Redness and Swelling of the Glans After Circumcision

Glans swelling and redness?

Hello doctor, I underwent a circumcision on July 12.
Initially, the recovery was going well for a few days, but after about two weeks (on the 15th day), the upper edge was almost healed, while the lower edge had split open.
I went back to see the doctor, who gave me another injection.
After the injection, I returned for a follow-up two days later, but the wound still split open and bled at night due to erections.
During my appointment on July 27, the doctor said to observe for two more days, and if there was still no healing, I would need to have it sutured again.

On July 31, I returned for a follow-up, and the doctor said I needed to be sutured again.
He mentioned that the skin where I was originally sutured had started to rot, so he administered anesthesia again, removed the necrotic tissue, and re-sutured it.
Now, I feel like I'm starting over.
However, I have noticed a problem: after this second suturing, there is a difference compared to the first circumcision.
After the initial procedure on July 12, my urination was only slightly split, and the glans was not red or swollen.
However, after the re-suturing on July 31, once the anesthesia wore off, my glans became red and swollen, almost as if engorged.
This occurs even when relaxed.
The urethral opening is also swollen, causing my urine to spray uncontrollably, almost to the point of splashing my face.
The next day, August 1, when I went to change the dressing, I asked the doctor about it.
He said that after the re-suturing, the dressing was tighter, which could cause swelling, but that it would gradually subside.
On that day, the doctor had adjusted the dressing to be less tight.
However, when I returned home, my glans was still red and swollen, resembling engorgement, even though I was not erect.
The tissue on either side of the urethral opening is painful when pressed.
Now, I have several questions:
1.
Is it normal for the glans to be red and swollen (causing uncontrollable urination and spraying)?
2.
If so, why did I not experience this symptom after the first circumcision?
3.
Why did this symptom only appear after the re-suturing?
4.
Why did the skin at the wound site rot?
5.
I am very worried about whether this will continue in the future.
What should I do? (By the way, after the first re-suturing, I went driving in the morning, but it was really hot, and I was sweating.
Could that be related?)
6.
Why is there such a significant difference between the upper and lower edges? One side is healing well while the other had to be re-sutured?

A Quan, 20~29 year old female. Ask Date: 2007/08/01

Dr. Liu Jianting reply Urology

That was amazing, truly a struggle, you've worked hard! Actually, it's best to rest for a few days after surgery and try to maintain a "quiet" state; the wound will naturally heal over time.
Please don't worry, the concerns you have will improve sooner or later.

Reply Date: 2007/08/01

More Info

After circumcision, it is not uncommon for patients to experience some degree of redness and swelling of the glans (the head of the penis). However, the symptoms you are describing, particularly the persistent swelling, redness, and issues with urination, warrant careful consideration and follow-up with your healthcare provider. Let’s address your questions one by one.

1. Is the redness and swelling of the glans normal?
After a surgical procedure like circumcision, some swelling and redness can be expected as part of the healing process. However, if the swelling is significant and accompanied by pain, discharge, or difficulty urinating, it may indicate an underlying issue such as infection or improper healing. In your case, the fact that you are experiencing difficulty controlling urination and that the urine is spraying uncontrollably is concerning and should be evaluated by a healthcare professional.

2. Why did I not experience these symptoms after the first circumcision?
Each surgical procedure can yield different outcomes based on various factors, including the surgical technique used, the individual’s healing response, and post-operative care. It is possible that the initial circumcision was performed without complications, while the subsequent procedure may have encountered issues such as tension on the sutures or inadequate blood supply to the area, leading to swelling and redness.

3. Why did these symptoms appear after the second suturing?
The second suturing may have caused additional trauma to the tissue, leading to inflammation and swelling. If the sutures were placed too tightly, it could restrict blood flow, resulting in swelling and redness. Additionally, the healing process can vary significantly from one procedure to another, and the presence of any underlying infection or tissue necrosis (as you mentioned with the "rotting skin") can exacerbate these symptoms.

4. Why did the skin around the wound rot?
Tissue necrosis can occur for several reasons, including inadequate blood supply, infection, or excessive tension on the sutures. If the area was not healing properly, it could lead to the death of the tissue, which may require surgical intervention to remove the necrotic tissue and promote proper healing.

5. What should I do if I am worried about future complications?
It is completely normal to feel anxious about your recovery, especially after experiencing complications. It is crucial to maintain open communication with your healthcare provider. If you notice any worsening symptoms, such as increased redness, swelling, pain, or discharge, you should seek medical attention promptly. Additionally, if you have concerns about your healing process or the appearance of the surgical site, do not hesitate to ask your doctor for clarification and reassurance.

6. Why is there a difference in healing between the upper and lower edges?
The healing process can vary based on several factors, including the blood supply to different areas, the tension on the sutures, and how well the area is cared for post-operatively. The lower edge may have experienced more tension or trauma during the healing process, leading to delayed healing or complications.
In summary, while some redness and swelling can be normal after circumcision, the symptoms you are experiencing, particularly the difficulty with urination and the appearance of necrotic tissue, should be closely monitored and discussed with your healthcare provider. Proper follow-up care is essential to ensure that any complications are addressed promptly and that you can achieve a full recovery. If you have any further concerns, do not hesitate to reach out to your doctor for guidance.

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