Circumcision: my experience

[DoctorTan]

Originally Posted by sigueroa

Hi Dr Tan, Signed up a new account to get your advice. I've benefited a lot from all your sharing!

I've been having these small foreskin cuts, not on the frenulum. These cuts came up more frequently over the past 2 months, sometimes at the same area, sometimes at different area. I am getting a little concerned as this affects my sex life. This cut appears mainly after erection when I pull my foreskin back - like an overstretched of the foreskin.

I am still able to retract my foreskin back, though it seems "tighter" than last time.

I've been to my GP about 2 weeks back who gave me antifungal and antibiotics cream - I applied for one week, seems in control until when I was planning to have sex and tried to stretch my foreskin, and the cuts appeared again. These 2 cuts healed after 2-3days, now every time I shower I also try to stretch the skin. And sometimes 1-2 small cuts appear at other areas too. My foreskin gets itchy sometimes too.

Today, I went to visit a urologist - he shared the skin looks a bit "white" and since I've tried so many creams and it comes back, he recommended me circumcision.

For now, the routine I'm adopting is:

1. Ensure my penis/foreskin is always dry.
2. Apply Vaseline whenever I can throughout the day.
3. Before bed, apply the antifungal + antibiotic cream, then with Vaseline.

Can I get your advice if this is okay? Or should I just go for circumcision?

Thank you so much Dr.

Hi,

Have you checked your blood sugar? These could be symptoms of Diabetes. If you are Diabetic you need to get that under control.

More likely, your symptoms are due to Balanitis Xerotica Obliterans (BXO). In which case you will need a circumcision. BXO will progress no matter what you do (strong steroid creams may delay the progression). The hardening might even spread to your urethra after which surgeries get really complicated. BXO also increases the risk of skin cancer.

So I have to say I agree with your Urologist. You need a circumcision. Send the skin for histological examination to determine if you truly have BXO or not.

[sigueroa]

Originally Posted by DoctorTan

Hi,

Have you checked your blood sugar? These could be symptoms of Diabetes. If you are Diabetic you need to get that under control.

More likely, your symptoms are due to Balanitis Xerotica Obliterans (BXO). In which case you will need a circumcision. BXO will progress no matter what you do (strong steroid creams may delay the progression). The hardening might even spread to your urethra after which surgeries get really complicated. BXO also increases the risk of skin cancer.

So I have to say I agree with your Urologist. You need a circumcision. Send the skin for histological examination to determine if you truly have BXO or not.

Hi Dr Tan,

Thank you for your quick response I truly appreciate it.

I did not check if I am diabetic, but the last I did my full body checkup few months ago, I was okay.

I am not comfortable with the use of steroids, however in the meantime, are the steps I provided enough for the management of BXO? And what are the signs/symptoms I should take note before confirming that circumcision is necessary?

On histological examination, should I consult my urologist to do so?

Honestly speaking, I know it seems like the solution points to circumcision, but I was really hoping to see how I can best manage and control it first. Also due to my work commitment, the earliest I can do the surgery is early March.

Thank you so much Dr.

[hornie]

Just go for a circumcision dude. Your quality of life will improve drastically.

Originally Posted by sigueroa

Hi Dr Tan,

Thank you for your quick response I truly appreciate it.

I did not check if I am diabetic, but the last I did my full body checkup few months ago, I was okay.

I am not comfortable with the use of steroids, however in the meantime, are the steps I provided enough for the management of BXO? And what are the signs/symptoms I should take note before confirming that circumcision is necessary?

On histological examination, should I consult my urologist to do so?

Honestly speaking, I know it seems like the solution points to circumcision, but I was really hoping to see how I can best manage and control it first. Also due to my work commitment, the earliest I can do the surgery is early March.

Thank you so much Dr.

[AdrusBarba]

Originally Posted by Dekachin

Great post... but I still prefer my uncircumsized cock...

You may not know the benefits You are free to many infections.

[loveletters]

Hi Dr Tan I am diabetes type 2 is it ok to go for circumcision?

[DoctorTan]

Originally Posted by loveletters

Hi Dr Tan I am diabetes type 2 is it ok to go for circumcision?

Yes. In fact I do a lot of circumcisions for people with Diabetes.
Diabetes increases the risk of fungal balanitis and can even lead to phimosis.
Some medicines used to treat Diabetes (the ones that make you urinate out sugar) also greatly increases the risk of balanitis.

Diabetes increases your risk of a wound infection and also can cause delayed healing. Because of this, I do NOT recommend a ShangRing procedure or people with Diabetes. Personally I like to do the laser method. I find that the healing is fastest and risk of infection the lowest.

Please do see a Doctor experienced in doing circumcision for patients with Diabetes. Also please ensure your blood sugar is as well controlled as possible before and after the surgery.

[loveletters]

Originally Posted by DoctorTan

Yes. In fact I do a lot of circumcisions for people with Diabetes.
Diabetes increases the risk of fungal balanitis and can even lead to phimosis.
Some medicines used to treat Diabetes (the ones that make you urinate out sugar) also greatly increases the risk of balanitis.

Diabetes increases your risk of a wound infection and also can cause delayed healing. Because of this, I do NOT recommend a ShangRing procedure or people with Diabetes. Personally I like to do the laser method. I find that the healing is fastest and risk of infection the lowest.

Please do see a Doctor experienced in doing circumcision for patients with Diabetes. Also please ensure your blood sugar is as well controlled as possible before and after the surgery.

Thanks for the advice.

[Ghrow]

If go polyclinic and get referral letter to public hospital what's the cost ah? Is it fully covered by Medisave? I also have integrated shield insurance plan - can use to cover if not fully covered by Medisave?

[Olofmeister]

has anyone done with Dr Tan at his clinic? I have been contemplating for years.

[DoctorTan]

https://www.mewatch.sg/watch/Circumc...-Health-315638

[rogerbear]

Originally Posted by DoctorTan

Hi. Technically you still have phimosis even though you can now expose the head. The tight ring and short frenulum could both negatively affect your erections. Also, this actually puts you at higher risk of paraphimosis. And you are right, this is quite scary. In fact, it is a medical emergency.

I have done many circumcisions covered by insurance. They honestly do not care if you are able to pull your skin back or not. They just need your Doctor to certify that it is medically necessary.

Yes. You should absolutely go for a circumcision. It will solve all your problems. As you can see from the experience of many here, the circumcision process is not as scary as you think it is.

I also have phimosis but also can slide back just that it gets tight around the head.
Is there anyway to get it insured under hospital plan or is it like accident plan that kind? Pls do give advice Dr tan. Ty

[DoctorTan]

Originally Posted by rogerbear

I also have phimosis but also can slide back just that it gets tight around the head.
Is there anyway to get it insured under hospital plan or is it like accident plan that kind? Pls do give advice Dr tan. Ty

This something best answered by your insurance agent. It will differ between policies.

All I can say is that many of my patients have successfully claimed the cost of their circumcision surgeries from their hospitalisation plans.

What I actually do is to refer my patients back to their own agents or an insurance claims specialist first. Get all the paperwork done swee swee before proceeding with the surgery.

Even better we get a payment guarantee upfront. In this way we not scared that the insurance will refuse to pay.

[Olofmeister]

I recently got mine done at a local clinic, conventional method using lasers.

Currently at Day3, the penis head and inner foreskin is still swollen, anyone who had similar experience can advise when does the swelling subside?

It is making peeing horrible, pee like a water cannon going in all directions.

[wbtym]

Originally Posted by DoctorTan

This something best answered by your insurance agent. It will differ between policies.

All I can say is that many of my patients have successfully claimed the cost of their circumcision surgeries from their hospitalisation plans.

What I actually do is to refer my patients back to their own agents or an insurance claims specialist first. Get all the paperwork done swee swee before proceeding with the surgery.

Even better we get a payment guarantee upfront. In this way we not scared that the insurance will refuse to pay.

Hi Dr Tan. I have hospital plan with rider. How much can I claim for a laser circumcision procedure? Forgot my hospital plan for Govt hospital only.
Must be hospitalised for xx hours?

[DoctorTan]

Originally Posted by wbtym

Hi Dr Tan. I have hospital plan with rider. How much can I claim for a laser circumcision procedure? Forgot my hospital plan for Govt hospital only.
Must be hospitalised for xx hours?

These kind of details best to check with your insurance agent

Some of my patients find this app useful:
https://easyclaims.com.sg/