I realise not everyone agrees with male circumcision, but both my husband and I wish to have our boy circumcised when he's born in February 08 (we are expecting boy/ girl twins after fertility treatment), so I'd rather not discuss the decision itself. There are three hospitals and clinics here in Dublin that perform the procedure, but it is still very rare. So I am planning to send an email with some questions to all of them. Here are the questions I am asking so far, what else should I add?

- How many circumcisions has your hospital performed on infants in the last 2 years (preferably broken down by consultant if you have more than one doctor performing the procedure)?

- At how many days old do you recommend the circumcision be done? Is there any other pre-requisites (such as minimum weight of the baby, adjusted age if they end up being born premature as they are twins)?

- I understand an appointment can only be made once the boy is born- I take it there is no waiting list, so we could get it done asap?

- I assume circumcision is an outpatient procedure for infants done under local, not general anesthetic; how long can we expect to be at the hospital?

- Is there a follow up appointment after the procedure?

- We have health insurance, but I assume as this is considered an elective procedure, we will go private. What is the charge for the circumcision and any preparation/ follow-up visits needed?

That's a very good list, I would only add two more, and they are related-

What complications have been reported after this procedure?
and
What aftercare is recommended to minimize post procedure risks?

It's my opinion that you'll be able to tell a lot about the facility and practicioner by how complete and clear their answers are to the questions you ask, and aftercare is certainly an important factor.

Good luck.

Good questions!
I am also going to add a question as to what methodology they use (cutting, cap etc).

Well, got an answer from the first of the three clinics. I was really surprised that they said it's a day patient procedure, but done under general anaesthesia (sp?). I have attended a bris before and just assumed circumcision were done under local anaesthesia in hospitals too?

They have a 6 months waitinglist as well!

PMFJI, but newborn infants in the first four weeks of life do not need general anesthesia for circumcision -- I sense something is wrong if they're telling you different.

There is ongoing controversy among doctors and nurses as to whether newborns need nothing in the way of anesthesia (the traditional method practiced in most hospitals) versus something minor, such as skin local, penile block, or a calming sugary pacifier -- all known to be helpful. The newborn's cerebral cortex and and pain-processing pathways are not yet developed to the point that it will suffer from the momentary painful stimulus, of which it will have no memory. Older babies would show much more stress response, but then they would be more stable under anesthesia than a newborn is.

For newborns the risks of general anesthesia outweigh the benefits of circumcision. Turn it around this way: If the patient must be anesthetized for a circumcision, then it's best to wait until he's older. Six months is safe (that waiting list is a good thing ) but 9 months or older would be better.