Managing Adhesions After Circumcision: Solutions for Persistent Issues

Q: Managing Adhesions After Circumcision: Solutions for Persistent Issues

Hello： Your issue involves recurrent inflammation, scarring, and difficulty maintaining cleanliness, which makes it harder to prevent further complications. <br>If the situation is severe, I recommend consulting a plastic surgeon. <br>Of course, a urologist at a major hospital ca

Adhesion of the coronal sulcus long after circumcision?

Hello, Doctor.
I would like to inquire about the issue of penile glans adhesion.
I underwent a circumcision about two years ago due to phimosis, which was caused by inflammation that made urination painful.
After the procedure, the doctor mentioned that the remaining adhered area could not be separated and suggested that it might tear apart during sexual intercourse.
However, due to the adhesion, it is difficult to clean the area around the small corona, and it tends to itch.
I would like to ask if this can be treated.
Additionally, I want to ask about the appearance of the glans after the circumcision.
It has not been smooth, and there is a rough area extending from the most severe adhesion at the corona down to the vicinity of the urethral opening.
I often feel the urge to pick or tear it off, but this results in small wounds, and it tends to grow back again.
Can this also be addressed, or is this the way it will remain? Thank you.

A Tai, 20~29 year old female. Ask Date: 2021/05/22

Dr. Du Shixi reply Urology

Hello: Your issue involves recurrent inflammation, scarring, and difficulty maintaining cleanliness, which makes it harder to prevent further complications.
If the situation is severe, I recommend consulting a plastic surgeon.
Of course, a urologist at a major hospital can also address this, but it depends on whether the physician has expertise in this area.
Please discuss with your doctor how much improvement can be expected after treatment.
Wishing you good health.

Reply Date: 2021/05/22

More Info

Managing adhesions after circumcision can be a complex issue, especially when it involves persistent problems such as adhesions between the glans (the head of the penis) and the remaining foreskin or surrounding areas. In your case, it seems that you are experiencing discomfort and hygiene challenges due to these adhesions, which can lead to itching and difficulty in cleaning the area properly.

Understanding the Condition
After circumcision, it is not uncommon for some patients to experience adhesions. These can occur when the skin of the glans and the remaining foreskin or surrounding skin stick together. This can be particularly problematic if the adhesions are in the area of the coronal sulcus (the groove between the glans and the shaft of the penis), as this area can be difficult to clean and may trap moisture, leading to irritation or infection.

The rough texture you describe on the surface of the glans and the thickened area extending towards the urethral opening could be a result of scar tissue formation or persistent adhesion. This can happen if the skin does not heal smoothly after the circumcision or if there is ongoing irritation in the area.

Solutions and Management
1. Consultation with a Urologist: The first step in managing your condition is to consult with a urologist who specializes in male genital health. They can assess the extent of the adhesions and any associated complications. A thorough examination will help determine the best course of action.

2. Topical Treatments: In some cases, topical treatments such as corticosteroid creams may be prescribed to reduce inflammation and help with the healing process. These treatments can sometimes help to soften the adhesions and make them easier to manage.

3. Surgical Intervention: If the adhesions are significant and causing persistent problems, surgical intervention may be necessary. This could involve a minor procedure to release the adhesions and smooth out the surface of the glans. This is typically done under local anesthesia and can provide significant relief.

4. Hygiene Practices: Maintaining good hygiene is crucial, especially in areas that are difficult to clean. Gently cleaning the area with mild soap and water can help prevent irritation and infection. Avoiding harsh soaps or irritants is important, as these can exacerbate the issue.

5. Avoiding Self-Trauma: It’s important to avoid picking or trying to forcibly remove any thickened areas or adhesions, as this can lead to further injury and scarring. Instead, focus on gentle cleaning and follow your doctor's advice regarding any treatments.

6. Monitoring Symptoms: Keep track of any changes in symptoms, such as increased pain, swelling, or signs of infection (like redness or discharge). If you notice any concerning symptoms, seek medical attention promptly.

Conclusion
In summary, while adhesions after circumcision can be bothersome, there are several management strategies available. Consulting with a urologist is essential to determine the best approach for your specific situation. They can provide tailored advice and treatment options based on the severity of your adhesions and any associated symptoms. Remember, it’s important to prioritize your health and comfort, so don’t hesitate to seek further evaluation and treatment.

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