Persistent Pain After Circumcision: Causes and Solutions - Urology

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Persistent pain after circumcision?


1.
I underwent circumcision approximately four months ago, and I am still experiencing some pain on the left side of the sutured area (the stitches have already dissolved).
The procedure was performed at a public hospital in the northern region.
I have consulted the surgeon several times, who initially suggested it might be an infection, but the biochemical tests showed no issues.
After applying topical ointment, which I felt was ineffective, I consulted the doctor again, who mentioned the possibility of granulation tissue and advised me to continue using the ointment, but it still did not help.
Subsequently, I began experiencing intermittent pain in the nerves beneath the glans.
I sought a second opinion, and the new physician recommended wearing supportive underwear, but that also proved ineffective, and I continue to apply the ointment.
2.
I have noticed what seems to be granulation tissue on the left side, which often comes into contact with the skin folds of the scrotum, causing pain, especially when sitting or squatting.
The pain is more pronounced in the area suspected of granulation tissue (within the suture line), and the nearby nerves are also painful.
I am unsure how to proceed and whether I will need to pay out of pocket for another surgery.
When I asked the doctor, they did not provide much information, only suggesting observation.
This situation has significantly impacted my daily life and work, so I would like to know how I should handle this issue.
(Initially, the surgery was performed because the glans was not exposed due to personal conservatism, and the procedure was self-funded.)

Lax, 40~49 year old female. Ask Date: 2007/06/29

Dr. Lai Ronghao reply Urology


Hello: The causes of wound pain are primarily 1.
infection and 2.
neuropathic pain.
If it is the second reason, the symptoms should gradually improve over time.
If there is no improvement, please consult a physician for further evaluation and management.

Reply Date: 2007/06/29

More Info


Persistent pain after circumcision can be a frustrating and distressing experience. Understanding the potential causes and exploring solutions is essential for managing this condition effectively.

Causes of Persistent Pain After Circumcision
1. Incomplete Healing: After circumcision, the surgical site may take time to heal completely. If the healing process is delayed or incomplete, it can lead to persistent pain. This is particularly true if there was any infection or if the wound was not properly cared for post-surgery.

2. Nerve Sensitivity: The glans (head of the penis) is sensitive, and after circumcision, the exposure of the glans can lead to increased sensitivity or discomfort. If the nerves in the area are irritated or damaged during the procedure, this can result in ongoing pain.

3. Scar Tissue Formation: The formation of scar tissue can sometimes lead to pain, especially if the scar tissue is thick or if it pulls on surrounding tissues. This can create discomfort during movement or when pressure is applied to the area.

4. Frenulum Issues: If the frenulum (the fold of tissue on the underside of the penis) was affected during the circumcision, it could lead to pain, especially if there is tension or if it has not healed properly.

5. Meatal Stenosis: In some cases, the opening of the urethra (meatus) can become narrowed, leading to pain during urination or discomfort in the area.

6. Skin Conditions: Conditions such as dermatitis or other skin irritations can occur in the circumcision area, leading to pain and discomfort.

7. Psychological Factors: Sometimes, anxiety or psychological stress related to the surgery can manifest as physical pain, making it important to consider the mental aspect of recovery.


Solutions and Recommendations
1. Follow-Up with a Specialist: Since you have already consulted with your surgeon multiple times, it may be beneficial to seek a second opinion from a urologist or a specialist in male reproductive health. They can provide a more thorough examination and may offer different treatment options.

2. Pain Management: Over-the-counter pain relief medications, such as ibuprofen or acetaminophen, can help manage pain. However, it’s essential to consult with a healthcare provider before taking any medication to ensure it’s appropriate for your situation.

3. Topical Treatments: If there is a suspicion of irritation or skin issues, topical treatments such as hydrocortisone cream or other prescribed ointments may help reduce inflammation and discomfort.

4. Avoid Irritation: Wearing loose-fitting underwear, such as boxers, can help reduce friction and irritation in the area. Avoiding activities that may exacerbate the pain, such as vigorous exercise or sexual activity, until the pain subsides is advisable.

5. Physical Therapy: In some cases, pelvic floor physical therapy may help alleviate pain by addressing any muscular tension or dysfunction in the pelvic area.

6. Surgical Revision: If the pain persists and is significantly affecting your quality of life, discussing the possibility of a minor surgical revision with a qualified urologist may be necessary. This could address any underlying issues such as scar tissue or frenulum problems.

7. Monitoring and Observation: If the pain is not severe and does not interfere significantly with daily activities, a period of observation may be recommended. Sometimes, the body needs more time to heal, and symptoms may improve on their own.

8. Psychological Support: If anxiety or stress is contributing to your pain, consider speaking with a mental health professional. They can provide strategies to cope with the emotional aspects of recovery.

In conclusion, persistent pain after circumcision can arise from various causes, including incomplete healing, nerve sensitivity, and scar tissue formation. It’s crucial to maintain open communication with healthcare providers, seek second opinions if necessary, and explore various management strategies to alleviate discomfort. Your quality of life is important, and addressing this issue with a comprehensive approach can lead to better outcomes.

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