What should I pay attention to after circumcision?

The harm caused by an excessively long foreskin is very serious, so it is necessary to go to a regular hospital for a circumcision. This is a very minor operation and the injury is not serious, but it will leave a wound after all, and a wound may become infected, so you must be careful after the operation. First of all, you need to pay attention to hygiene, and secondly, avoid penile erection. The following precautions must be kept in mind.

1. Postoperative incision pain:

Postoperative incision pain is generally tolerable, and is more obvious 30 to 60 minutes after the operation. The pain lasts for about 30 to 60 minutes and then improves. The degree of pain varies depending on the individual's pain threshold. Children will cry, and parents should comfort them, divert their attention, watch TV, play games, etc. to relieve the symptoms. Secondly, night erections within 1 to 3 days after the operation will also cause pain, and the penis will return to normal after it becomes soft. (Ice cubes, ice towels, etc. can be used to cool the inner side of the legs to quickly stimulate the penis to become soft, and avoid covering it too thickly and overheating it.) It is generally not recommended to take painkillers. It is recommended to rest on the day of surgery and avoid walking too much to cause discomfort.

2. Postoperative incision bleeding:

Bleeding is common within 2 hours after surgery and after an erection at night. If the amount of bleeding is not large and only a small part of the gauze is soaked in red, it can be observed and generally stops on its own. If the incision bleeding does not stop, the gauze gradually becomes red and drips from the gauze, the penis becomes swollen and deformed, or the patient cannot determine the condition of the wound, please go to the hospital immediately.

3. Postoperative urination problems:

After the operation, due to the pressure bandage of the elastic bandage to prevent edema and bleeding, some patients will experience pain and effort when urinating, bifurcated or scattered urine, and deflection. This is a normal phenomenon. The elastic bandage can be removed 3 days after the operation to return to normal. Children are prone to urination due to the tight bandage. It is recommended to urinate once normally after the operation before leaving the hospital. If you cannot urinate, please ask the surgeon to adjust the tightness of the elastic bandage. Do not adjust it by yourself to avoid bleeding or hematoma. Try to lean forward when urinating within 3 days to avoid urine flowing onto the gauze. It is recommended to wipe the remaining urine in the urethra with toilet paper or dry cloth after each urination to keep the gauze dry and clean. If the gauze is obviously soaked, go to the outpatient clinic in advance to change the dressing.

4. Postoperative dressing change issues:

3 days after the operation, go to the doctor on the 3rd floor of the outpatient clinic to register for a follow-up visit. After the dressing change order is issued, go to the dressing room on the 3rd floor of the outpatient clinic (wound treatment center) to change the dressing and remove the gauze. If the situation is normal, there is no need to bandage again. No follow-up is required if there is no special change. For patients with phimosis or patients with infection and more exudation before the operation, multiple dressing changes and follow-up visits may be required depending on the condition. There are two types of circumcision in our hospital: disposable circumcision and traditional circumcision. No stitches need to be removed after the operation. The disposable circumcision does not require stitches or removal of the titanium clip, and it will fall off by itself. If it has not fallen off for more than 40 days, you can return to the hospital for removal. Traditional circumcision surgery uses absorbable sutures, which can be absorbed by themselves in about 3-4 weeks and the suture knots will fall off.

5. Postoperative wound exudation problem:

After the operation, there will be an increase in yellow-white secretions at the glans penis, coronal sulcus, and incision, and the scab will turn black. This is more common in children with phimosis, and most families mistake it for an infection. The secretions are fibrin exudates, not pus. You can use the Kangfuxin liquid prescribed by our hospital for external use to spray the area, and gently wipe off the secretions with a cotton swab. Do not forcibly peel off the blood scab, keep it dry, and wait for it to fall off naturally. Infection rarely occurs after circumcision. Because the penis has a good blood supply and strong anti-infection ability, oral antibiotics are generally given after the operation to prevent infection. At the same time, the local area needs to be kept clean.

6. Postoperative local cleaning issues:

You can generally take a shower normally 7 days after the operation, but do not take a bath. When showering, you can rinse the glans penis with warm water, scrub it dry after the shower, and then spray it with Kangfuxin solution. It is recommended to soak the incision with Kangfuxin solution (or dilute iodine solution) 10 days after the operation to accelerate nail removal. For children with phimosis, especially obese children, because the foreskin is retained for a long time during the operation, the foreskin needs to be turned out to clean the coronal sulcus every time it is cleaned to prevent adhesion of the inner plate and narrowness of the foreskin opening.

7. Postoperative foreskin edema problem:

Edema and subcutaneous bruising after circumcision surgery are normal phenomena and have no effect on the recovery of the incision. It is usually most obvious in the coronal sulcus below the urethral orifice. Routine bandaging is performed for 3 days after surgery to reduce edema and bleeding. Generally, no special treatment is required. 2-4 weeks after surgery, foreskin edema will gradually subside, but a small number of patients will have foreskin edema for a longer period of time after surgery. This is because the original circulation is destroyed after surgery, and the edema will not disappear until a new circulation is established.

8. Postoperative diet issues:

After the operation, you should eat a light and nutritious diet, avoid alcohol, spicy food, blood-activating and blood-stasis-removing supplements or herbs. Appropriate supplementation of high-protein foods such as meat, milk, eggs, and poultry can promote wound healing.

9. Issues with wearing underwear after surgery:

After circumcision, due to the incision and the sensitivity of the glans penis, especially for patients with phimosis, activities may cause pain or discomfort due to friction. It is recommended to wear loose and breathable pure cotton underwear after surgery to reduce friction on the glans penis and keep the perineum fresh and breathable. Children can use a disposable cup (without the bottom for ventilation) to cover the penis to avoid the glans penis from contacting the surrounding area, and then wear loose underwear, or wrap it with a towel to reduce friction and keep it breathable and dry.

10. Postoperative work/school issues:

After the operation, it is recommended to rest for 1-2 days to prevent pain and bleeding. Avoid standing, sitting or walking for a long time. Generally, you can do non-physical work and study 3 days after the operation. You can resume physical work 1 week after the operation.

11. Postoperative incision dehiscence problem:

Commonly seen in postoperative bleeding and frequent erections, premature sexual intercourse and vigorous exercise. Therefore, within one month after circumcision, try to avoid sexual stimulation that causes repeated erections of the penis, and avoid sexual intercourse and vigorous exercise (swimming, playing basketball, climbing, swimming, lifting heavy objects, etc.).

12. Postoperative emergency treatment:

If the incision site is abnormally swollen and deformed after surgery, or if there is a lot of bleeding or dripping on the gauze, go back to the hospital for follow-up immediately (please go to the outpatient operating room during regular hours, and go to the emergency department during late night non-regular hours). If the glans penis is bruised and bloody, and you cannot judge whether it is normal or the bandage is too tight, you should also go to the hospital immediately for treatment.