Post-Surgery Concerns for Phimosis Treatment

Q: Post-Surgery Concerns for Phimosis Treatment

Hello： It is caused by edema. <br>The skin should be kept clean and dry. <br>It usually takes several weeks for the skin color and edema to improve. <br>If there are any issues, please return for a follow-up. <br>Wishing you good health.

Surgical issues

Hello, I would like to ask about my condition.
I previously had a diagnosis of "incarcerated phimosis," which means that during an erection, my foreskin could not retract behind the glans due to a very tight opening.
Last month, I underwent a laser circumcision procedure, and I informed the doctor that I wanted to retain some foreskin to cover half of the glans when not erect, which the doctor agreed to.

Now, four weeks post-surgery, I noticed that during my first erection since the procedure, my glans appeared purplish, and there was a sensation of tightness around the foreskin beneath the glans, although it wasn't painful—just a tight feeling.
I'm wondering if this tightness is due to the doctor leaving too much foreskin, resulting in a feeling that it hasn't been adequately removed, or if it could be due to residual swelling and some subcutaneous bleeding that hasn't fully resolved yet, causing the sensation of constriction.

If it is indeed a case of insufficient removal, would I need to return for another procedure? Or is it possible that I could gradually stretch the tight skin during erections to alleviate the tightness?

Niming, 20~29 year old female. Ask Date: 2017/06/21

Dr. Du Shixi reply Urology

Hello: It is caused by edema.
The skin should be kept clean and dry.
It usually takes several weeks for the skin color and edema to improve.
If there are any issues, please return for a follow-up.
Wishing you good health.

Reply Date: 2017/06/21

More Info

After undergoing a laser circumcision surgery for phimosis, it is understandable to have concerns about the healing process and the results of the procedure. Your experience of noticing a tight feeling around the head of the penis (glans) and some discoloration is not uncommon in the post-operative phase. Let’s break down your concerns and provide some insights based on medical knowledge.

Understanding Post-Surgery Symptoms
1. Swelling and Discoloration: It is quite normal to experience some swelling and bruising after surgery. The body reacts to surgical trauma with inflammation, which can lead to temporary discoloration and a feeling of tightness. This swelling typically subsides within a few weeks, and as it does, the tightness should diminish as well.

2. Tightness of the Remaining Skin: Since you requested to leave some skin, it is possible that the remaining foreskin is still tight, especially if the incision was made conservatively. If the skin is still tight when you are erect, it could be due to a few factors:
- Residual Swelling: As mentioned, swelling can create a feeling of tightness. This should improve as healing progresses.

- Scar Tissue Formation: After surgery, scar tissue can form, which may also contribute to a feeling of tightness. This can take time to soften and stretch out.

- Insufficient Removal: If the remaining foreskin is indeed too tight, it may not have been adequately addressed during the procedure.

What to Do Next
1. Monitor Your Symptoms: Keep an eye on the tightness and discoloration over the next few weeks. If the tightness persists or worsens, or if you experience pain, it is essential to consult your surgeon or a urologist.

2. Gentle Stretching: If you feel comfortable, gentle stretching of the remaining foreskin may help alleviate some tightness. However, this should be done cautiously to avoid causing pain or injury.

3. Follow-Up Appointment: It is advisable to schedule a follow-up appointment with your surgeon. They can assess the healing process and determine if the tightness is due to swelling, scar tissue, or if more tissue needs to be removed. They will also be able to provide guidance on whether any further surgical intervention is necessary.

4. Avoid Self-Diagnosis: While it’s natural to worry about the outcome of the surgery, self-diagnosing based on symptoms can lead to unnecessary anxiety. A healthcare professional can provide the best advice based on a physical examination.

Potential Risks and Considerations
- Reoperation: If it is determined that the remaining foreskin is too tight and causing issues, a minor revision surgery may be necessary. This is not uncommon and can often be performed under local anesthesia.

- Infection: Watch for signs of infection, such as increased redness, swelling, or discharge. If you notice these symptoms, seek medical attention promptly.

- Long-Term Outcomes: Most patients experience significant improvement in symptoms after circumcision, but individual outcomes can vary. Open communication with your healthcare provider is key to addressing any ongoing concerns.

In conclusion, while your symptoms may be concerning, they are not uncommon in the post-operative period. Monitoring your condition and maintaining open communication with your healthcare provider will be crucial in ensuring a smooth recovery. If you have any doubts or if symptoms persist, do not hesitate to seek professional advice.

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