Problems After Circumcision – Potential Risks and Complications

Circumcision or foreskin removal surgery is a commonly performed surgical procedure that is performed to remove the foreskin. Circumcision is often considered to be a safe procedure with minimal chances of any complications.

However, as is the case with any other surgical procedure, they can still occur and should not be taken lightly. Before deciding on circumcision for yourself or even your child, it is important to know what complications are associated with circumcision and how you can further minimize the chances of any potential complications.

In this blog, we will discuss some of the risks and complications associated with circumcision, what symptoms you should be on the lookout for, and when to seek medical attention from your urologist. 

Potential Risks and Complications After Circumcision Surgery

As previously mentioned, cases of any complications after circumcision surgery are rare. However, it is still essential to know what complications are possible. Some complications that may occur after your circumcision surgery include:

• Excessive bleeding: Mild to moderate bleeding after circumcision surgery is considered normal and to be expected. However, excessive and persistent bleeding may be a sign of complication. Most cases of bleeding can generally be controlled by applying direct, firm pressure on the incision site for a couple of minutes.

  Severe cases, on the other hand, may require sutures. If you are facing symptoms of excessive bleeding that does not seem to stop on its own, contact your healthcare provider as soon as possible.

• Infection: When performed under sterile conditions, infection is an uncommon complication of circumcision. But, in some cases, it can still happen despite safety measures and should not be taken lightly.

  Usually, signs of infection after circumcision include fever, chills, redness, and drainage of yellowish pus from the incision site. If you notice any of the mentioned symptoms, it is imperative to seek medical attention immediately. If caught early, most cases of infection can be treated with antibiotics and topical creams.

  But if treatment is delayed, you may require further surgical intervention. If you are considering circumcision for your newborn, it is advised to be extra cautious and inform your urologist if you see any odd symptoms during recovery.

  Newborns are immunocompromised, and infection at such an age can become a serious problem.

• Insufficient Removal of the Foreskin: Normally, circumcision surgery removes the foreskin to the level where the penis glans are completely exposed.

  But, in rare cases, too little skin is removed, resulting in ineffective treatment of the foreskin issue or unsatisfactory cosmetic results. This condition is known as redundant foreskin and requires a revision circumcision procedure for treatment.

  A revision circumcision is an uncommon but sometimes necessary procedure that is performed to correct unsatisfactory results with the original circumcision.

  Some other conditions that may require revision circumcision include a buried penis (a condition where the penis drops back into a fatty area surrounding it to ‘trap’ it) and penile skin bridges (a condition where the shaft of the penis becomes attached to the tip of the penis).

• Adhesions and skin bridges: Penile adhesions and skin bridges generally occur in newborn boys when the skin of the penis’s shaft sticks to the glans at the top of the penis.

  During the process of circumcision, these adhesions need to be lysed in order for the foreskin to be removed entirely. If these adhesions are not completely removed, the circumcised edge of the foreskin may be drawn up over one section of the corona, creating an asymmetric appearance.

  On the other hand, skin bridges are areas of the skin that extend from the circumcision edge back onto the glans. These generally occur due to minor injury on the edge of the glans that become abnormally adhered to the circumcision edge.

  Because the area under the bridge is unattached, it can facilitate the excess accumulation of bacteria and smegma, leading to hygiene problems after circumcision surgery. Such cases generally require surgical excision for treatment.

• Inclusion cysts: As the surgical site is healing, inclusion cysts may form along the incision line. These cysts generally result from smegma accumulating in the incision site or from the epidermis rolling in at the time of the surgery.

  Inclusion cysts are typically asymptomatic and do not require any intervention. Sometimes, however, they can become infected and become problematic. In such cases, surgical excision may be necessary.

• Delayed healing:  On average, recovery after circumcision surgery can take anywhere from 7 to 14 days. However, the healing ability of every patient is different, and depending on your overall health, method of surgery, and quality of postoperative care, recovery time may vary.

  If your incision wound is taking slightly longer to heal than expected, it is advised to remain calm and consult with your urologist. Most cases of delayed healing are not serious and can be rectified with topical creams and ointments. Minor pain and swelling after circumcision are to be expected and considered normal.

  Avoid the use of any unprescribed cream or ointments. In case you experience unbearable pain or discomfort, it is advised to consult your urologist at the earliest.

  Before surgery, your urologist will likely perform a series of tests to understand your overall health better and minimize any chances of abnormal or delayed healing as much as possible.

• Meatal stenosis: Meatal stenosis is an uncommon complication that may occur after circumcision surgery. Meatal stenosis is a condition where the opening at the end of the penis becomes narrower than normal, leading to difficulty urinating.

  Steroid creams may provide you with some relief. However, in most cases, a surgical procedure known as meatotomy is considered to be the best treatment.

  This procedure involves cutting the stuck part of the meatus to make the opening bigger. After this procedure, it’s rare for the meatal stenosis to reoccur.

• Amputation of the glans: While extremely rare, some cases of glanular amputation have been reported due to inappropriate placement of the surgical device.

  If recognized promptly with both the amputated piece (in a saline-soaked sponge) and the patient transported immediately to a urologist, successful reattachment of the glans may be possible.

Difference Between Side Effects and Complications

There is a general misconception among people who consider the side effects of a surgery to be the same as potential complications. In truth, though, they are two different terms used to refer to different postoperative implications. While both are unintentional, they vary in their predictability and severity. 

• Side Effects: Side effects after a circumcision surgery are unintended but predictable symptoms that generally do not require any medical intervention.

  Side effects can occur even after successful procedures and are usually not serious. Apart from mild swelling after circumcision, some side effects that may occur include minor bleeding, mild pain, nausea (as a result of anesthesia), and bruising.

  These symptoms do not hint towards any serious damage and should resolve on their own in a few days after surgery.

• Complications: Complications, on the other hand, are defined as any undesirable or unexpected repercussions after an operation.

  Complications are more serious than side effects and typically require medical attention. Some examples of complications that may occur after your circumcision surgery include excessive bleeding, infection, excessive pain, insufficient removal of the foreskin, and formation of inclusion cysts. 

How to Minimize Chances of Complications After Circumcision?

To ensure smooth recovery after circumcision, your urologist will likely instruct you to follow some guidelines. By following the tips and guidelines given below, you can drastically reduce the chances of any postoperative complications or problems after circumcision surgery:

• Stay hydrated: After circumcision surgery, you need to stay sufficiently hydrated. Make sure to drink at least 7-8 cups of water every day. Increasing your nutritional fluid intake, such as fruit juice and coconut water, is also advised. Staying hydrated will help decrease urine acidity and reduce discomfort or pain while urinating.
• Wear Comfortable Underwear: It is recommended to wear comfortable underwear that is not too tight. Make sure it fits snugly and can hold the penis in an upright position.
• Keep Surgical Site Clean: After circumcision surgery, keep the penis clean. Avoid scrubbing or using a harsh towel to dry the area. Instead, use mild soap and lukewarm water. 
• Avoid Using any Unprescribed Ointments and Creams: It is essential to avoid using any unprescribed creams or ointments on the penis to reduce swelling or discomfort. Before using any ointments or creams, make sure to consult with your urologist first. 
• Avoid Strenuous Activities: Avoid any exercises or activities that could exert too much force around your surgical site. Instead, perform light impact exercises such as walking or cycling. These exercises help regulate blood flow and can help you significantly minimize the chances of any problems after circumcision surgery.
• Maintain Good Hygiene: Maintaining good genital hygiene after circumcision surgery is always essential. Keep the penile region clean and dry for 48 hours after surgery. Change the dressing as directed by your urologist regularly. When your urologist thinks it’s safe, you can start taking regular baths or showers. Make sure to thoroughly clean the glans and wash off any excess smegma or bacteria that may have accumulated.
• Avoid Sexual Intercourse: Urologists usually advise avoiding sexual intercourse or masturbation for at least 5-6 weeks after surgery. Engaging in sex before giving your penis enough time to heal could lead to delayed healing and skin tearing. Even after 5-6 weeks, it is advised to consult with your urologist first.

Conclusion

Circumcision is one of the most commonly performed urological procedures that is considered safe by healthcare providers. Side effects are usually predictable and minimal, and complications or problems after circumcision surgery are rare. However, they can still happen, and it is crucial to understand what they are and how to effectively deal with the initial symptoms.

If you notice any odd symptoms during recovery, such as excessive pain or bleeding, that do not resolve on their own, it is highly advised to inform your urologist about them at the earliest. These symptoms could indicate a complication and timely medical treatment can prevent further problems.

Undergoing a surgical procedure of any kind can be challenging for many people. Dealing with any complications, no matter how rare, can be scary and people often express worry about the same before finalizing surgery.  And nobody understands that better than our urologists.

If you are considering undergoing a circumcision procedure, you can contact us and book your appointment with our qualified and highly experienced urologists today.

All our urologists are proficient in performing various urological procedures, including circumcision, and have a track record of minimal or no postoperative problems and complications. Rest assured, you can safely undergo circumcision surgery with us and lead a healthy, improved life.