Post-Circumcision Complications: Addressing Tightness and Pain Issues

Q: Post-Circumcision Complications: Addressing Tightness and Pain Issues

Hello： <br>1. <br>There is a hard structure resembling a blood vessel located directly beneath the right side of the wound, extending from the center to the posterior ligament [Image 2]. <br>This appeared approximately 8 days post-surgery, and during an erection, the hardness cau

Post-circumcision issues: stenosis?

Hello, doctor.
The surgeon made me feel very casual about my situation, so I would appreciate your answers to my questions.
Thank you.

Originally, I only had a condition of phimosis, where the foreskin could be retracted normally when not erect and also when erect.
However, due to repeated inflammation and the burning treatment for warts, I developed a narrowing of the foreskin at the tip, which led to the circumcision surgery.
It has been 14 days since the surgery, and the stitches have been removed.

1.
There is a hard line, resembling a blood vessel, located just below the right side of the incision, extending from the center to the back of the frenulum (as shown in image 2).
This appeared about 8 days post-surgery.
When I have an erection, this hard line causes pressure on the wound, resulting in pain.
Could this be lymphangitis or phlebitis?
2.
The area around the wound is very narrow, and I cannot expose the glans when erect.
I want to try pulling it back, but because of that hard line, I am unable to do so.
How should I handle this? Should I wait for the hard line to disappear before reassessing?
3.
It has been 14 days since the surgery, and I experience pain at the base of the penis when pressing down, sitting, standing, or during an erection.
What could be the reason for this?
Image 1: https://imgus.cc/2xvo7
Image 2: https://imgus.cc/NPLZb [No password set]

Hong, 20~29 year old female. Ask Date: 2024/03/13

Dr. Du Shixi reply Urology

Hello:
1.
There is a hard structure resembling a blood vessel located directly beneath the right side of the wound, extending from the center to the posterior ligament [Image 2].
This appeared approximately 8 days post-surgery, and during an erection, the hardness causes pressure on the wound, resulting in pain.
Could this be lymphangitis or phlebitis? -- It is common to experience swelling post-surgery.
Please report this during your follow-up visit.
Ensure proper care of the wound, and if there is redness, return for evaluation.
2.
The wound is very narrow, and during an erection, I cannot expose the coronal sulcus.
I would like to try pulling it back, but the hardness prevents me from doing so.
What should I do? Should I wait for the hardness to subside before reassessing? -- Post-operative swelling can sometimes take longer to resolve, but once the swelling decreases, it should return to normal.
3.
It has been 14 days since the surgery, and I experience pain at the base of the penis when pressing, sitting, or standing during an erection.
What could be the reason for this? -- Please report this during your follow-up visit.
It is common to experience pain post-surgery, but as the wound heals normally, the discomfort should gradually improve.
Wishing you good health.

Reply Date: 2024/03/13

More Info

Post-circumcision complications can be concerning, especially when they involve pain and tightness in the surgical area. Based on your description, it seems you are experiencing several issues following your circumcision procedure. Let's address your questions one by one.

1. Hardness Near the Wound: The hard area you are feeling near the wound, especially if it appeared about eight days post-surgery, could be due to a few reasons. It might be a normal part of the healing process, such as scar tissue formation or edema (swelling) in the area. However, if it feels like a distinct vessel or is causing significant pain, it could potentially indicate a vascular issue such as thrombophlebitis (inflammation of a vein due to a blood clot) or lymphangitis (inflammation of the lymphatic vessels). It's essential to monitor this area for any signs of infection, such as increased redness, warmth, or discharge. If you have concerns about lymphangitis or phlebitis, it would be advisable to consult your surgeon or a urologist for a thorough evaluation.

2. Tightness and Inability to Expose the Glans: The tightness you are experiencing, which prevents the glans (the head of the penis) from being fully exposed during an erection, is a significant concern. This could be due to excessive scarring or a tight circumcision line. It's crucial not to force the skin back, as this could lead to further injury or complications. You should definitely consult your surgeon about this issue. They may recommend a follow-up examination to assess the tightness and determine if further intervention is necessary, such as a revision of the circumcision or other treatments to alleviate the tightness.

3. Pain During Erection and Movement: Pain in the area during erections or when moving could be due to several factors, including inflammation, nerve irritation, or tension in the surrounding tissues. Given that you are only 14 days post-surgery, some discomfort can be expected as the area heals. However, if the pain is severe or worsening, it is essential to seek medical advice. Your surgeon may recommend pain management strategies, such as over-the-counter pain relievers, and may also assess whether there is any underlying issue that needs to be addressed.

In summary, while some discomfort and tightness can be part of the healing process after circumcision, persistent pain, tightness, or any unusual changes should not be ignored. It is crucial to maintain open communication with your healthcare provider, especially if you feel that your concerns are not being adequately addressed. Follow-up appointments are essential to ensure proper healing and to address any complications that may arise. Always prioritize your health and well-being, and do not hesitate to seek a second opinion if you feel it is necessary.

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