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Updated: Jun 25, 2026

Transcutaneous Microcirculatory Imaging in Preterm Neonates

Transcutaneous Microcirculatory Imaging in Preterm Neonates

Published on: December 31, 2015

Optimal time for neonatal circumcision: an observation-based study.

¹Division of Pediatric Surgery, University of the Witwatersrand, P.O. Box 5042, Cresta 2118, Johannesburg, South Africa. banieghbal@worldonline.co.za

Journal of Pediatric Urology

|February 19, 2009

Summary

Performing neonatal circumcision within the first week of life significantly reduces pain. This study found that almost all newborns experience painless circumcision if done during this optimal early period.

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Area of Science:

Pediatric Surgery
Neonatal Care
Pain Management

Background:

Neonatal circumcision is a common procedure with ongoing ethical discussions regarding non-therapeutic parental consent.
Ensuring safe and minimally traumatic circumcision is crucial for pediatric surgeons and urologists.
Effective pain management strategies are essential during neonatal circumcision.

Purpose of the Study:

To identify the optimal age for performing neonatal circumcision to minimize pain and trauma.
To provide evidence-based recommendations for the timing of neonatal circumcision.

Main Methods:

A prospective study involving 583 neonatal circumcisions over three years.
Pain assessment using the Neonatal/Infant Pain Scale (NIPS), with a score of 2 or higher indicating pain.

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Pain reduction techniques included penile ring block with lignocaine, and administration of milk or sucrose solution.

Main Results:

Only 6.5% of neonates under one week old experienced pain (NIPS ≥2).
Pain incidence increased to 100% by the fourth week of life.
Two minor complications were reported in the study cohort.

Conclusions:

Painless neonatal circumcision is achievable in nearly all newborns when performed within the first week after birth.
The first week of life represents the ideal window for minimizing procedural pain during circumcision.
Safe and effective circumcision practices are paramount, especially given the procedure's continued prevalence.