Complications of circumcision, also known as post-ectomy or phimosis surgery, are rare. Because of the emotional impact they can have, measures should be taken to avoid circumcision complications. Therefore, the procedure must be performed in a meticulous manner.
Common circumcision complications
- Superficial hematomas of the penile skin: they occur because a suture comes loose or because of anesthesia punctures. They present a purple color during the first days, but with the passing of the days they change to a yellowish tone. They last between 6 and 8 days and always disappear completely.
- Surgical hematoma. They occur when a vein or artery loses the suture that plugged it and blood flows, so that blood accumulates under the skin. Sometimes, it is important to drain the clots and plug the vein.
- Wound infection. It is usually caused by a bad dressing technique. When the infection affects the entire wound with pain and inflammation, it is important to administer antibiotics, as well as to follow a correct hygiene.
- Suture dehiscence of the penis. The stitches come loose and a part of the wound opens as a consequence of an infection or because of an accumulated hematoma. On other occasions, it can be caused by a sustained erection or premature sexual intercourse. The treatment of this situation varies depending on the time elapsed since the intervention.
- Penile floater edema. This is one of the most frequent complications, which is produced by the section of the lymphatic vessels during circumcision. In general, the edema tends to disappear in a few months, when the lymphatic circulation is restored.
- Post-circumcision meatitis. It is the inflammation of the opening of the urethra (urethral meatus). It is usually caused by the urethral meatus rubbing against underwear. In most cases, it disappears spontaneously in a few weeks. And in bothersome cases, corticosteroid ointments may be prescribed.
Late complications of circumcision
- Stenosis of the meatus (orifice) of the urethra. This usually occurs in patients who had to undergo circumcision due to sclerosing balanitis or penile lichen. In these cases, the orifice closes, making it difficult to pass urine. Treatment is usually sufficient with anti-inflammatory ointments and gentle dilation of the urethral orifice. In some cases, it is necessary to perform a meatotomy.
- Keloids. This is scarring that does not stop and grows despite having properly joined the wound edges, causing the scar skin to become thick, hard and raised. Sometimes it is caused by exaggerated tension of the stitches. If the final aesthetic result is bad, after 6-8 months it can be reoperated by trimming the excess skin.
- Poor aesthetic results. They are usually a consequence of the previous complications, but sometimes they are due to the excessive tension of the stitches.
Exceptional circumcision complications
- Ischemia and necrosis of the glans penis. This is most often due to the use of local anesthetics with an added vasoconstrictor. It can also be caused by applying a bandage that is too tight. It is common in patients with diabetes or circulatory problems.
- Partial section of the glans.
- Urethral fistula. It is usually caused by excessive electrocoagulation over the frenulum area. Urine flows out through the fistulous orifice, as well as through the urethral meatus. Repair of the fistula requires plastic reconstruction.
Avoiding circumcision complications
- Hygienic measures. It should take 24 hours to perform the first dressing. Then, it is advisable to wash your hands with soap and water, before making the cure. To perform the treatment, a gauze soaked with disinfectant liquid should be applied on the stitches to remove any remaining dirt. After applying an antiseptic ointment, the penis is wrapped with gauze, to avoid rubbing against clothing, and secured with a plaster.
- The dressing should be applied 2 or 3 times a day and the wound should be covered for at least 8-10 days. After this time, the stitches can be removed or left to fall off on their own.
- During the operation: give the stitches without tension, because excess tension leaves marks.
- Remove the stitches after 10 days. Do not wait for the stitches to fall out on their own after three weeks, because this makes the scar less visible.
- Protect the lymphatic circulation during the operation.
- The bandage at the end of the intervention should be protective and press just enough and necessary.
- During the first days, the penis should be placed upwards, avoiding the accumulation of liquids and reducing the risk of edema.
Surgical treatment of circumcision complications
Generally, circumcision complications resolve spontaneously or with simple treatments. When the results are not very aesthetic, it is necessary to wait. The second operation should be delayed for at least 6 to 8 months so that the tissues can be operated on without inflammation. The results of the second operation are usually very good.