Post-Circumcision Concerns: Swelling, Sensation, and Surgical Techniques

Inquire about circumcision-related issues?

Hello, doctor.
I underwent a circumcision at the City United Hospital on January 26, 2013, using the standard Korean circumcision technique.
It has been over sixty days since the surgery, and I still have about thirty percent swelling, particularly at the frenulum area, which is the most swollen.
Is this normal? Additionally, I have encountered some issues regarding sexual activity after the surgery, as follows:
1.
My erection and hardness are significantly worse compared to before the circumcision.
2.
During intercourse, I feel very little sensation after entering my partner.
If I use a condom, I lose all sensation and my penis becomes soft.
If I enter without a condom, I still feel weak and ejaculate in a very short time, which is illogical (having no sensation yet still wanting to ejaculate).
Before the circumcision, with a condom, I could last about 20 minutes, and without one, about 10 minutes.
However, after the circumcision, I ejaculate in about 3 minutes without a condom, and with one, my penis becomes soft.
3.
I initially chose to have the procedure at the City Renai Hospital due to concerns about a small clinic, but I did not expect to experience these issues.
When I followed up with the doctor, he said everything was normal.
4.
Could it be that I have had some sensitive nerves cut during the procedure, leading to decreased hardness and stamina? Does swelling affect hardness and stamina?
5.
Due to the various problems I have experienced post-surgery, such as swelling and decreased hardness, I researched and found that there are many methods of circumcision.
Among them, the sleeve-style circumcision, also known as the modified circumcision technique, is considered the best.
This method only removes the foreskin without damaging the underlying blood vessels and other tissues.
However, the standard circumcision often removes part of the superficial fascia, penile fascia, blood vessels, and lymphatic vessels, which can lead to fibrous adhesions with the white membrane, affecting venous and lymphatic return post-surgery, resulting in distal foreskin swelling and potential nerve damage.
6.
Has the sleeve-style circumcision or modified circumcision technique been introduced in Taiwan? For example, at National Taiwan University Hospital? Thank you!

A Yong, 30~39 year old female. Ask Date: 2013/03/24

Dr. Jiang Yini reply Urology

It is recommended to follow up with the attending physician at the Municipal United Hospital.

Reply Date: 2013/03/24

More Info

Post-circumcision concerns can be quite common, and it's important to address them with a clear understanding of the surgical procedure and its implications. Based on your description, it seems you are experiencing some complications following your circumcision, which was performed on January 26, 2013. Let's break down your concerns and provide some insights.

1. Swelling and Recovery
It is not unusual to experience some swelling after circumcision, especially around the frenulum (the band of tissue on the underside of the penis). However, if you are still experiencing about 30% swelling more than 60 days post-surgery, it may warrant further evaluation. Persistent swelling could indicate issues such as fluid retention, infection, or improper healing. It is essential to follow up with your surgeon or a urologist to ensure that your healing process is on track and to rule out any complications.

2. Changes in Sensation and Erectile Function
You mentioned a significant decrease in erectile hardness and sensation compared to before the circumcision. This can be concerning and may be attributed to several factors:
- Nerve Sensitivity: During a circumcision, some sensory nerves may be affected. If the surgery was not performed with care, it could lead to reduced sensitivity in the glans (the head of the penis), which might explain the diminished sensation during intercourse.

- Psychological Factors: Anxiety and stress related to the surgery and its aftermath can also impact sexual performance and sensation. It’s important to consider the psychological aspect of recovery.

- Physical Changes: The removal of the foreskin alters the way the penis interacts with stimulation. Some men report changes in sensation post-circumcision, which can take time to adjust to.

3. Impact of Swelling on Sexual Function
Swelling can indeed affect erectile function. If there is ongoing swelling, it may impede blood flow or create discomfort, leading to difficulties in achieving or maintaining an erection. Addressing the swelling should be a priority, as it could significantly impact your sexual health.

4. Surgical Techniques and Their Implications
You raised a valid point about the different techniques used in circumcision. The sleeve technique (or modified circumcision) is designed to minimize damage to the underlying structures, including blood vessels and nerves. This technique may lead to better outcomes in terms of sensation and recovery. If you are concerned about the technique used in your surgery, it may be beneficial to consult with a urologist who specializes in circumcision techniques to discuss your options.

5. Availability of Advanced Techniques
Regarding the availability of the sleeve technique in Taiwan, many hospitals, including major medical centers like National Taiwan University Hospital, may offer various circumcision techniques. It would be best to inquire directly with the urology department of the hospital to see if they perform this specific technique and to discuss your concerns about your previous surgery.

Conclusion
In summary, your ongoing swelling and changes in sexual function post-circumcision are valid concerns that should be addressed with a healthcare professional. It is crucial to have a thorough evaluation to rule out complications and to discuss potential treatment options. If you feel that your current healthcare provider is not addressing your concerns adequately, seeking a second opinion from a urologist may provide you with more clarity and options for your recovery. Remember, open communication with your healthcare provider is key to ensuring a satisfactory recovery and addressing any lingering issues.

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