All of you must be familiar with circumcision, whether it is the necessity of the procedure, the surgical approach or the post-operative rehabilitation, you can find the answer through the almighty Internet.
However, a seemingly simple procedure can still lead to a series of complications if errors in preoperative evaluation and perioperative management occur. Although most of the mild cases can be gradually improved by symptomatic treatment, if more serious complications are encountered, they can cause lifelong regrets to patients.
1. Postoperative incision pain As an invasive treatment, postoperative pain is difficult to avoid, and I have found in my clinical work that men’s tolerance for pain is much less than that of women. Therefore, in order to improve the comfort level of my patients, I usually prescribe analgesic drugs.
I can assure you that there are many of you who have various misconceptions about pain medication, which boils down to the fear of adverse drug reactions. But pain itself can be a very unpleasant experience that is extremely detrimental to surgical recovery, and pain can also induce penile erection which increases the risk of post-operative bleeding. After years of development and iteration, pain medications are not only reliable, but their side effects are also minimal, and there is no need to worry about short-term use.
It should be noted that if the pain still does not improve after taking the medication, you should be alert to the possibility of incisional infection.
2. Surgical site edema Traditional circumcision (using the coronal sulcus as the surgical access, including various circumcision device surgeries) usually leads to edema. The main reason is that the surgical operation disrupts the lymphatic circulation of the subcutaneous tissues of the penis, and the edema will persist until new circulation is established (7-14 days).
In contrast, cosmetic surgery, represented by cuff circumcision at the root of the penis, rarely results in local edema because only the epidermis is removed without affecting the lymphatic vessels of the subcutaneous tissues of the penis, and the postoperative pain is far less than that of traditional surgery. For those who are interested, please read my article, “Men’s Guide! A modified form of “invisible circumcision”! The article has a detailed description of this procedure.
3, post-operative bleeding and incision infection bleeding after circumcision is not common, mainly due to inadequate hemostasis during surgery or post-operation due to penile erection resulting in incision dehiscence. If the amount of bleeding is small, you can stop the bleeding by compressing the surgical incision on your own. If the bleeding is large, it is recommended that you contact your surgeon and return to the hospital for emergency treatment. The treatment process includes drainage of the hematoma and re-suturing of the wound.
Postoperative incision infection may arise from the following reasons, including incomplete intraoperative disinfection, low immunity of the patient, poor absorption of the local hematoma, and irregular application of antibiotics during the perioperative period.
Incisional infections often appear about 5 days after surgery and mainly manifest as wound pain, redness and swelling or even abscess formation. The principle of treatment is as follows: the wound should be changed regularly, the abscess should be drained and the incision sutures should be removed, the less serious infected wound can be healed in about 14 days, the wound infection can cause local scar growth in the long term and affect the beauty.
4, circumcision has not been corrected This phenomenon is often seen in patients with occult penis, due to the misdiagnosis of it as circumcision before surgery.
The cause of occult penis is the adhesions of the subcutaneous tissues that cause the penis body to be unable to stretch freely, or the relative shortness of the penis caused by too much subcutaneous fat in the pubic mound, which visually gives the illusion of a relatively long foreskin.
If necessary, the penis can be lengthened by removing the penile suspensory ligament, and the thickened subcutaneous fat in the pubic mound can be removed to improve the length of the penis, and then the foreskin can be removed according to this length. Therefore, circumcision alone cannot improve the local appearance of occult penis, but also lays a hidden danger for future treatment. As you can imagine, when the occult penis is corrected, we suddenly find that the skin of the penis is not long enough, and finally we have to solve the problem through skin implantation. This not only increases the patient’s pain and treatment cost, but also the local appearance will not be satisfactory due to the existence of skin color difference.
5. Scarring at the surgical incision site In some cases, scarring will appear at the incision site after surgery, partly in the shape of a ring, called annular stenosis or stenosis ring, and partly in the form of keloid. The common causes are as follows: first, keloid; second, postoperative incision infection causing excessive local fibroblast proliferation to form a scar. In addition to causing local unsightliness and affecting the patient’s mood and self-confidence, keloid scars may also present with erectile pain and erectile limitation due to lack of ductility.
The vast majority of keloids can be surgically removed, and circumferential stenosis can be completely treated with a W-flap suture based on excision of the scar. In order to prevent the appearance of scar, for those who have clear scarring, radiation therapy or glucocorticoid injection can be chosen after surgery, which is beneficial to prevent the appearance of scarring.
6, too much foreskin removal The deviation of preoperative assessment leading to too much foreskin removal is a common reason, and its biggest harm is the limitation of penile erection after surgery, and the solution can only rely on skin implants. The skin of the scrotum is usually used, and the symptoms of erectile limitation can be eliminated after surgery, but the color and texture of the original penile skin and the implanted skin will appear significantly different.
It is always more important to prevent complications than to remedy them afterwards. Once again, it is recommended that all partners who are willing to undergo surgery must consult an experienced specialist at a regular hospital, which is always the most crucial factor in preventing post-operative complications.