Docteur Jean-Philippe Bercier BSc, MD, CCFP
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Introduction
La préparation
L’intervention
La guérison
1 – Introduction
La circoncision est une intervention simple lors de laquelle on retire le prépuce qui recouvre le gland du pénis.
La circoncision néonatale est pratiquée assez tôt dans la vie. L’âge idéal de la circoncision chez les nourrissons est dans les deux premières semaines de vie, mais l’intervention peut être pratiquée au cours des trois premiers mois.
La Société canadienne de pédiatrie reconnaît les bienfaits potentiels de la circoncision (voir ci-dessous), mais ne formule pas de recommandations pour les nouveau-nés. Ainsi, la circoncision de votre garçon est une décision personnelle que vous devez prendre avec votre partenaire après avoir soupesé les bienfaits et les risques. Elle relève souvent de préférences religieuses ou culturelles.
Les bienfaits potentiels sont les suivants : la réduction du risque d’infections urinaires, la réduction du risque de phimosis (le phimosis est caractérisé par une cicatrisation et un épaississement du prépuce qui empêchent de découvrir le gland), la réduction du risque de cancer du pénis, la réduction du risque d’infections transmises sexuellement, la réduction du risque de cancer du col de l’utérus chez les femmes dont le partenaire est circoncis, la prévention de devoir subir une circoncision à un âge plus avancé, la facilitation de l’hygiène.
Risques
- Les complications aiguës de la circoncision néonatale incluent les adhérences, qui se règlent facilement par une simple rétraction, les saignements mineurs (~ 1/500), les infections locales (~ 1/4000) et un résultat esthétique insatisfaisant (~ 1/500).
- La sténose méatique, qui est la principale complication tardive de la circoncision (2 % à 10 %), peut nécessiter une dilatation chirurgicale. Pour la prévenir, il suffit souvent d’appliquer de la gelée de pétrole sur le gland jusqu’à six mois après l’intervention. Il n’est pas rare que la peau du pénis réadhère partiellement au gland. Ce problème se règle souvent spontanément avant la puberté, mais lorsqu’il est important, il peut être soigné à l’aide d’un stéroïde topique. La lyse chirurgicale est rarement requise.
- Les interventions chirurgicales, y compris la circoncision, sont douloureuses. Malgré l’analgésie pendant l’intervention, les personnes opérées ressentent des douleurs qu’il faut soulager. Nous prenons soin de limiter cette complication en utilisant du Tylenol, une solution de sucrose a 24% et une anesthésie locale au moyen de lidocaïne.
- Les complications graves, telles que l’amputation partielle du pénis et le décès causé par une hémorragie ou une sepsie, sont très rares et ne se sont jamais produites dans notre pratique.
- Le prépuce, doté d’une abondance de nerfs sensoriels, sert à recouvrir le gland, mais selon les études médicales, la circoncision ne nuit pas à la fonction ou à la satisfaction sexuelle des hommes ou de leurs partenaires. Selon certains comptes rendus, des parents ou des garçons plus âgés sont insatisfaits des résultats esthétiques de l’intervention, mais aucune donnée précise tirée des publications scientifiques ne quantifie ce mécontentement.
Contre-indications
Si votre bébé garçon présente un problème de santé non courant, nous ne serons pas en mesure d’effectuer l’intervention. Cela inclut les anomalies congénitales des organes génitaux externes, comme l’hypospadias. Il en va de même en cas d’antécédents familiaux de troubles hémostatiques comme l’hémophilie. Également, nous ne pratiquerons pas l’intervention à un moment où votre enfant est très malade ou instable, s’il présente une irritation cutanée locale ou un érythème fessier, ou s’il a une diarrhée active.
Consultation
Vous pouvez simplement prendre rendez-vous par l’entremise du système de santé privé sur ce site Web. Le coût de l’intervention est mentionné sur le site Web juste avant de faire le choix de la clinique pour la circoncision.
LISEZ LES COMMENTAIRES
Had my vasectomy performed by Dr Dumais, who has taken over for Dr Weiss who has since retired. She was absolutely excellent. Great bedside manner, clear explanations of what was happening and any potential discomfort that might be felt during each step. Entire procedure from freezing to finish took under 10 minutes.Before beginning Dr Bercier confirmed my age (31), that I had no children, and that I was 100% certain I never wanted to have any (and that my partner felt the same way). She reiterated that while surgical reversal is sometimes possible, the procedure should be considered permanent.Nurses/office staff were friendly and efficient. Got up from the table a bit too quick and ended up sitting down in the chair and fainting. They were right on top of things and immediately went into their usual routine for when those things happen. We had a little chuckle about it, and at no point did it feel weird or judgemental which I very much appreciated.A couple of other notes based on some things mentioned in a few other reviews here:- Total out of pocket fees are $170, consisting of a $20 deposit and $150 on the day of the procedure. Those costs are detailed in the attached photo of the “Pre and Post Vasectomy Kit”. As detailed on the page patients can choose to pay only for the specific items/services they want, and they also give you a week post-procedure to request a refund and pay only for the needed items. This information is not provided anywhere before going in, so most will just pay the $170 and be done with it. While some of these costs are certainly quite highly inflated, they do help make up for the fairly minimal compensation the clinic receives from OHIP for each procedure.- Website is a bit of a mess, although most of the important bits are easy to find (and all the most important info is attached to the emails you’ll get). Specifically one thing they have changed is that you do *not* need to travel to the office to pick up your vasectomy package before the procedure! You are given it after your appointment just before leaving.- To the few complaining about pain/discomfort lasting more than the first week and “not being made aware of the risks”… did you not bother to fully read through the documentation available both on the website as well as repeatedly sent to you in the emails? All of the risks and rates of various complications are explicitly laid out in advance. Every body is different, and there is a small chance of a variety of complications. Choosing to ignore the provided information and then complaining that you wouldn’t have gone through with it if you knew is just ridiculous.One last recommendation for the doctors here: I highly recommend investing the few thousand dollars towards having a professional web design company re-build you a new website from the ground up. The current site is a mess, particularly on modern phones, and this is something that will radically improve the patient experience.
Dr. Valerie Dumois did my vasectomy, and she was really quite kind willing to answer questions. It was for the most part painless and the pain you feel is minimal. Reception was also pretty great they answered all my questions to male sire I heal properly. Was great meeting them all and doing it the modern way or a scalpel and needle is definitely in every males favour. Thank you so much for being such great people
Half an hour to my appointment they told me to wait outside(35 degrees celcius) until exactly my appointment. Dr. Bercier if you can call him a doctor had the most rude and disrespectful attitude I've had from a doctor. I asked him three questions to which he said he didn't care. During the procedure I simply asked how long does it take and he replied with "How long do you think it takes? Did you see me with the other patients?" I think his attitude was racially motivated because I'm not French. Don't come here! Go somewhere else!
Great clinic, 5 stars all around. Leading up to the appointment they provide you with fantastic information that explains everything in detail. Great communication, super organized, friendly and professional. Everyone from reception, to the nurse, to the doctor - all were pleasant, efficient, and professional. It was a huge piece of mind. The doctor played my choice of music during the procedure. It was practically painless, with only minor discomfort for a brief moment, and it was quick. I am now recovering comfortably with very detailed instructions about how to enhance my recovery. Thank you Dr. Weiss and Dr. Bercier! Highly recommend.
The process of getting my vasectomy was quite efficient. From walking in the office door to sitting down in my car again was only 20 minutes. The staff was very friendly in greeting you and providing instructions and Dr. Bercier was pleasant to deal with, friendly and gentle. Dare I say the experience was enjoyable! Any trepidation one has about the procedure, don’t worry! Thanks to all.
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