Neonatal circumcision: When can infants reliably be expected to void?

Objective. Analysis of factors influencing voiding after neonatal circumcision. Design. Prospective study of the following factors in 200 circumcised infants: birth weight, gestational and postnatal age, type and timing of feeding before the procedure, and timing of last voiding before circumcision. Results. There was no significant difference in the age when circumcision was performed between breastfed infants (6 and 60 hours) and in those formula-fed (8 and 130 hours). All infants voided after circumcision, with 75% of breastfed infants and 100% of formula-fed infants voiding within 8 hours of the procedure. Breastfed infants voided up to 8 hours after the procedure, compared with up to 6 hours in formula-fed infants, but without a significant difference. The interval between last feed before the procedure and the time of voiding after circumcision was significantly shorter in formula-fed infants (1 to 9 hours) than in breastfed infants (2 to 21 hours). The interval between precircumcision and postcircumcision voiding was also significantly shorter in formula-fed infants (3 to 12 hours) than in breastfed infants (1 to 23 hours). Ninety percent of formula-fed and 64% of breastfed infants voided within 10 hours of the last voiding before circumcision. No infants aspirated during the procedure, regardless of the time of the last feed. No hemorrhagic, infectious, or surgical complications of circumcision were observed. Conclusion. Postoperative voiding time is predictable. Healthy infants who undergo an uncomplicated circumcision can be discharged before voiding occurs.