Can Men with Diabetes Undergo Circumcision?

Circumcision in Diabetic Men

Yes, men with diabetes can safely undergo circumcision. Operation for freoskin may be a beneficial treatment option for foreskin conditions in diabetic men. This blog will cover several aspects of circumcision for diabetic men, including reasons for the procedure, necessary health metrics, where to get it done, and who performs the surgery,

1. Reasons for circumcision in diabetic men

2. Normal HbA1c results of diabetes required for the procedure

3. Locations where men can get circumcision 

4. Types of anaesthesia needed for circumcision 

5. Specialist doctors for performing the circumcision 

6. Risks of circumcision in diabetes 

7. Aftercare for circumcision with diabetes 

Reasons for Circumcision in Diabetic Men:

Men with diabetes are more susceptible to developing balanitis, inflammation, BXO, and infection of the foreskin. Fungal infection or other factors often cause these conditions. Despite antifungal and antibiotic treatments, recurring infections can lead to scarring due to BXO and phimosis. Circumcision becomes the most effective option for managing these conditions in diabetic men, especially when phimosis is severe and less responsive to non-surgical treatments.

Importance of Diabetic Control:

Reasonable diabetic control is crucial for optimal healing and reducing the risk of complications. Even if diabetes is not perfectly controlled, circumcision may still be an option, but HbA1c must be less than 7.6%.

Where to Find Adult Circumcision for Diabetic Men:

At the London Circumcision Centre, specialist consultants who are NHS urologists perform circumcisions for diabetic men.

Anesthesia for Circumcision:

Most circumcisions with glue or stitches can be done under local anaesthesia. However, some patients with needle phobia may require general anaesthesia.

Benefits of Local Anesthesia:

Local anaesthesia is a safer alternative for diabetic patients about to undergo circumcision, especially when considering other health conditions that make general anaesthesia risky.

Minimising Infection Risk:

Antibiotics are typically administered after circumcision, and waterproof glue is applied to reduce the risk of infection in diabetic patients. Diabetic patients are also advised to keep diabetes under control afterwards and are given antibiotic cream to use for ten days. Showers or washing are recommended after three days postoperatively.

Specialist doctor:

We are experienced specialist doctor who does circumcision in diabetes patients at London Circumcision Centre

Disclaimer:

This blog post is for informational purposes only and should not be a substitute for professional medical advice. It is essential to consult with a specialist to discuss your situation and determine if circumcision is the right choice for you.

Cuts or tears of foreskin

Cuts and Tears in the Foreskin: Causes, Treatment and When to See a Doctor

The foreskin in men is delicate and prone to minor cuts or tears during sexual activities. While these cuts usually heal within a week, knowing their cause, how to care for them, and when to seek specialist urologist advice are essential. Possible causes of foreskin cuts or tears include rough sex, tight foreskin, diabetic complications, skin lesions like lichen sclerosis (BXO), STDs, and fungal infections. Treatment options include simple care, medications, controlling underlying conditions, and surgery, e.g. circumcision or preputioplasty in some cases.

This blog will explore the potential causes of foreskin cuts or tears, treatment options, and when to see a specialist.

Causes of Foreskin Cuts or Tears

Rough Sex

Friction during sexual activity can cause minor tears. While these minor cuts usually heal within a week, it is essential to know how to care for them in case you have some medical conditions.

Tight Foreskin

A condition called phimosis can make it difficult to retract the foreskin over the head of the penis, leading to tearing during retraction.

Diabetic Complications

Poorly controlled diabetes can decrease blood flow and slow healing, making the foreskin more susceptible to cuts and infections. The repeated infection will require prompt treatment, and tight freoskin will require circumcision in diabetes.

Skin Lesions

Eczema, Balanitis Xerotica Obliterans (BXO) or other skin conditions on the foreskin can cause cuts or tears.

Balanitis

Balanitis is an infection and swelling of the foreskin and the tip of the penis (called the glans penis). Balanoposthitis is called a more severe infection of the head of the penis along with the foreskin.

Sexually Transmitted Diseases (STDs)

Certain STDs can cause sores or ulcers on the penis, including the foreskin.

Fungal Infections

Yeast infections can irritate and inflame the foreskin, making it more prone to tearing.

Treatment Options

Simple Care

For minor cuts, gentle cleansing with warm water and a saline solution, followed by applying petroleum jelly or lubricant, can promote healing.

Medical treatment

Depending on the cause, your doctor might prescribe:

• Antifungal creams for fungal infections.

• Antibiotic creams to prevent bacterial infections.

• Steroid creams to reduce inflammation in early BXO

Controlling Underlying Conditions

If diabetes or an STD is the culprit, managing those conditions can help prevent future cuts and promote healing.

Surgical Options

In some cases, surgery might be necessary. Here are some potential procedures:

• The Dorsal Slit

A small incision was made on the upper side of the foreskin to relieve tightness and prevent future tearing.

• Preputioplasty

Preputioplasty repositions the foreskin to allow for easier retraction and reduce the risk of tears.

• Circumcision

Complete or partial removal of the foreskin.

• Biopsy

Sometimes, a small tissue sample might be taken to rule out more serious conditions or BXO.

Post-Operative Care:

Following surgery, your doctor will provide specific instructions on wound care, pain management, and follow-up appointments after circumcision or other procedures. This might include using steroid creams to reduce inflammation in BXO and monitoring for signs of recurrence of BXO on different parts of the penis.

When to See a Urologist

See our specialist if you experience any of the following:

*  Severe pain or bleeding

*  Signs of infection, such as redness, swelling, pus, or fever

*  Difficulty urinating

*  The cut doesn't heal within a week

*  The foreskin is exceptionally tight

*  You suspect an STD

Conclusion

Most foreskin cuts heal with simple care. However, seeking medical attention is crucial if you experience any concerning symptoms. Early diagnosis and treatment can prevent complications and ensure a speedy recovery.

Disclaimer

This blog is for informational purposes only and should not be a substitute for professional medical advice. Always consult with our consultant urologist for diagnosis and treatment.

Balanoposthitis Or Balanitis

Balanoposthitis and Balanitis for adults and Children

Balanoposthitis is an inflammatory condition that affects both the glans penis (balanitis) and prepuce (foreskin). The condition is most common in uncircumcised males and is characterized by symptoms such as penile pain, pruritus (itching), discharge, erythema (redness), rash, or inconsolable crying in children.

There are several possible causes of balanoposthitis, including poor hygiene, infections (such as candidal, bacterial, or viral infections), inflammatory skin diseases, irritants, trauma, and cancer. Poor hygiene is the most common cause of nonspecific balanoposthitis. Infections such as candidal infections are common in children. They can be associated with diaper rash, while other infectious causes include aerobic bacteria such as Staphylococcus aureus and Group A Streptococcus, anaerobic bacteria, and viruses such as human papillomavirus.

The prevalence of balanoposthitis is between 12% to 20% in males of all ages. Paediatric patients commonly present around ages 2 to 5 years, likely due to physiologic phimosis and hygiene habits. In adults, uncircumcised males with diabetes mellitus are at the highest risk, with a prevalence of around 35%. Circumcision has been shown to decrease the prevalence of inflammatory conditions of the glans penis by 68%.

According to the American Urological Association, balanitis affects up to 11% of men and can occur at any age, but it is more common in older men and those who are uncircumcised.

Pathophysiologic processes can vary widely depending on the aetiology of balanoposthitis. Most cases commence with moisture such as urine, sweat, or smegma (physiologic secretion from genital sebaceous glands) becoming trapped within the preputial space, creating a nidus for bacteria and fungi. Balanoposthitis can also be commonly provoked by irritants and allergens, causing non-specific inflammation leading to erythema and pruritis.

A thorough history and physical exam are sufficient in most cases of balanoposthitis for diagnosis and establishing a course of treatment. Your doctor may also recommend testing for sexually transmitted infections (STIs) if there is a suspicion of infection.

if you experience persistent or severe symptoms of balanitis or balanoposthitis, or as untreated cases can lead to complications such as scarring or phimosis. The diagnosis of BXO is typically made based on the appearance of the affected skin. Still, a circumcision and biopsy may be necessary to confirm the diagnosis and treatment of the phimosis.

Treatment may include hygiene improvements, topical or systemic antimicrobial agents, anti-inflammatory agents, topical steroids and circumcision in severe cases. Establishing the underlying cause of balanoposthitis is vital to guide appropriate treatment. Additionally, practising good hygiene habits and using protection during sexual activity can help prevent the development of balanitis.

Circumcision is recommended in phimosis and scaring due to BXO

Treatment options for BXO include topical and intralesional steroids, circumcision with frenuloplasty, and various surgical techniques for more severe cases.

Regular follow-up care is important to monitor changes in the affected areas that may indicate malignancy.

Sources:

1. American Urological Association. Balanitis. https://www.auanet.org/education/auauniversity/medical-student-education/conditions-education/balanitis

2. Mayo Clinic. Balanitis. https://www.mayoclinic.org/diseases-conditions/balanitis/symptoms-causes/syc-20354817

3. NHS. Balanitis. https://www.nhs.uk/conditions/balanitis/

4. Harvard Health Publishing. Balanitis. https://www.health.harvard.edu/a_to_z/balanitis-a-to-z