Post-Surgery Concerns: Penile Plication Complications

Suture dehiscence after surgery?

Hello, Doctor: A month ago (on January 30), I underwent surgery for penile curvature correction using the plication technique.
There are two areas where the surgery was performed.
Yesterday morning, while stretching unconsciously in my sleep, I felt a "pop" sensation.
Last night, I attempted to masturbate without touching the circumcision or plication areas, and I felt that "pop" sensation twice again.
I wanted to check if the angle had shifted, so I induced an erection once more, and again, I felt that "pop" sensation twice.
Now it seems that the angle has shifted again, and I suspect that the sutures may have come undone.
Should I be reassessed to determine if another surgery is necessary?
Additionally, I would like to ask if I should avoid erections after the surgery.
My attending physician told me that I could still avoid touching the surgical site while masturbating, which is why I attempted to check for suture failure and my desire to masturbate may have contributed to the erection.
However, I first noticed the possible suture failure while sleeping.
Should I take progesterone to prevent erections? My erections are quite firm, and before any potential suture failure, they felt very tight.
Is there a correlation between suture failure and the firmness? If there is no suture failure, will it always feel this tight to the point of discomfort? I apologize for asking so many questions, and I appreciate your patient response!

Wanwan, 20~29 year old female. Ask Date: 2012/02/25

Dr. Xu Weikai reply Urology

Hello, do you need to undergo another corrective surgery? 1.
You can assess that if there is significant deviation, another surgery may still be necessary.
2.
The clinical physician can evaluate your condition; you may want to ask the doctor if the materials used during the surgery were too fine, which could have led to tearing.
Of course, it could also be due to excessively high erection pressure.

Reply Date: 2012/02/25

More Info

After undergoing penile plication surgery to correct penile curvature, it is understandable to have concerns about potential complications and the healing process. Here’s a comprehensive overview of the possible complications, the importance of post-operative care, and what to expect during recovery.

Understanding Complications
1. Suture Failure: The "popping" sensation you described could indicate that the sutures used during the plication may have loosened or failed. This is a concern that should be addressed promptly. If the sutures have indeed come undone, it may lead to a recurrence of the curvature, necessitating a reassessment by your surgeon. It is crucial to communicate any unusual sensations or changes in the angle of the penis to your healthcare provider.

2. Post-Operative Pain and Discomfort: It is common to experience some discomfort after surgery, especially during erections. If the sensation of tightness or discomfort persists, it could be due to the healing process or the tension in the sutured area. If the pain becomes severe or is accompanied by other symptoms, such as swelling or unusual discharge, it is essential to seek medical advice.

3. Erection Management: Your surgeon likely advised you to avoid activities that could induce erections, particularly in the early stages of recovery. Erection can place stress on the surgical site, potentially leading to complications such as suture failure or increased pain. If you are experiencing involuntary erections, it may be beneficial to discuss options with your doctor, such as medications that can help manage this issue temporarily.

4. Healing Process: The healing process can vary from person to person. It is not uncommon for the penis to feel tight during erections, especially if the plication was performed to correct a significant curvature. Over time, as the tissues heal and adapt, this sensation may diminish. However, if the tightness persists or worsens, it is essential to consult your surgeon.

Post-Operative Care
1. Follow-Up Appointments: Regular follow-up appointments with your surgeon are crucial for monitoring your recovery. During these visits, your doctor can assess the surgical site, check for any complications, and provide guidance on resuming normal activities.

2. Avoiding Strain: It is advisable to avoid any activities that could strain the surgical area, including vigorous sexual activity, until your doctor gives you the green light. This precaution helps ensure that the sutures remain intact and that the healing process is not disrupted.

3. Pain Management: If you experience discomfort, your doctor may recommend over-the-counter pain relievers or prescribe medication to help manage pain. Always follow your doctor's instructions regarding medication use.

4. Monitoring Symptoms: Keep an eye out for any signs of complications, such as increased swelling, redness, discharge, or fever. If you notice any of these symptoms, contact your healthcare provider immediately.

Conclusion
In summary, while complications can arise after penile plication surgery, many patients recover well with appropriate care and monitoring. If you suspect that your sutures may have failed or if you have concerns about the tightness during erections, it is essential to reach out to your surgeon for a thorough evaluation. Open communication with your healthcare provider is key to ensuring a successful recovery and addressing any issues that may arise. Remember, every patient’s healing journey is unique, and your surgeon is the best resource for personalized advice and support.

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