Bury Circumcision Clinic
Dr. Afzal Hussain (FCPS, FRCS, MRCGP) Walmersley Road Medical Practice
110 – Walmersley Road,
Bury: BL9 6DX
INTRODUCTION
Circumcision Service:
The Circumcision Service was initially set up at Woodbank Surgery in Bury in 2009 to meet the cultural and religious needs of the local population. It is now provided at WALMERSLEY Road Medical Practice in Bury on weekend mainly on Saturday morning clinic. It is a doctor-led service with a dedicated nurse & Reception staff. The doctor has been supervised and approved by a Consultant Urologist to undertake the procedure.
The service was introduced as a result of the request made by the Bury Council for Mosques. The service is welcomed by the local community and is of special benefit to the Muslim population as every male baby must be circumcised on religious grounds. Circumcision is provided under NHS only for medical but not for religious reasons. Therefore, a variable charge for the cost of the procedure is made depending upon the age of the child. For further details, please search the Circumcision Service page on the WALMERSLEY Road surgery website: https://www.walmersleymp.nhs.uk/page1.aspx?p=1&t=2
The service access is by ringing mobile number: 07811 125404 for appointments.
1. This service will be provided on every Saturday to newborn babies between 2- weeks to 12-months of age. The babies out of this age range will be operated only in exceptional circumstances.
2. The babies are assessed initially using a questionnaire and both parents are asked to sign an informed consent for their son’s procedure. The parents are also given Information leaflet about the procedure.
3. Plastibell procedure is carried out under local anaesthetic using lidocaine. Occasionally, we use EMLA cream for older babies. The procedure takes place in a dedicated minor surgery room. Parents may be allowed only on special permission.
4. We use an aseptic technique with a single use, pre-sterilised surgical packs for each baby. The baby lies on a specially designed mattress for circumcisions. Once the procedure is finished, the baby is returned back to the parents in recovery room to observe for up to ½ hour or longer, as needed, for review of any post-op bleeding.
5. Occasionally, we use silver nitrate stick to stop bleeding underneath the tip of penis. This is the same stuff which is used to stop nose bleed in A/E. It may look yellow in a few days’ time but it is not due to infection. It usually gets better by itself in a few days’ time after the ring fallen off.
6. Pre-op Calpol can be given at home an hour before the procedure only for babies more than 2-months old. Please follow the advice given for older babies as the calpol dose varies with the age of the baby.
7. Parents are given written information, advice, and leaflet with 24/7 contact details. All clinically high-risk babies or the babies with high levels of parental apprehension will receive a phone call the next day. A routine post-op review appointment is available in 2Ws. All parents are encouraged to ring back if there is any concern at all until the ring falls off and to arrange a follow-up 2-weeks appointment.
8. A dedicated 24-hours advice line is available for phone advice all the time including weekends but direct same day post-op review will be limited for emergencies only. The appointment can be made by ringing the above mobile number only.
9. Circumcision at home: I fully appreciate the logic, demand, and the benefits of doing circumcision in their own trusted home environment but my current full-time commitment as GP in Bury and travelling from Huddersfield does not allow me to spare enough time to do circumcisions at home visits.
10. It is the parental legal responsibility to use a baby car seat for safe travelling to & from the Clinic. Circumcision Clinic will not be responsible for any legal consequences for not using the car seat during
Some of the written comments passed by Parents in 2023/24 audit report:
1. Well organised, very well explained procedure and post circumcision care, very happy with the process and good environment.Amazing service, doctor handled things brilliantly, we are very happy.
2. Doctor has been so gentle with our baby that he did not cry at all. Aftercare instructions were well explained especially about nappy changing.
3. Very good 5* service, will recommend to the family and friends.
4. Really pleased with the procedure and over all care, clear information given, felt very comfortable.
5. Doctor & nurse is very polite and communication with parents was clear.
6. Very personal service given. Both Dr & nurse were brilliant & highly recommended.
7. I shall definitely be recommending this clinic to other parents. Fantastic experience, very well-informed procedure, will recommend to F&Fs.
8. Very professional, educational, and quick, Dr in particular was very knowledgeable and empathetic to parental concerns and answered all Qs.
9. Fantastic experience, this is our 3rd child, been done. We were made to feel welcome and comfortable. All relatives and family use the same doctor, thanks for everything.
10. Great experience, doctor was in full control of the procedure and takes parents wellbeing in to consideration, he is highly recommended.
11. The service is brilliant; doctor and nurse explained everything really well. Im happy.
12. Aftercare explained parents reassured, happy with service.
13. Very easy looking procedure, no issues occurred during the procedure, all were great.
14. Dr was very nice, informative, made the experience easy for us all, religious in his ways, will recommend to others.
15. Very nice & kind staff, Dr explained everything step by step, thanks very much.
16. I am very happy with how the doctor handled everything and with the outcome of the procedure after a week.
17. This is our 2nd experience, both times we are really satisfied and happy, Many thanks.
18. Good service and excellent Islamic procedure provided.
19. Very good reassurance handled baby well.
20. Really pleased, they have great service and evert thing is excellent.
21. Very friendly and professional service, all information provided accurately.
22. Highly recommended, younger brother recommended this place and I shall be doing the same.
23. Very friendly and kind staff, doctor talked us through everything.
24. Good experience and staff is really friendly.
25. Fantastic staff, excellent service.
26. Great service, efficient and clean.
27. Great & friendly service being provided, advice provided was excellent.
28. Friendly staff, we will recommend to family & friends.
29. Staff was very helpful and well advice given.
30. Doctor was very helpful and gentle with the procedure, very happy, thank you.
31. I am happy that we came here rather than going somewhere else, good surgery and good doctor.
32. Thank you very much doctor, we have been back many times and will be back with another family member soon.
PRE-OP ADVICE & GUIDANCE:
Circumcision Clinic address:
WALMERSLEY Road Medical Practice, 110 WALMERSLEY Road, BURY, Lancs, BL9 6DX
A few other important points:
1. Any flu like symptoms, please use mask or rebook circumcision appointment.
2. Only 2 people with each baby unless extra people allowed.
3. Both parents need to sign consent and need to be present to sign the consent unless a parent is ill or abroad.
4. Both parents need to bring their Id’s with them.
5. Use hand sanitizer in the Surgery.
6. If the Clinic is running late, to avoid crowding in the Surgery, we may advise you to stay in your car until requested to come in later.
7. Strict appointments by time, any delayed arrival for more than 20-mins, you need to wait or to rebook at the next Clinic.
8. No children allowed in the Surgery, please keep them in the car.
9. £150/- up to 5Ms old, only CASH payment is allowed. There is no card payment facility available.
10. Please bring 1-2 size bigger nappies with the baby.
11. Post-op period, please keep nappy open most of the week for quick healing & better pain control with less risk of bleeding.
12. You can use 2Ms plus Calpol for pain control but the dose & frequency will be advised by the clinic in view of the age & Wt of the baby. Please use it to the minimum and strictly follow the advice given by the clinic.
13. It is the parental legal responsibility to use a baby car seat for safety for travelling to & from the Clinic.
14. Circumcision Clinic will not be responsible for any legal consequences for not using the car seat during travelling.
For further details, please search the Circumcision Service page on the WALMERSLEY ROAD SURGERY WEBSITE:
https://www.walmersleymp.nhs.uk/page1.aspx?p=1&t=2
CIRCUMCISION SERVICE POST-OP CARE:
Your baby has had a circumcision. This is not a major procedure but care in the first few days can prevent any problems. You should remember that bleeding is a rare but possible problem following the procedure. You may find that the baby’s nappy may have a few small spots of blood on it where the penis touches the nappy. If spots are large or dark in colour or increasing in size, we advise you to contact Mr Hussain on 07811 125404. You may be asked to bring your baby to be seen.
A FEW THINGS TO LOOK FOR:
- A bit of spotting of blood is acceptable but too much bright red blood need reporting.
- Light swelling / bruising / redness is acceptable but if baby start running temp with it, it needs reporting.
- Ring normally moves towards the tip of penis within a week. If it is still stuck at the same place after a week or seems to be moved back at any time, then it needs reporting to the doctor. Any other concerns, give me a call during the day time.
HYGIENE: You must keep the nappy area as clean as possible. Check and change the nappy regularly and cleanse the area with cotton wool and warm water. DO NOT use baby wipes or rub the end of the penis. Avoid bathing your baby on the day of circumcision. After this time bath baby once / twice a day, avoid using bubble bath. You are allowed to put some salt in his bath water. A smearing of petroleum jelly, such as Vaseline on the front of the nappy (as shown in clinic) will prevent his penis sticking on to it.
CARE OF THE WOUND: You should be able to see the bell at all times. The bell should drop off after 3-8 days. If it remains on, this is not a problem, however, if it is still attached at 14 days, we will ask you to come for its removal. Expect to see some swelling and redness for a few days, this is normal and will settle down.
INFECTION: We aim to ensure a sterile procedure; a small number of babies may acquire infection. (Observe for the penis becoming tense and swollen or any discharge). In severe cases your baby may become unwell, off feeds and develop a temperature. If you are worried, please contact the number supplied.
Some yellow spot under the head of penis or sometime all around the ring is due to Silver Nitrate used during the procedure to stop bleeding. So don’t worry about it, its normal and its not infected, It will get better in a few days’ time by itself once ring goes off.
FEEDING: Your baby has not had a general anaesthetic and therefore can feed normally. Although today’s procedure may have upset him and this could affect his feeding pattern during the first day or two.
PAIN: Your baby had a local anaesthetic before the procedure and paracetamol. You may find your baby a little difficult to settle, do not be afraid of holding him. Rocking and cuddling him will help calm and reassure him.
PLASTIBELL RING: It may hang or dangle for couple of days before falling off completely. So don’t worry and don’t try to pull it or cut it off as it may start bleeding otherwise. It will fall off by itself. Please let us know if it’s still hanging after 2-days. Once the ring goes off, please continue with plain water bath for 2-3 days without salt but still without using any soup, shampoo or Dettol in water. Now need to use Vaseline or tissue paper inside the nappy but still keep lose 1-2 size bigger nappy to avoid friction on delicate skin.
NAPPY CHANGE: Please keep the nappy open most of the time especially during the day time most of the week as it heals quicker, its less painful and there is less risk of bleeding with the nappy left open
PLASTIBELL RING: may hang sometimes during the week before falling off for couple of days. Its considered normal in this procedure, so please continue to follow the same advice until ring comes off completely.
SWELLING: Post-op swelling is normal. Its due to the procedure as well as due to foreign body reaction to the hard plastic ring in place. Don’t worry about it as long as baby has not got temp with it. It will get better by itself within a few days after ring has fallen off.
TRAVELLING: Its parental legal responsibility to use the baby car seat for safe travelling to & from the circumcision clinic. All parents need to report at reception before departure to log-in their exit time and to make sure that baby is well secured in the car seat before departure. Its for safe travelling and clinic will not be responsible for any legal consequences.
FOLLOW-UP: Parents are given written information, advice, and leaflet with 24/7 contact details. All clinically high-risk babies or babies with high levels of parental apprehension will receive a phone call the next day. A routine post-op review appointment is available in 2Ws. All parents are encouraged to ring back if there is any concern at all until the ring falls off and to arrange a follow-up 2-weeks appointment.
WEBSITE: For further details, please search the Circumcision Service page on the WALMERSLEY Road surgery: https://www.walmersleymp.nhs.uk/page1.aspx?p=1&t=2
CAUTION
Please keep baby in the car seat all the time during travelling to & from the clinic
Thanks