Thursday, September 18, 2008

Diary of Circumcision Due to Phimosis (tight foreskin)

Diary of circumcision.

I’ve almost read this entire forum from ‘cover to cover’ found it very helpful:

http://www.menshealth.co.uk/chatroom/topic/242527?startnum=1


Personally speaking, I also found the most helpful posts were the ones that gave a follow up or progress reports over a long duration, and the ones that gave details. So with that in mind, I’ve put together a detailed record of my circumcision and how it went, followed directly by highlights at crucial stages during the recovery.

My aim is to keep ‘everything’ together for you (the reader) in one post. Hope I can post this much info in one go! By the time you read this, several months will have elapsed from my surgery. This is a fairly detailed report – I hope it will answer many questions and put your mind at ease. If you don’t want details then feel free to kindly skip to the next post.

Please note – I have also photographed in detail the recovery, showing ‘before and after’ photos, and photos from day 1 up to day 44 (by which point I was fully healed).

I am hosting these photos at the following web address below. If you find the link no longer works it will be because they have removed the content and I apologise in advance if this is the case.

Each image is a link to an album with several more photos in it. There are various angles and I should warn you: if you click on the image and then on the magnifying glass icon these are close up high detail. Here is the address:

This is the MASTER link to all the image albums:

http://picasaweb.google.com/Anonymous.Guy.Anonymous

Background:

Age: 34

Country New Zealand.

Reason for Circumcision:

Pathological Phimosis developed over a period of 8 months. I had no idea what Phimosis even was until researching the internet for “tight foreskin”. Since childhood I have suffered from a mildly tight frenulum (banjo string) but I as an adult I have always been able to retract my foreskin. However over the years, tears and scaring of the frenulum may have been what caused the onset of BXO (Balanitis xerotica obliterans), and thus phimosis.

Learn more about BXO here: http://en.wikipedia.org/wiki/Balanitis_xerotica_obliterans

I went to a local doctor, who prescribed cream, but said I would probably need a circumcision. Stretching and cream did not work, so I booked in with a private Urologist. Urologist discussed partial circumcision and also a dorsal slit, although he did not recommend either. Only later did I discuss Preputioplasty with him.

Click here to see images of before the operation showing the Phimosis scarring:

http://picasaweb.google.com/Anonymous.Guy.Anonymous/BeforeOperation#

Preputioplasty not an option in my case as the scaring was too severe and the Urologist advised that the phimosis would very likely re-occur requiring further surgery if I choose that option.


As for a partial Circumcision, he was unwilling to perform this due to previous failure and dissatisfying results. I was advised strongly against this, as it can cause unsightly ballooning of the foreskin, as there is often no easy way for the body to return fluids generated inside the remaining foreskin. Also the Urologist told me there are far more likely to be complications with a partial circumcision. He did offer me the chance to have a second opinion from another Urologist (as I was hoping to leave as much foreskin intact as possible to maintain maximum sensation) but the surgery was already scheduled for that day so I went ahead with the full circ.


Dorsal Slit: I seriously considered this as an option in the week leading up to the surgery, because I was scared that if the foreskin was removed that I might end up ‘worse case scenario’ with sever reduction in sensation over time. My Urologist tried to reassure me that this was very unlikely to be the case. He said that,

“Most patients had noticed little (if no) reduction in feeling.”

Although maintaining sensation in my penis was my primary concern, the thought of a dorsal slit with the foreskin hanging down at the bottom did not rate favourably with me or my partner.

The problem is that AFTER my initial consult with the Urologist, I had done a vast amount of reading on the internet and had so many more questions on the day the surgery was scheduled. My advise? I would recommend doing all the research you can before your initial consult and writing down all those questions so that you have time to change your decision and (or) seek a second opinion. Also find out in advance what types of procedure your Urologist will actually perform. I went to a private hospital, but even that does not guarantee that they actually perform all the varied types of circumcision that you might want to choose from.

Operation went like this:

Day 1: (operation day) Operation 10:am

Prep:

Lay on table, T-shirt and socks only. Sponged with Iodine around the pubic area to kill any bacteria. Urologist placed a blue material sheet over pelvic area with a Square hole with which to operate through. Assisting nurse also present.

Anesthetic:

Pain during administration of local aesthetic was bearable (unpleasant, enough to make me twinge, but nothing really above 6/10 on pain scale.) Pain did not last long. First couple of needles were the worst. Within 5 mins entire area was numb from any pain. Pain test was done by surgeon before beginning going any further (standard practice). I was later told that they use two types of anaesthetic, short and long duration. The anaesthetic had worn off later in the day. After about 3 to 4 hours.

Surgery:

Couldn’t see the actual op, but I was fully alert during procedure. Careful cutting went ahead with a scalpel. Followed by the use of a small cauterising tool about the size of a pen, which helps seal the wound and stop bleeding. This was completely painless, but made a funny buzzing and cracking sound. I thought this would feel like a burn once the anaesthetic wore off later, but I don’t feel any pain, and it’s day 1. During Op I was advised by Urologist that my frenulum was also badly scared and as a result of this it was best to remove it. Retrospectively, I would have asked him to leave it; heal from the Circumcision first and then make the decision to have the frenulum looked at later if it was still causing problems. The reason for this is that the removal of it has caused some loss of sensation just under the head. Overall, I’m happy though.

Next the Stitches were put in (about 20). These are [or should be] dissolvable over time. I Here are the answers from the urologist about stitches: They’ve done their job within about 7 to 8 days, but don’t just rip them out then. Showers only for first week, but then baths or warm soaking will encourage the stitches to dissolve faster. If stitches still in at two weeks, feel free to come have them removed (he didn’t recommend me removing them myself, but didn’t say why). I assume it’s fine to do this yourself after a couple of weeks. He also said that he’s had the odd patient come back after as long as 6 weeks, still with some remaining stitches. It’s uncommon, but nothing to worry about. My previous reading on the net said this could cause some tiny bumpy scars. I’d say get them removed after the two weeks if you are worried about leaving marks. They’re pretty annoying anyway.

click here to see images of the stitches:

http://picasaweb.google.com/Anonymous.Guy.Anonymous/Day2#

Bandaging:

Was allowed to sit up to see the final result. Was a great feeling to finally see the head again after so long! Looked really tidy, but with 20 little stitches all the way around the base of the Glans. Slight swelling at the time, no noticeable bruising but that came up later. I was bandaged with a strip about an inch wide around the base of the Glans, with about half the head poking out. This was put on fairly tightly to help reduce any bleeding. The Urologist told me that the bandage can come off the next day in the shower and that soaking it will help it to come off more easily.

Click here to see images of the bandages:

http://picasaweb.google.com/Anonymous.Guy.Anonymous/Day1OfCircumcisionOperation#

After Operation:

The operation itself took about an hour, beginning at 10:15 am.

Anaesthetic was worn off by 2pm. Up to then, I couldn’t really feel a thing and everything felt as normal. It’s now almost the end of Day 1 (Op’ day). As far as pain – there hasn’t been any really. I can feel the head of my penis is quite sensitive but it’s not pain, feels more like when someone rubs a dry piece of cotton sheet on the head of your penis. Uncomfortable – yes. But it’s not stopping me from walking around the house etc, although I’m taking it easy. Bending down is a little more uncomfortable. I would not want to be running anywhere.

The Pain killers I’m on are Diclofenac 75MG (which is also an anti-inflammatory). Also standard Paracetamol. I’m sure I’d be fine even without these but better to be safe. Over the day, I noticed quite a bit of swelling came up and numerous bruises along the shaft became visible. The swelling has subsided and the bruises have become far more visible, however the Urologist explained this is common. The bruises are not from rough handling during the Operation. What happens is that the post Op swelling actually breaks some of the vessels under the skin and so it looks like I’ve been thumped by something hard – but I know this is not the case as he was very gentle. An interesting note, I can ‘taste’ the anaesthetic in my mouth a bit even though it was injected only into my penis! The taste is like when you go to the dentist. That taste had gone by the evening.

Urinating, post op.

I’ve urinated several times on the first day. Zero pain. No blood in urine. Obviously I recommend initially sitting down for this as there is no foreskin to guide the stream. I’m careful to keep the urine away from the bandage and away from visible stitch where the frenulum was.

Bleeding:

Have noticed a very small amount of blood in my pants. Urologist advised that bleeding is normal, as long as there is not too much. He also advised that should I begin to bleed, the best thing to do is to grip the penis fairly tightly for about 5 mins to allow it to clot. I don’t have any serious bleeding at this point so have not had to do this yet.

Night Meds.

I mentioned Diclofenac and Panadol. I also asked the Urologist if he could prescribe me Valium (diazepam) as I had read that this can help prevent night time erections. He gladly did this and also mentioned that one can use night time “coldrex” or similar night time cold and flu tablets for a similar result. I went with the Valium.

Day 2

Erections and sleep

I took 1 Valium tablet late in the evening of day 1. Went straight to sleep at 1am. However, the tablets are fairly low dosage and it only lasted for about 6 hours. I woke at 7am to an unwanted erection. This was mildly painful, but mainly just uncomfortable. It felt very tight with the stitches being pulled. My bandage was still on, and had been wrapped fairly tightly for that first day and night (which is good) but with the combination of the erection, and the tight bandage and the previous days swelling, it was difficult for the blood to return from the head of my penis. The result was somewhat similar to a ‘cock ring’ but without the pleasure. I found that urinating helped to alleviate the erection right away and I went back to bed. It is difficult to say whether the Valium helped averted any night time erections, as I have no idea how many night time erections I might normally get. I am 34 … not exactly in my twenties so I’m not sure if that makes a difference.

Urinating:

Regarding the first pee on Day 2, There is no blood in my urine. No pain. Still sitting, I smiled to find that I am now peeing in two directions simultaneously (one up and one down). One has to laugh at this and not take it too seriously. After all, the glans (head) is still mildly swollen and also in the process of drying out, so although I had a straight ‘jet’ yesterday – today I do not. The flow is still somewhat restricted. I have to push a little but it’s easy enough. I had visions of always having to sit like a girl, I’ll report back on this, but I’m sure that won’t be the case!

Bandages off and first shower

As you’ll remember earlier, the Urologist recommended showers only for the first week to let the stitches do their thing. Also he advised that the bandage can come off on day two, and I did this in the shower as suggested. To be honest, this is the only time so far that I’ve felt any pain. But once again, this was really nothing more than uncomfortable stinging as the wound was exposed to the water. I expect this experience will vary from male to male. I would describe the pain as nothing more than about 3 or 4 out of 10, and fairly brief.

The sticky tape holding the bandage was a little bit painful to remove and fairly tricky but after a couple of minutes the whole bandage was off. After 10 seconds in the shower, what a relief! There was very limited pain after this. Because I’ve not been able to able to pull my foreskin back for such a long time, it must have become slightly ‘adhered’ to the base of the glans. I noticed that the Urologist had made a few tiny incisions around the base, further forward from the stitches, just to release the foreskin completely before removing it. These are minor and have no stitches in them.

Appearance

The bruising is no worse than yesterday, so that’s a good sign to me. Swelling is still easily visible throughout my entire penis. There is a kind of ‘ballooning’ effect in the middle right of the shaft and I’ve noticed that the penis is significantly pulled to the left. I’m fairly confident that this is just due to the swelling on the opposite side – I’ve always been left hanging anyway but not to this extent. [After note : This later subsided after about day 14]

Click here to see images of ballooning and bruising:

Image 1

Album showing this phenomenon

Sensation & Medications.

Except for the pain in the shower as described above, I’m really in no pain at all. I’m sure if I were to bump the area there would be pain. But I have not taken any pain killers since last night and all is well. There is no stinging, no burning, but what there is… is a constant awareness of the exposed head. Lets face it, it’s sensitive. I suspect this initial feeling is going to be different for every male. If you’ve never been able to pull your foreskin back then the sensation might be quite alarming and I speculate that it might even feel hyper sensitive. If however you’re like me and have been previously able to retract your foreskin, then the feeling will not be all that unfamiliar. It feels just like when you pull your foreskin back, and then put your pants on.

It’s an uncomfortable feeling that creates that strong instinctive desire to return the foreskin to its normal position - covering the head. Of course this can no longer be done. At the same time (for me at least) it kind of feels good to have that sensation back because it’s been ages since I’ve felt that tingling. I have put some vasaline over the glans (but NOT in the wound) and covered the glans with some clean gauze so that it does not rub in my pants. This seems to help reduce the intensity a little. I have put an ointment on the stitches as the Urologist prescribed. It’s called Chlorsig the active ingredient is Chloramphenicol 10mg/g in a sterile oculentum base. This is actually a type of eye ointment (as he mentioned) but good for killing bacteria in a wound such as that left by circumcision.

I’m going to stay off the pain killers – I don’t’ think I even need them and it’s only day 2

[after note: 6 weeks later: I never needed any more pain killers after day 2].

Day3

Just a summary required here really.

Click here to see the Album of images showing day 3


Urinating

back to a single stream. In fact with a little practice I can water the garden. Nice strong stream, still coming to grips with the directional flow. Easier to sit down for a ‘normal’ toilet, but stand up urinal is a blast. Outside is even more fun. Partner is impressed with the amazing distance.

Swelling:

This is due to the fact that the swelling (although still present) has subsided by about 60%. Penis is still fatter than Normal (but to my humorous disappointment, no longer than normal!)

Pain and medication

No pain all day. Don’t get me wrong; applying the ointment to the stitched area is certainly sensitive but nothing worth crying over. As I said earlier, I’ve tried it with no pain killers since day 1 (operation day). And honest to god, I’m serious, I’ve not even had more than the odd twinge of pain. I can hardly believe it – I thought I’d be on monstrous pain killers for days but there simply is just no pain. I’m pleased to say that the bruising has begun to disappear too.

Now, I should say that this might not be the case for every male. Also I did not take any of the prescribed Valium last night – and I didn’t have any problems with erections during the night. Perhaps I just don’t get the ‘involuntary’ ones as much as when I was younger. Having said this, I was still awoken at 6am with a partial (tight but not so painful) boner. I quickly reminded myself that it was just not an option to satisfy it, and went back to sleep.

Shape:

Yes. Something good is happening here. The swelling is going, and my penis is not curving as much to the left as I mentioned earlier – which is a mental relief.

I’m actually really excited with one particular aspect…

READ THIS: Loose circumcision and protection:

I had an average ‘loose circumcision’. This is not to be confused with a partial circumcision; which my urologist refused to perform. The loose circumcision is where the remaining foreskin, as cut - is stiched approximately 5-10 millimetres (1/4 inch) from the base of the glans. Now, you might think that the entire glans would be entirely exposed from that point on. But you might be mistaken. It will depend on how much ‘skin’ you have remaining and how big / small your penis is when flaccid. I made it clear I wanted to keep as much foreskin a possible and my Urologist was willing to accommodate this request. When flaccid, my little guy is about 1 and ½ inches in normal conditions. Pretty small I guess. He’s about 5 ½ inches when erect. The smallness when flaccid is working to my benefit because I’ve noticed that the remaining outer foreskin, is beginning to fold forward over the glans. In fact, now that it’s not so swollen the remaining foreskin is providing considerable protection for the head. Only the tip is poking out (refer to image link below):


http://picasaweb.google.com/Anonymous.Guy.Anonymous/Day3#5247341734980974690


For me, I was worried that I’d loose sensitivity due to the constant exposure of the glans rubbing against my pants - but I’m happy to say that this looks less likely to be an issue.

Now, I’ve read some things on the internet that say this type of ‘loose circumcision’ should be avoided. Perhaps they felt it was ‘wrong’ for the outer skin to be facing the glans but from my point of view I’m quite happy to have this extra protection. I don’t and never wanted a ‘porn star’ (American ‘tight’) style cut, and I’m glad to say I didn’t opt for one. Although the head looks a little buried when flaccid – the slightest excitement or stimulation and ‘pop’, out it comes - and the remaining outer foreskin retracts exposing the full head. This is just perfect given my options when I started out uncircumcised.

Sexual urges:

Yep. I pretty much expected this, but having not been able to get my end off, I’m almost constantly having to remind myself that :”It’s just not an option”. The stitches themselves would make it extremely uncomfortable. I’d have to say I feel sympathy for all those who have previously posted. Not being able to ‘get off’ is a bit of a downer, but on the upside, I’m looking forward to the somewhat distant possibility and am in the process of getting a male sex toy on-line to ‘reward’ my little guy for his bravery. A genuine ‘Flesh light’ is top of the agenda when healing is complete!! If you have no idea what a flesh light is then I suggest you google it – its’ the number one male masturbation toy currently. The reason for this is that I just don’t know how the hand is going to work after all is healed. With no foreskin, I’m looking to other techniques of masturbation that will work with the circumcised penis. I figure, why not get creative?

Day4

Nothing to report – no change

Day 5

Nothing to report – no change

Day 6

Tip is really sensitive.

Have re-learned to pee standing up. Have not mastered the technique yet but getting better.

Glad to say no longer peeing in two directions.

CAN’T wait to get the stitches out. Soaked my little guy in a container of warm water for about half and hour tonight to help soften up the stitches. I don’t think this did much really. I’m going to try and remove as many as I can at the end of day 7.

Masturbation:

Just as a side note, I tried to get a release, partly out of sheer desperation and also to relieve the pressure. But with the stitches still in, and still partly swollen on one side, this was impossible. I tried several techniques, and for quite a long time but nothing worked. Ended up getting somewhat close but it was just too uncomfortable. Had to give up, very discouraged.

Day 7

Stitches

Now, I would not recommend this by any means, but tonight I managed to remove the stitches. The Urologist had said after the op that the stitches would have done their job by about 7 to 8 days.

I just had to get them out because they’re so darn uncomfortable – but I’ll be honest, it was not easy. Once again to make this clear, I do not suggest that you do this yourself as it would be easier and wiser to let a physician or nurse do this. BUT, If you are going to do it, you will need everything to be sterile.

That would include towel, tissues, surgical scissors and scalpel (or VERY sharp clean blade) and a pair of good tweezers. Also some diluted antiseptic such as Detol and warm water. I soaked my penis in a disposable cup in warm salty water for about an hour then rinsed with the dilute antiseptic and kept it wet through out most of the ‘procedure’. If you proceed, be prepared. There were about 20 stitches and it took me a good one and a half hours plus the soaking and yes, it was difficult. You don’t want to leave any cut ones embedded!

If you find it difficult to handle pain you won’t want to be doing this. Nor would you want to do it so early if you had a very tight cut type of circumcision. Mine was a loose circumcision remember. I found that the worst part is having to pull the stitch tight with the tweezers so that you can cut the knot (they’ll be double knotted). The pulling can hurt quite a bit at times. I found that some came out fairly easily with the scissors – others were really difficult and required the blade. Overall, I’d rate this as risky and a desperate measure at best. If you don’t have steady hands, persistence or good pain threshold then just don’t do it. Let them fall out or have them removed by a nurse on day 20ish.

Having said that – what a relief !!! It’s still very much healing down there so I’m still applying the antibacterial ointment that the Urologist suggested. I’m also going to ‘leave it alone’ for at least a couple more days of healing if I can!

Click here to see images of day 7 with the stitches just out:

http://picasaweb.google.com/Anonymous.Guy.Anonymous/Day7StichesTakenOut#

Protection.

I read earlier in a post that wearing a condom can provide some protection from the almost constant over stimulation of the glans against pants. I can totally relate to that, as the tip of my glans has become incredibly over sensitive and its not fun. But what I found early this morning is type of ‘cup’ to put discretely over the head. Works like a treat and only goes on if flaccid. I’d describe it as similar to a small egg shape cut in half – but with longer sides. It just sticks on with natural suction when I push the head in there. Does a great job of reducing the hyper sensitivity and I can walk normally now without that irritation. One could argue that my penis is just going to have to get used to it at some time or other – but we’ll see. If you’re having the same problem, use your imagination to find something similar around the house.

Refer to Image link below to see the cup I used:

http://picasaweb.google.com/Anonymous.Guy.Anonymous/Day7StichesTakenOut#5247342726949678226

Day 13

I’ve been able to masturbate gently since the stitches have come out and it’s a lot more comfortable. Also healing is accelerated it seems without the stitches. I’m urinating as normal, have had no problems. Sensation is fine although it can hurt a little if I’m too rough with my penis.

Link to images:

http://picasaweb.google.com/Anonymous.Guy.Anonymous/Day13#

Day 44

It’s week 6 and a bit now, and there really is nothing much further to report at this point so I’m going to wrap this up. Healing seems if it was about 80% by day 13, and since then there is nothing of major interest. Peeing while standing only took a matter of days to master. Sex is great, but here is my final conclusion on sensation.

Click here to see images of how it looks on day 44

http://picasaweb.google.com/Anonymous.Guy.Anonymous/Day44#



CONCLUSIONS - about sensation.


I have to be honest - I think there has been some loss of sensation,

but a gain in sensation when it comes to orgasim. Now, for those of you up for surgery - before you freak out, let me explain further. What I’m talking about is some of the sensation in the long lead up to an orgasm. Too much of that type of stimulation, and it used to push me over the edge far too quickly resulting in that 5 minute wonder ejaculation. Fine if you just want to “get off”. But what I’ve noticed is that it’s quite a bit more work now to build up to an orgasm – and that’s a GOOD THING! Not only can I go longer, but because I’ve had to work for it, when I finally ejaculate it’s far stronger than before I was circumcised.

Overall, I’ve very happy with the result. I have sensation back in my head (remember I could not uncover my head for 8 months before the op). Masturbation is fine: I do it just as frequently as before and I enjoy it just as much (it just takes a little longer is all). I should mention that my technique has had to change though – I can’t just use the grab and “up down” motion that I used to because there is no foreskin to rub against the head and my fingers are too rough skinned for that – so I have to use my wrist and push my penis up against my body in an up down motion.

Anyway, as I mentioned earlier I ended up getting one of those male sex toys since I anticipated that things might change a little. It’s been great, Fleshlight have done a great job at making their product and you can read my review on that here: PS if you're curious, just do a google on fleshlight (all one word). I'm quite serious.

My review of fleshlight:

http://www.fleshlight.co.nz/pink-lady-stamina-training-unit-pri-28.html?reviews_id=4

Don’t forget there is an outstanding forum on Adult Male circumcision at the following address with everything you would want to know and other people’s experiences: (hundreds of pages of accounts and questions answered).

http://www.menshealth.co.uk/chatroom/topic/242527?startnum=1