Frequently Asked Questions for the Ring Methods (Plastibell and Circumplast)
After the circumcision of your child expect blood spotting in your child's nappy for the first several
days. After the procedure your child may be fussy, may sleep more or less and may eat poorly. There
will be some swelling and the penile skin may turn purple/dark for several days. If however, the
penile skin turns green then contact us on the appointment telephone number, we will assess the
patient. The ring (Plastibell/Circumplast) circumcision takes about two weeks to heal completely
regardless of the method. Open/Traditional surgery takes longer than the ring method to heal
completely.
How much bleeding is normal after a circumcision? Some spotting of blood is normal. Actively
dripping blood and/or soaking of the underwear or nappy with blood is abnormal and you should call
us immediately on the appointment telephone number.
How long can the ring stay on? If the ring is still on there after 10 days then call us on our
appointment telephone number.
The skin where the ring is has turned black around edges, is this OK? Yes, the skin beyond the ring
has to die in order for the ring to fall off. This is excess skin and is only left in place to allow the suture
to stay on whilst the skin being left behind heals.
There is a white or yellow layer of skin appearing near the glans is this normal? The thin layer of
white or yellow by the glans is called the epithelium, this is normal and is part of the healing process.
What if the ring is hanging on by a small amount of skin? Leave the ring in place and it will
eventually fall off. By pulling off the ring you may cause significant bleeding.
What if the ring has slid back behind the head of my child's penis? This is not considered an
emergency as long as he is producing wet nappies. However we will assess the situation within a day
or two.
What if the plastic ring falls off early? With younger babies the ring can fall off within 2 or 3 days
after the circumcision. This is not a problem as long as there is no bleeding. After the ring falls off
please apply Vaseline on the penis during nappy changes.
Is it okay for the penis to look red and swollen after the ring falls off? There is minimal risk of
infection with both ring circumcisions. Often the penis is red and swollen after a ring circumcision
because the skin that is compressed by the string is ischemic (no blood supply) and as a result causes
some inflammation. However, if the penis is looking extremely angry red, hot to touch and the
inflammation is spreading down the penis then please call us on the appointment telephone number,
we will assess to make sure it is not infected.
Below is a day by day healing account of a 7 month old baby who had the ring procedure.
Please NOTE, not every child will follow this guide, some may heal quicker and some may heal
slower, every child is different. The healing process for all ring methods takes APPROXIMATELY 2
weeks.
Day 1: On the day of the procedure the penis looks swollen and the nappy has pots of blood.
Surgeon notes: It is very normal for the penis to look swollen and for there to be blood spots, as long
as it's not actively dripping blood then we are not concerned. The swelling will settle but may take a
few weeks. You may give the child paracetamol (calpol) but please follow the instructions and
measurements on the bottle or back of the box. Also lubricate the penis with Vaseline after every
nappy change but do so gently so the skin doesn't catch to the nappy and pull.
Day 2: Still spots of blood and a thin layer of white or yellow near the glans.
Surgeon notes: The thin layer of white or yellow by the glans is called the epithelium and is normal.
The occasional blood spotting is also normal. As the skin dies it will bleed. Bathe the child gently in
water for 10 minutes. Also lubricate the penis with Vaseline after every nappy change but do so
gently so the skin doesn't catch to the nappy and pull.
Day 3: Some spotting of blood where the ligature is tied and a thin layer of white or yellow around
the glans. Part of the transparent ring looks darker in colour like the blood has dried and parts look
red still.
Surgeon notes: This is as expected and normal. Bathe the child gently for 10 minutes. Also lubricate
the penis with Vaseline but do so gently after every nappy change so the skin doesn't catch to the
nappy and pull.
Day 4: All the area of blood has dried and is darker in colour/ black.
Surgeon notes: This is as expected and normal. Bathe the child gently for 10 minutes. Also lubricate
the penis with Vaseline after every nappy change but do so gently so the skin doesn't catch to the
nappy and pull.
Day 5: The penis is swollen and looks inflamed. There is a yellow connective tissue appearing.
Surgeon notes: The swelling is called oedema, this is normal and should go down after a few
days. The yellow connective tissue is just the skin healing. Gently bathing the child will help reduce
the swelling so continue doing this on a daily basis. Also lubricate the penis with Vaseline after every
nappy change but do so gently so the skin doesn't catch to the nappy and pull.
Day 6: The ring is hanging from a thread of yellow connective tissue and the penis is still inflamed.
Surgeon notes: Gently bathing the child will help reduce the swelling so continue doing this on a daily
basis. Leave the ring it will come off naturally in the nappy. The yellow tissue is part of the healing
process. Also lubricate the penis with Vaseline after every nappy change but do so gently so the skin
doesn't catch to the nappy and pull.
Day 7: The ring has come off completely in the nappy. The penis still looks swollen and uneven.
Surgeon notes: Gently bathing the child will help reduce the swelling so continue doing this on a daily
basis. Also lubricate the penis with Vaseline after every nappy change but do so gently so the skin
doesn't catch to the nappy and pull. The skin is sealed and will take a further week to heal. Also
gently pull the skin at the base of penis away from the glans to sop the new scar sticking to the
glans during each nappy change.
Day 8: The penis looks swollen and uneven.
Surgeon notes: The swelling is called oedema, this is normal and should go down after a few
days. Gently bathing the child will help reduce the swelling so continue doing this on a daily basis.
Also lubricate the penis with Vaseline after every nappy change but do so gently so the skin doesn't
catch to the nappy and pull. The skin is sealed and will take approximately a further 6 days to heal.
Also gently pull the skin at the base of penis away from the glans to sop the new scar sticking to the
glans during the nappy change.
Day 9: The penis has gone very dark and is not his original skin colour and it is still swollen.
Surgeon notes: The colour changes as the blood is absorbed, so the colour goes purple or dark. The
purple/dark colour will go away after a few weeks. The swelling is called oedema, this is normal and
should go down after a few days. Gently bathing the child will help reduce the swelling so continue
doing this on a daily basis. Also lubricate the penis with Vaseline but do so gently after every nappy
change so the skin doesn't catch to the nappy and pull. The skin is sealed and will take
approximately a further 5 days to heal.
Day 10: the swelling has reduced
Surgeon notes: Gently bathe the child daily to reduce the rest of the swelling and lubricate the skin
gently with Vaseline. It will take approximately a further 4 days to heal.
Day 11: The swelling has reduced further and it is beginning to look normal.
Surgeon notes: Gently bathe the child daily to reduce the rest of the swelling and lubricate the skin
gently with Vaseline. It will take approx. a further 3 days to heal and look like a regular circumcised
penis.
Keep gently bathing the child daily for the next few days and the swelling will disappear
gradually. After a full 2 weeks have passed, the skin will have healed and you can return to
normal. The penis will return to its original colour after a few weeks.
