about having their son circumcised, we will not be able to carry out the procedure.
Where a child has only one parent, that person can give their consent alone.
In some cases, however, a doctor may make a professional judgement that the overall social, psychological, emotional and/or clinical benefits of a particular child undergoing a circumcision do not allow for the procedure to be deferred or cancelled.
Due to current COVID-19 restrictions we can only allow one parent or guardian into the clinic. They can choose to stay with the child throughout the procedure or may feel more comfortable to wait outside the operating room whilst the circumcision is being carried out.
After the injection, the doctor will test the foreskin, and proceed only when they are certain that the child is unable to feel any pain. The type of anaesthetic we use can last for up to six hours.
Some children prefer to play games or watch something on a phone or electronic device whilst the procedure is being carried out.
For a small percentage of children aged 2 and above, the Plastibell method (detailed below) may still be suitable. However, for the vast majority of older children and all teenagers, our preferred and safest method is to use one of the formal surgical circumcision techniques.
Formal Surgical Circumcision Techniques
The three formal surgical techniques are:
• Forceps Guided Circumcision
• Sleeve Resection Circumcision
• Dorsal Slit Circumcision
The most preferred formal surgical circumcision at The Modality Circumcision Service is the “sleeve resection” method. According to the World Health Organisation, the sleeve resection method requires good surgical skill and cosmetic results are better than the forceps guided and dorsal slit method. Our surgeons have the skill to carry out all three methods and will at times, when necessary, combine or modify the methods. This is because every patient is different and the experienced and skilled surgeon will be able to choose and adjust the circumcision method that is suitable for a specific patient.
All of the formal circumcision techniques require the use of a scalpel to remove the foreskin, bipolar forceps to control any bleeding and then the cut edges are stitched with absorbable sutures (this means that the stitches will automatically dissolve over a period of two to six weeks and do not need to be removed). The area is then cleaned and a dressing applied. The entire process can take approximately 45 minutes.
The Plastibell Circumcision Technique
The Plastibell is a clear plastic ring with a handle and a deep groove running around it. This was invented in America in the 1950’s and is now one of the most popular circumcision methods, for babies and young children, in the world.
After the local anaesthetic, the penis and foreskin are separated by gentle pushing. A cut is then made from the top of the foreskin, allowing it to be pushed back and the Plastibell to be placed in position.
The appropriately sized Plastibell is chosen and placed over the head of the penis. It is then covered over by the foreskin. A ligature is tied firmly around the foreskin in order to hold the skin against a groove in the Plastibell. The excess skin is then carefully trimmed off. Finally, the handle of the Plastibell is broken off at the end of the procedure. The entire circumcision procedure takes 10 to 15 minutes. The ring falls off within 10 days, leaving a small wound that will heal over the following weeks. No stitches are required.
- Lack of informed consent. Older children and some young teenagers cannot consent to the procedure. The decision must be made by the family/legal guardians. The procedure is considered permanent and there is a risk that when the child is older he will be unhappy he was circumcised.
- Pain. The child may experience some pain whilst the local anaesthetic is being injected and also after the procedure, once the effect of the anaesthetic has worn off.
- Complications during circumcision are rare, being estimated to occur in 1 of every 500 procedures. These complications, which can be severe, include poor cosmetic outcome, bleeding, infection, injury to the penis and the removal of too much or too little skin.
- Change in sexual satisfaction. Some people believe that circumcision leads to decreased sexual pleasure later in life. Data recently collected from a large group of adult males who underwent circumcision later in life suggest that there is no change in sexual satisfaction between circumcised and uncircumcised men and their partners. However, some patients may be unhappy that they were circumcised.
The aftercare will differ depending on the method of circumcision that is used. We will send detailed written aftercare information, together with other important documents, once you make the booking. After the procedure you will be taken to a separate recovery room and the doctor will go through the aftercare in more detail.
Our circumcision clinic operating theatres are modern and of a high standard. They are equipped with electro-hydraulic operating beds and overhead theatre lights. This ensures a safe operating environment.
We have strict infection control procedures that meet all Care Quality Commission standards. We use only sterile single use equipment and instruments for the circumcision. This means we do not reuse any surgical instruments.
After the circumcision we dispose of all used materials. This ensures that we comply with the highest level of infection control and reduce the risk of our patients acquiring any type of infection. Because of this we do not use certain circumcision methods that require the same equipment to be reused on other patients.
Our COVID-19 policies.
After booking the appointment you will be sent detailed information about the circumcision procedure and aftercare service. This will allow you to read through all the necessary details and prepare any questions you may want to ask the doctor. You will also be sent directions to the clinic. On the day of the appointment please bring the following:
- Due to COVID-19 restrictions and to keep everyone safe, we can only allow one parent into the building . We require the parent or guardian to wear a face mask.
- The consent form and health questionnaire must be completed, signed by BOTH PARENTS and brought on the day of the appointment. The doctor will contact the parents a day or two before the appointment to go through the procedure and consent over the phone. Where there are no extenuating circumstances and both parents have not consented, the doctor may cancel the procedure.
- Photographic ID for both parents (passport, driving license or other similar documentation) must be brought to the appointment.
- ID for the child (Red Book with a record of the most recent weight, birth certificate or other similar documentation) must be brought to the appointment.
- For young children who are still in nappies, please bring a tub of Vasleine or Sudocrem and also extra nappies and a change of clothing.
- For Older children and teenagers, please bring loose fitting trousers or something similar.
- Please bring appropriate painkillers such as Paracetamol (also called Calpol) and Ibuprofen.