There may be a small amount of blood that oozes from the edges of the dressing, enough to lightly stain a nappy or pair of underpants. Any further bleeding should be discussed with your local doctor or myself. ‘Painstop Day-time’ (or ‘Painstop Night-time’ if over one year of age) or paracetamol with codeine should be given regularly for the first 24 to 48 hours after the operation. After that time, assess your child’s pain to see if paracetamol only (‘Panadol’) is all that is required. Follow the manufacturer’s dose instruction but never give more than 4 doses in a 24-hour period and never Painstop and Panadol at the same time. Because of the tube in the penis and the risk of infection in the urine, you will have been prescribed some oral antibiotics for your child to take at home until this tube has been removed. These usually need to be taken twice a day.
Your child should not be bathed for the first 48 hours, but nappies can be changed as required and a ‘wet-wipe’ of similar cloth used. On the second post-operative day (48 hours after surgery) your child should have a bath at home and the dressing removed completely once it has been thoroughly soaked. This process is often made more comfortable by a dose of Painstop one hour before the bath. It is also very important to do this with two adults: one to look after the child and one to remove the dressing. Remember that the penis and scrotum will appear very bruised and swollen at this time. After the bath it is important to apply the tube of topical antibiotic cream (‘Chlorsig’) supplied to the wound 2 times a day for 1 week. In addition, to help prevent the tip of the penis from sticking to underpants or nappies, a thin layer of Vaseline or petroleum jelly is helpful.
Normal bathing is safe from the next day onwards. Often the penis will appear red, swollen and ulcerated in the first few weeks after surgery. This is normal and does not represent infection. The swelling improves considerably after the first few weeks but does not resolve completely for up to one year after surgery.
Your child can begin eating when he gets home. Start with clear liquids (apple juice, iceblocks) and add solid food slowly and in small amounts. Your child may vomit from the anaesthesia on the day of surgery. This should stop by the morning after surgery.