Post-Operative Complications: Managing Hematoma and Excessive Bleeding After Circumcision

Q: Post-Operative Complications: Managing Hematoma and Excessive Bleeding After Circumcision

Hello： 1. Will the hematoma caused by bleeding on the 5th extend the recovery period? --> Yes. 2. After reviewing numerous experiences on forums about circumcision, I noticed that it seems like no one else had to apply pressure bandaging the day after surgery

Postoperative day with significant bleeding and hematoma, subsequent issues?

Hello Doctor, on the afternoon of September 5th, I underwent a traditional circumcision surgery.
That night, I experienced a significant amount of unexplained bleeding, and after a challenging trip to the emergency room, the bleeding was finally controlled in the early morning.
At that time, my penis had turned purple, black, and swollen to twice its original size, with some deformity.
On the afternoon of the 6th, I hurried to the hospital for a follow-up.
The doctor examined me and said that I had a hematoma due to the bleeding.
After changing the dressing, the doctor advised that I no longer needed to apply pressure bandaging; I just needed to apply ointment to the wound and wrap my penis in gauze, securing it lightly with breathable tape.

On the morning of the 7th, I noticed that the gauze the doctor had applied was stained with a large area of blood.
After changing the dressing briefly, I went about my day, but by the evening, I found that there was still oozing blood from the wound, and the gauze was damp in the areas with blood stains.
Therefore, I have some questions for you, Doctor:
1.
Will the hematoma caused by the bleeding on the 5th prolong my recovery period?
2.
After reading numerous experiences on forums regarding circumcision, I noticed that most people did not need to apply pressure bandaging the day after surgery.
Could this pose any issues?
3.
I have a follow-up appointment with my attending physician on the 12th, but I have noticed that the gauze covering the wound is still oozing blood (the area is concentrated at the wound site without spreading, but it feels damp when I touch the gauze, and there are blood stains on my hand).
Should I contact my attending physician to reschedule for an earlier visit?
4.
My penis currently resembles a deformed hot dog, with the glans being enveloped by the swollen shaft, and there is still oozing blood.
I have noticed blood scabs forming at the junction of the glans and the swollen shaft, but the wound has not healed significantly.
How should I clean this area?
5.
Lastly, after the surgery, whether it was during the significant bleeding incident or the subsequent hematoma and dressing changes, I have not experienced any pain, and I feel almost no sensation.
The only sensitivity occurs when touching the glans, which causes a slight stinging sensation when a cotton swab touches the sutured area.
I feel as though this little buddy is not mine anymore.
Is this normal?

24-Year-Old Newbie, 20~29 year old female. Ask Date: 2022/09/07

Dr. Du Shixi reply Urology

Hello:
1.
Will the hematoma caused by bleeding on the 5th extend the recovery period? --> Yes.

2.
After reviewing numerous experiences on forums about circumcision, I noticed that it seems like no one else had to apply pressure bandaging the day after surgery like I did.
Will this cause any issues? --> Due to the hematoma, the physician may have their reasons for not applying pressure, but it is important to keep it covered.

3.
I have an appointment with my attending physician on the 12th, but I have noticed some oozing blood at the site of the dressing (the area is concentrated at the wound site, with no spreading, but the dressing feels damp and there are blood stains on my hand when I touch it).
Should I contact my attending physician to reschedule my appointment? --> A small amount is not concerning.

4.
My penis currently resembles a deformed hot dog, with the glans being enveloped by the swollen shaft, and there is also oozing blood.
Consequently, I have noticed blood scabs at the junction of the glans and the swollen shaft, but the wound has not healed much.
How should I clean it? --> Gently clean the wound with sterile saline solution.

5.
Lastly, after my surgery, whether it was the significant bleeding incident or the subsequent hematoma deformation, I have not experienced any pain during dressing changes.
I feel almost no sensation, except for slight sensitivity when touching the glans (there is a tiny sting when a cotton swab touches the suture site).
I feel like this little buddy isn't mine anymore.
Is this normal? --> Generally, a hematoma caused by bleeding needs time to resolve.
Currently, keep the area clean and dry.
If you have concerns, you can return for a check-up with your physician.
Wishing you good health.

Reply Date: 2022/09/07

More Info

Post-operative complications, particularly after a circumcision, can be concerning and require careful management. Based on your description, it seems you have experienced significant issues following your procedure, including excessive bleeding, hematoma formation, and changes in the appearance of your penis. Let's address your questions one by one.

1. Will the hematoma from the bleeding on the 5th extend the recovery period?
Yes, the presence of a hematoma can potentially prolong the healing process. Hematomas occur when blood collects outside of blood vessels, leading to swelling and pressure in the surrounding tissues. This can impede normal healing and may cause discomfort or additional complications. The body will eventually reabsorb the hematoma, but the duration of this process can vary depending on its size and location.

2. Is it problematic that my doctor advised against pressure bandaging after the procedure?
The decision to use or not use a pressure bandage can depend on the specific circumstances of your surgery and the surgeon's judgment. In some cases, excessive pressure can impede blood flow and healing, while in others, it may be necessary to control bleeding. If your surgeon felt that your situation did not warrant a pressure bandage, it may have been a calculated decision. However, if you are experiencing ongoing bleeding or swelling, it is essential to communicate this with your healthcare provider.

3. Should I contact my doctor due to the ongoing bleeding?
Yes, you should definitely reach out to your doctor regarding the persistent bleeding. Even if the bleeding is localized and does not appear to be spreading, it is crucial to have a healthcare professional evaluate the situation. They may want to assess the wound to ensure there are no complications, such as infection or a need for further intervention.

4. How should I clean the area with the scab and ongoing bleeding?
It is essential to keep the area clean to prevent infection. You can gently clean the area with mild soap and water, avoiding any harsh chemicals or scrubbing. Pat the area dry with a clean towel. If there is a scab, do not pick at it, as this can lead to further bleeding or infection. If the scab is causing discomfort or if you notice any signs of infection (such as increased redness, warmth, or pus), contact your doctor for advice on how to proceed.

5. Is it normal to feel no pain or sensitivity in the area?
It is not uncommon for patients to experience altered sensations after surgery, including numbness or reduced sensitivity in the surgical area. This can be due to nerve irritation or damage during the procedure. However, if you are experiencing a complete lack of sensation or if you have concerns about the healing process, it is essential to discuss this with your doctor. They can evaluate whether this is a normal part of your recovery or if further investigation is needed.

In summary, your situation requires careful monitoring and communication with your healthcare provider. Persistent bleeding, changes in the appearance of the surgical site, and altered sensations should all be addressed promptly. Make sure to follow your doctor's advice and do not hesitate to seek further evaluation if you have concerns about your recovery. Proper post-operative care is crucial to ensure a smooth healing process and to minimize the risk of complications.

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