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Children procedures

Circumcision

Removal of Foreskin of penis

Most commonly it is done under general anaesthesia (by putting the child to sleep), because the pain caused by local anaesthesia or no anaesthesia can have serious or even fatal consequences.

Majority of the hospitals (NHS or Private) do not allow this operation done before the child is three years old, as it is normally not indicated before that age and the risk of anaesthesia in a smaller child is too high for this simple operation.

Orchidopexy (Undescended / Maldescended Testes)

UNDECENDED TESTIS/MALDESCENDED TESTIS

When the baby is developing in the womb, the testes normally develop in the loin area just under the kidneys. Differential growth of the body makes the testis move into the scrotum. They should normally be in the scrotum at birth. In some children, the decent of the testis is normally halted at the loin or displaced anywhere along the tract of decent.

Hydrocoele repair

A hydrocoele is a collection of fluid around the testis. It presents as a painless swelling in the scrotum.

It is mostly congenital (present at birth) usually in boys aged 1-2 years of age.

Most of these resolve by the end of the first year of life.

If it persists, it can be corrected surgically by a day case operation under general anaesthesia.

Hernia repair - Inguinal, Umbilical, Epigastric

INGUINAL (Groin)

A swelling in the groin usually appears when the child cries, strains at stools or laughs.

The swelling can be present at birth.The parents may notice that there is no swelling in the morning, but starts to appear through the day, being large by the end of the day. These hernias almost always need surgical intervention.

UMBILICAL HERNIA

Usually present at birth.

Parents are very concerned that every time the child strains or cries, a large swelling appears at the belly button.The parents can be reassured that vast majority of these hernia resolve spontaneously, by the time the child is 2 years old.

Gynaecomastia (Enlarged male breast)

ENLARGED BREASTS IN A BOY (PUBERTAL GYNAECOMASTIA)

It is the commonest problem with male breast

Can be present at birth, but usually takes importance at puberty. Majority of cases have no known cause (Idiopathic). Can be due to excess of female hormone Oestrogen. Occasionally it is associated with other diseases such as testicular failure either congenital or due to tumour or cirrhosis of liver.

Ingrowing Toenail

Usually caused by ill fitting shoes and poor hygiene.

Encouraging children to take off the trainer when at home and wash feet helps If the nail is ingrowing, antibiotics and dressings have no role.Surgery is the only proper treatment and the earlier it is seen by a specialist, the better are the results.

Pre-auricular sinus

Pre-auricular sinus is a congenital pit present in front of the ear, which from time to time can become infected and discharge pus. It sometimes forms scabs which when removed, can release pus.

It can be removed under local anaesthesia or general anaesthesia.

Tongue-tie

All children are born with a fold of thin tissue from the under surface of the tongue to the floor of the mouth called frenulum. In some babies it may be tight to the extent that it prevents the protrusion of the tongue out of the mouth.

It can cause problem with suckling and later speech.

Excision of Thryoglosal cyst and fistula

A Thyroglossal cyst is a fluid filled sac that is a remnant of Thyroglossal duct, which forms the Thyroid gland. It usually appears in childhood and is attached to the hyoid bone in the neck.