Circumcision - Not a happy bunny

[nheather]

I had a circumcision on Monday - for medical reasons.

Brief background - a few years ago my frenulum had become short make it painful to full back my foreskin when erect. Also my foreskin had become a little tight but not so much to be a problem. So I had a frenuloplasty (Z-Cut) to try and lengthen my frenulum.

It didn't really work - the frenulum stayed about the same length but was now scar tissue so less stretchy then ever.

I tried to work with it but, this summer I saw the urology specialist again and he immediately said he would refer me for circumcision, which I accepted. It was a very short consultation and he wasn't one for discussing the pros and cons and types of procedure. However, as I was leaving he said "or we could try a frenuloplasty revision, which do you want". Again he offered no advice other than saying that I could leave it open and decide on the day of the operation which way I wanted to go.

I read up on circumcision with my wife and after reading lots of views against I decided that I would give the frenuloplasty revision a go - if it didn't work out I could always do the circumcision at a later date.

I had also read up about circumcisions so had a good idea of the different cut styles.

On this Monday I checked into the hospital and when the doctor came to see me I showed him the letter saying that I could choose a frenuloplasty revision if I preferred and he was very good. I gave my reasoning that circumcision was pretty drastic and final so would like to consider other possible options first. He confirmed that he had already seen that option in the referral letter and asked to inspect the frenulum. He concluded that he was happy to give it a go but recommended that because it was so scarred success would be very unlikely and that circumcision was the best course. I was happy with that as at least he had looked at the possibility.

He then described the procedure for a 'Normal' circumcision. Scar line a cm or two so below the glans, medium tight foreskin. He even described the different skin tone colour above and below the scar line. I was happy with this as that was the style I would have chosen myself.

Operation done, I was in the recovery ward and the doctor came to see me before I left. he said that all had gone well and that he had decided to do a 'Low and Loose' cut based on my concern that a circumcision was drastic.

Really disappointed and annoyed about this.

Basically he described one procedure, got my consent and then did another procedure. There was no medical reason dictating the need to change. Fine if he thought that was a good idea but he should have discussed it with me first.

Because if he had discussed it with me first I would have said "no, hell no".

Couple of reasons :-

I am a grower so when flacid I have a lot of loose foreskin. The type of cut that he has done means that only a small amount of foreskin has been removed which means that when flacid the glans is mostly covered but has the tip protruding and exposed - doesn't look too good.

Rather than have a nice flat scar line on the shaft I think I am going to be left with an ugly ridge scar just behind the glans.

There is no inner foreskin remaining which I understand is the most sensitive.

I suspect that this cut is also final - there is no way in reverting it back to the cut I wanted and thought I was getting - is that correct?

Cheers,

Nigel

[Goldfish_]

Up until a few years ago I anaesthetised for a urology operating list each week and saw hundreds of circumcisions. There was only one type of procedure, but some surgeons had a neater result than others, but I never heard of anyone giving the option of different styles, although I see they are now offered (especially privately)

it takes several months for the scarring and suture lines to settle and an "ugly ridge scar" would be very unlikely, so I would suggest giving it 6 to 12 months.

Obviously you can only have tissue removed, but if you want further surgery it maybe that a plastic surgeon or specialist clinic would be the person to approach although this is unlikely to be funded by the NHS

[nheather in reply to Goldfish_]

Hope you are right but I am beginning to have grave concerns.

I have to try and visit the ward today because I think some of the stiches have failed. It was a nightmare trying to contact them yesterday, no direct contact information on the discharge summary sheet, just the switchboard who didn't answer. The discharge summary says that I should deal with my GP in the first instance - I managed to do that seeing the nurse and the duty doctor - both said that it does look like some of the stiches have failed and I need to go back to the ward as they can't do anything.

Also noticed another possible problem with the type of cut - rather than be exposed to the air to heal it is constantly covered in foreskin. This morning it looks very angry and red with a burning sensation.

As for the scarring - I hope you are right but it doesn't look good to me. Because he has made the join practically under the glans it looks like it has been difficult to sitch neatly - the stitching is no uniform around the glans, in some places it looks fine but in others there is a very distinctive ridge.

Nigel

[Goldfish_ in reply to nheather]

You need to be patient. I expect there are dissolving stitches, which will settle over several weeks, but you will hear more today.

[nheather in reply to Goldfish_]

Don't think they are dissolving the other stitches are not showing any signs, nor did the nurse or the doctor at the surgery think so.

In the part of the wound with the 'broken stiches' there is a widening gap showing black underneath and yellow fatty tissue is being pushed out.

Also the whole area is hurting and burning more than it as ever done since the operation.

Cheers,

Nigel

[Goldfish_]

Well you'll hear more later today, but I've seen many post op circs that look bad at 1 week which settle to an excellent result.

That area has immense recovery powers. There is a circumcision technique for babies that doesn't use any stitches and it heals well

Please let us know what they say.

[jimpollard Partner]

Let us know how you get on Nigel

[Hidden]

If some foreskin is remaining that will help gliding on the labia for satisfaction of your partner. If no foreskin is left then you have to only depend on the rubbing and thrust on the inner G-spot for your partner's satisfaction which largely depends on mental state and time of foreplay . Take it easy . Good luck

[Goldfish_]

How did you get on?

[Hidden in reply to Goldfish_]

What exactly you want to know Goldfish ?

[Goldfish_]

Any feedback?

[nheather]

Sorry, missed your questions.

Two bits of feedback.

(1) went to the ward on Friday morning about the failed stitches. Saw a junior doctor and a registrar and they confirmed that there was a gap but that there wasn't any sign of infection, that it was fairly common and that it wasn't a cause for concern.

(2) regarding my concern that the procedure performed was different to that dicussed before taking consent - the hospital have got back to me and said that my concerns have been passed onto the doctor that did the operation. He said that he was happy to see me in 6-8 weeks time to assess how it has healed, my satisfaction and whether any corective procedure is needed/possible.

Must admit I am still concerned. I know it is only a week in but I am still rather worried and concerned how it is going to heal. I can't possibly see how it can heal neatly without living ugly ridges and steps but as you say the body can do marvellous things.

Much osf this stems from the lack of advice and guidance that I have received throughout.

When I first saw the specialist, he said 'circumcision' within a few minutes. When I tried to discuss what it involved it was clear that he didn't have a great bedside manner and didn't say much. Then as I was leaving he complicated things by saying "alternatively we could do a frenuloplasty revision, your choice". Again when asked about the relative pros and cons he was not very talkative.

Then after the operation I was not told what to expect in terms of healing, how long it will take, what it will look like, what I should expect the fully healed result to look like.

So I could be worrying over nothing but little wonder as I have no guidance on what to expect, no follow-up appointments and no-one to turn to for advice.

Cheers,

Nigel

[jondfh in reply to nheather]

I had frenulopasty which did not work for me and so I too elected for circumcision. About a year after the op my scar looked very rough. There were large stitch tracks and an area of puckered skin on the scar line where I imagine it had not been drawn together evenly. I did not like the appearance and so had it redone privately. The scar tissue was removed and the skin rejoined with glue and one or two small stitches. The result is much better, now the scar is barely visible and it is more even. I hasted to say that it looks "natural" but it is a great improvement. I suggest giving yours time to settle down, see if you can live with it and if not consider what to do. Good luck.

[nheather in reply to jondfh]

Thanks for sharing your experience - very helpful.

I feel really stupid because I have just changed jobs and private health schemes. I was intending to have it done on the old scheme before I left but the NHS appointment came through so quickly I didn't bother.

Thought there wouldn't be any difference but what I think the NHS lacked was patient involvement - explaining the operation, the options, what recovery looks like, after op care. Treated more like a thing that has no say and doesn't need to know or be involved.

Hindsight is a wonderful thing.

Cheers,

Nigel

[jondfh]

Like you I was not told much by the NHS surgeon. I think there is a tendency to do what the surgeon thinks is required rather than what the patient might want.

The guy I saw privately explained much more about what he could do and what the finished result would be. He took care to ensure that the end result was not too tight when erect, which I imagine could be uncomfortable and possibly troublesome.

Jon

[nheather]

There is a happy balance though. Giving zero advice and guidance is short sighted and is only going to cost them in the long run. Look at my case, the hospital and surgeon has had to respond to a number of emails from me and agree to a follow up assessment because the only mechanism available to make contact was to raise a complaint.

I didn't want to complain, I just wanted to ask some questions about my worries but the only mechanism that the NHS makes available is to register a complaint.

Cheers,

Nigel

[nheather]

The crazy thing is that I think thar the procedure that the doctor did was more complex and more difficult. I think he had good intentions, thinking I would prefer it done that way but I wish he had asked first because I would have told him 'NO' and I fear that because what he did was more difficult the result is going to look less good.

Cheers,

Nigel

[nheather]

UPDATE

Saw the doctor/surgeon in hospital today. It wasn't bad news but at the same time it wasn't bed of roses.

He explained why he had done the cut the way he did. Basically it is because I am a 'grower' and because of problems I had experienced with a tight frenulum he didn't want to cut to tight. He also said that by taking less of the foreskin there is always the option to take off more in the future if I was not happy.

So good with that, made sense when he explained it.

What wasn't so good was the potential scarring, particularly in the area where the stiches broke. He agreed that the stitches had broken so the wound was gaping more than he would have liked. He has asked me to go back next thursday as he is a little concerned that it isn't healing as well as he would have liked and it quite sore. He didn't say outright that the scarring might be bad but he did say that if it turns out that way they will be able to cut the scarred area out.

So a bit happier, just a little annoyed that when the wound was still fresh and the stiches had broken I went to the hospital and the doctor/registrar (not the surgeon) dismissed it as fine.

Cheers,

Nigel

[Hidden]

Actually lubricants of both partner help in getting the excitement , togetherness and you will get lost in ecstasy...no matter whether you have skin or no skin. This is created by nature .Relax

[nheather in reply to Hidden]

Don't really understand the context of your response and how it applies to my latest update.

As I said, I accept that the explanation that the doctor/surgeon gave for doing it the way he did.

The Remaining issue is that the wound where the stiches broke is not healing and gaping open. Because of the remaining foreskin it is not exposed to the air so is not staying dry and there is a risk of infection.

The doctor/surgeon has hinted that this may result in unsightly scar tissue but is immediate concern is that it is not healing and the risk of infection - this is why he has asked me to go back to the hospital next week.

I don't see how lubricants will influence that.

Cheers,

Nigel

[Hidden]

I thought you are apprehensive for future use of the penile shaft for copulation, so I mentioned about the lubricants . Now if the wounds/scar has not healed/dried you have take help of oral antibiotics and if possible leave the space airy , means perhaps you have be to be in loose clothes or no cloth for few days . It will certainly dry up, may be a matter of time only . Hope your blood sugar is not high .Show it to your doctor .

[nheather in reply to Hidden]

So the history

Mon 21st Nov

Operation

Thurs 24th Nov

Noticed stitches torn, yellow fatty tissue bulging out. Went to GP and was seen by nurse and duty doctor. They expressed concern but said there was nothing they could do and said I should go back to the ward the next day

Fri 25th Nov

Went to hospital ward. Seen by junior doctor and registrar. They said there is nothing to worry about

Fri 2nd Dec

Having included my concerns in the feedback/complaint, the Doctor/Surgeon asked to see me. He hinted that it wasn't good and asked me to go back and see him on 8th Dec. Said I should keep it dry and exposed to the air but agreed that this was near impossible because the remains of the foreskin cover it. Said that if it starts hurting, getting more red or seeping puss then I shouldn't wait for my appointment with him and get to the doctor. Said he would have liked to dress it but agreed with the nurse present that nothing would stay on. No antibiotics given. Says to keep it clean but accepted that this was difficult as the whole area is sore and painful and I should only be using water. Gets smelly quickly.

The scarring is a future thing - he seemed to accept that there was a good chance significant scarring (but if necessary that could be cut out).

Cheers,

Nigel

[Hidden]

If I would have correctly understood even a local application of antibiotic cream with Hydrocortisone will heal those . Chances of infection may not be high because of the skin . If it is airy the would will take its required oxygen from the air . Still you meet some doctor for further advices .

[nheather in reply to Hidden]

But I saw the doctor/surgeon only yesterday - he saw all this in person and his advice was to keep it clean and dry and see him again next thursday.

[Ntuthuko15 in reply to nheather]

Hi nheather, how has the gapping progressed if I may ask, reason being I had my circum 2 weeks ago, and the gap wound worries me abit.

[Hidden]

I hope by Thursday you will find it okay

[MikeHH]

Being circumcised is great... but you do lose some sensitivity over time though. But there is a creme called Man1 Man Oil on the market that contains a protein called acetyl L carnitine, which naturally repairs the damaged nerve endings and restores a lot of lost feeling. It works really well and is safe too. Keep it in mind.

[UnhappyOne]

Hi, I just had a circumcision and I am in the same boat as yourself. Neither my GP or any doctor told me about the potential need for a frenuloplasty, nor was I told about the side effects if one was performed. It took me repeatedly asking for information post op to discover one had been performed on me when I feel I should have either been told before hand so I could make a choice, or my next of kin asked. I feel I have been lied to and the doctor has performed a procedure against my informed consent. I am considering legal action. I have a few questions if I may.

How do you feel a year later.

Have you noticed a marked reduction in sensitivity during sex?

Were you told about the extra procedure after the op?

Thanks

[enricom23]

More copy-and-paste rubbish with no medical foundation whatsoever. Langerhans cells do not transmit the AIDS virus, and are possessed by both males and females.