Circumcision in Ontario with the Pollock Technique™
Circumcision in Ontario with the Pollock Technique™Toronto Clinic2018-10-10T16:02:58+00:00
Virtually Painless Circumcision in Toronto
Dr. Neil Pollock
At Gentle Procedures Toronto East circumcision clinic, we use the Pollock Technique™ for circumcision procedures for all ages.
We offer circumcision for babies up to 12 months of age, and for boys, teens and men 11 years and older. The detail below focuses on infant circumcision, so please visit the adult circumcision page or the teen circumcision page if you would like more specific information on circumcision at an older age.
Our doctor, Dr. An-Huy Nguyen, has trained with the renowned Dr. Neil Pollock at his clinics in Vancouver, and has been certified in the use of his virtually painless circumcision technique.
Extensive pain control methods are employed; including Tylenol, sugar solution (which has been shown to reduce pain perception), soothing music, topical freezing cream, padded baby holders, and a long acting local anesthetic.
Is Our Doctor’s Circumcision Method Like Plastibell?
The Pollock Technique™ can be used for babies, boys, and men of all ages, and consists of using a Mogen clamp under long-acting local anesthetic. This method is quite different from the Plastibell procedure in that it is faster and there is no device left attached to the penis after the surgery.
Our circumcision doctor performs Pollock Technique™ circumcisions for infants, babies, boys, teens, and adult men. The Pollock Technique™ circumcision operation takes only one minute for newborns – and this is quicker than most hospital circumcisions. This is different from the Plastibell circumcision procedure where an infant circumcision requires 10 minutes to affix the Plastibell device to the baby’s penis and it remains in place for up to 7 days.
We feel that Pollock Technique™ circumcision is the most effective procedure practiced in Canada today. Only local anesthetic is needed and recovery time is relatively fast. Our method is quicker than other procedures, and has proven safe over the past 25 years and 50,000 procedures. This is one of the reasons why so many Toronto doctors refer their patients to our circumcision clinic.
It is best to have finished feeding your son just before bringing him to see the circumcision doctor, so that your baby will not be overly hungry while you are waiting in the office. If your baby is hungry when you arrive, you can feed him at any time during your visit.
Please read on to learn about the multiple steps we will take to minimize your baby’s discomfort during the short infant circumcision procedure. Our doctor will take good care of your son and you will be present the whole time.
You will be at our Scarborough circumcision clinic for just over an hour, and we want to make that time as pleasant as possible.
All the following steps are taken to ensure your son has minimal discomfort during the procedure.
Baby Tylenol Just Before You Come to the Clinic
First, give your son Tempra or Tylenol drops (also called acetaminophen) just before you leave home or, if you are traveling a long distance, after you arrive at the clinic. Infant acetaminophen drops usually come in a concentration of 80 mg/1 ml (check the bottle that this is the correct preparation). The proper dose for his weight is shown in the table below.
¾ ml (60 mg)
1 ml (80 mg)
1¼ ml (100 mg)
1½ ml (120 mg)
1¾ ml (140 mg)
2 ml (160 mg)
If you are uncertain of the proper dose after reviewing this, please wait for us to advise you at the clinic and give it there.
Please do not give any other medication besides Tylenol or Tempra (i.e., No Ibuprofen, Advil, Motrin, etc.) because it may increase bleeding time.
Anesthetic Cream to Numb the Skin
In our office, your child will have topical anesthetic applied to his penis. This is an anesthetic cream that numbs the skin.
This surface painkiller is the second step we take to minimize discomfort during circumcision. This stays on for 20-30 minutes.
Pain Blocking Injection – Local Anesthetic
Next, once the skin is numb, your son will be given an injection called a dorsal penile ring block into the soft tissue alongside the penis.
Our doctors use a combination block of both short and long acting anesthetic. This provides comfort and coverage for both the procedure and for hours after.
Since the topical anesthetic has already numbed the skin, the injection is hardly felt. After 7-8 minutes, the penis is “frozen”, and the circumcision can be done.
Sugar Pacifier During the Brief Circumcision Operation
During the injections and the circumcision, your son will receive a sugar pacifier to suck on. Ten minutes after the injection, the penis is fully desensitized and the circumcision can be done.
During the circumcision soothing music is played, room temperature is increased and your son may continue to receive sugar pacifiers to suck on for additional comfort. Studies show that the sweet flavours distract babies and reduce their perception of pain.
Caring Team Always Available
Although the circumcision takes about one minute, we request that you be in the clinic for about one hour and fifteen minutes in total, so that we can carefully review with you all post procedure care and answer your questions before you take your child home.
As parents we understand that safety concerns are always number one. For your peace of mind, Doctor Nguyen will be reachable 24 hours a day. All clients are given our 24-hour contact information so they can reach the doctor directly should any concerns arise.
You will be given after-care instructions to follow in the days after your son’s circumcision. You can also find a lot of detail on post-procedure care for babies on the Post Circumcision Care page.
The three images below show the change in your baby boy’s penis brought about by circumcision.
1. A profile of the uncircumcised penis with the foreskin covering the glans (head of the penis).
2. The same penis as in Figure 1 but drawn as if the foreskin was transparent. Here you can see the foreskin in relation to the inner side of the foreskin and the glans. Notice the adhesions along the inner side of the glans. These are present at birth in almost all babies and must be released before the actual circumcision.
3. The same penis following the circumcision. Notice that the cut edge of the skin retracts to just behind the back rim of the glans. This is the site of healing.
Our Circumcision Method and Pain Control Approach
The Pollock Technique™ used by Dr. Nguyen is based on the Mogen technique. This technique is known for its quickness and safety. In conjunction with this method, our circumcision doctor uses the most complete and extensive pain control methods available. This ensures that your son will feel little or no pain at all. The objective of the Pollock Technique™ is to minimize stress on the infant and family via maximum pain control and a quick and simple procedure.
Methods used by other Ontario circumcision doctors
Gentle Procedures Clinic uses the Pollock Technique™ for all circumcisions. Other doctors and clinics use other techniques, and here are examples of the more common methods used by physicians at other clinics or circumcision providers in the GTA and beyond. We mention just two of the more common alternate methods here and this is not intended to be an exhaustive list of circumcision types.
The Gomco Clamp – Not used at Gentle Procedures Toronto East
This is the most common technique used by general practice physicians who are not specialized in circumcision. It requires much longer to perform and involves more tissue handling. The technique involves compression of the foreskin for five minutes prior to incision.
The clamp is left in place long enough to allow clotting to occur, then the foreskin is removed using a scalpel. The clamp’s base and bell are then removed from the penis. The clamp itself must be rigorously sterilized prior to surgical use. Gentle Procedures Clinic does not use this method.
The Plastibell – Not used at Gentle Procedures Toronto East
With this technique, the baby must go home with a small plastic device tied on to his penis that allows the foreskin to desiccate over subsequent days. This is also a lengthier procedure to perform. Our opinion is that there is no need to introduce a surgical device that stays on the baby’s penis for up to a week.
The Plastibell Circumcision Device is a clear plastic ring with a deep groove. The Plastibell is placed onto the head of the penis during a 10-minute surgical procedure, and the device will fall off within a week. Gentle Procedures Clinic does not use this method.