Post-Circumcision Complications: Addressing Frenulum Issues and Scarring

Q: Post-Circumcision Complications: Addressing Frenulum Issues and Scarring

Hello： I underwent a circumcision procedure, and the surgeon tied the sutures on the frenulum. <br>Is this a normal practice? --- It should be, as there is no issue with tying the sutures on the frenulum. <br>However, due to elevated blood sugar levels, the wound was not fully he

After circumcision, issues related to the frenulum?

Hello Doctor: I underwent a circumcision procedure, and the surgeon tied the sutures on the frenulum.
Is this a normal practice? Due to elevated blood sugar levels, the sutures were forcibly removed before the wound had fully healed.
It has now been over six months post-surgery, and I have developed hypertrophic scarring around the penis, with pain in certain areas, especially at the suture site where the foreskin meets the frenulum.
There is also pain during intercourse and masturbation.
Should I seek a diagnosis from another doctor, or is it sufficient to consult the original surgeon? Additionally, are there any other repair measures I should consider, such as applying vitamin E?

k xing ren, 30~39 year old female. Ask Date: 2024/05/03

Dr. Du Shixi reply Urology

Hello: I underwent a circumcision procedure, and the surgeon tied the sutures on the frenulum.
Is this a normal practice? --- It should be, as there is no issue with tying the sutures on the frenulum.
However, due to elevated blood sugar levels, the wound was not fully healed when it was forcibly removed.
Now, more than six months post-surgery, I have developed scar tissue around the shaft of the penis, and touching certain areas causes pain, especially at the suture site where the foreskin meets the frenulum.
Intercourse and masturbation also cause pain.
Should I seek a diagnosis from another doctor, or is it sufficient to return to the original surgeon? --- If the pain is primarily due to scar formation, it would be advisable to return to your original physician for evaluation, as well as to discuss other repair options (such as applying vitamin E?).
--- Maintain cleanliness and ensure good blood sugar control.
Wishing you good health.

Reply Date: 2024/05/03

More Info

Post-circumcision complications can vary widely, and it’s important to address any concerns you have regarding your healing process, especially since you are experiencing pain and scarring.
Firstly, regarding the surgical technique, it is not uncommon for surgeons to place sutures in the frenulum area during circumcision. The frenulum is a sensitive band of tissue on the underside of the penis, and proper suturing is crucial for optimal healing. However, if the sutures were tied too tightly or if there was excessive tension during healing, it could lead to complications such as scarring or discomfort.

The fact that you are experiencing pain at the site of the sutures, especially during sexual activity or masturbation, suggests that there may be some degree of scarring or sensitivity in that area. Scarring can occur as part of the normal healing process, but excessive scarring (hypertrophic or keloid scars) can lead to discomfort and functional issues.
Since you mentioned that your blood sugar levels are elevated, it’s worth noting that high blood sugar can impair wound healing and increase the risk of complications. It’s essential to manage your blood sugar levels effectively, as this can significantly impact your healing process.

In terms of treatment options, it would be advisable to consult with a urologist or a healthcare provider who specializes in male genital health. They can assess the extent of the scarring and any underlying issues that may be contributing to your pain. Depending on their evaluation, they may recommend various treatments, which could include:
1. Topical Treatments: Applying silicone gel sheets or creams designed for scar management may help reduce the appearance of scars and alleviate discomfort. Some patients find that vitamin E oil can be soothing, but scientific evidence on its effectiveness for scar treatment is mixed.

2. Steroid Injections: If the scar tissue is particularly thick or painful, corticosteroid injections may help flatten the scar and reduce inflammation.

3. Surgical Revision: In cases where scarring is significant and causing pain or functional issues, a minor surgical procedure to revise the scar may be considered. This would involve removing the scar tissue and allowing for a more favorable healing process.

4. Physical Therapy: Sometimes, gentle stretching exercises or physical therapy can help improve mobility and reduce discomfort in the area.

5. Pain Management: Over-the-counter pain relief medications may help manage discomfort, but it’s best to discuss this with your healthcare provider to ensure it’s appropriate for your situation.

It’s crucial to follow up with your original surgeon or seek a second opinion from a specialist. They can provide a thorough examination and discuss the best course of action tailored to your specific situation. Do not hesitate to express your concerns about pain and scarring, as these are valid issues that warrant attention.

In summary, while some degree of scarring is normal after circumcision, persistent pain and discomfort should be evaluated by a healthcare professional. Managing your blood sugar levels and seeking appropriate medical advice will be key to addressing your concerns effectively.

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