Dr. Reed, Thank you for the advice regarding a large Hematoma after an Adult Circumcision. Jorge
On October 7th, you said you had a circumcision, 3 days ago, that would be October the 4rd. Now it’s 4 days later. At this time the hematoma is starting to organize. That means little collagen fibers are ingrowing like a web into the mass, later followed with capillaries. The hematoma now has very little free blood and starting to become a firm blood clot. The decision to drain it should have been made in the first 24 hours. Yes, the mass still can be removed but there’s is a greater probability of collateral injury or leaving some peripheral clot behind.
Am also seeing one half of the glans is covered with skin. Did you ask for an extremely loose circumcsion or is this related to the hematoma?
If you walked into my office at this time, having been done elsewhere, I would probably suggest you let it slowly be re-absorbed. Warm tub baths with a half a cup of table salt twice a day for 15 minutes will dilate surrounding normal capillaries and help reabsorb fluid. Shower before you leave the tub. Take a tape measure and get a baseline maximal circumference and you can follow your progress. Less likely is that the hematoma will get infected. If this happens you will need drainage ideally not antibiotics. At this time, based (only upon the photo) you have submitted there appears to be no indication for antibiotics.
Please continue to check in with us. Remember chit-chatting on a blog is no substitute for an actual visit with an expert urologist
Harold M. Reed, M.D.
The Reed Centre for Cosmetic Circumcision- Miami