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Suggest Treatment For Granuloma

Posted on Sat, 19 Apr 2014

Question: 6 weeks ago I had minor surgery for a thrombosed vein on the shaft of my penis. In my followup today my surgeon diagnosed me with a granuloma from my body reacting to the dissolvable sutures. It is quite swollen and a hard lump fully under the skin roughly 1 cubic centimeter in size. The surgeon said he can do another procedure, or see if it heals on its own, but would not advise what I should do. Should I have it removed or wait? Also, if I have it removed, how can I prevent another granuloma.

Answered by Dr. Ashish Verma (1 hour later)

Brief Answer: wait for a week Detailed Answer: Hi, Thanka for writing to HCM. In my opinion you should wait for a week and see if it resolves. If it doesn't then go for its excision. Shaft of the penis has very thin skin with very less subcutaneous tissue. So any foreign body is likely to produce granuloma. Its body's defense mechanism. In most of the other body sites, due to adequate subcutaneous tissue this is not seen. If you are going for its excision, ask your surgeon to leave as less of suture material inside as possible. Hope that i have been helpful. Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (10 hours later)

Thank you for your answer. All the swelling and granuloma is below the skin, there is nothing coming through the incision itself, which has healed. Is this still due to the thinner skin of the penis? Also, if I have it redone, the doctor gave me the option of trying a different type of dissolvable suture, or having monofilament sutures that would then be later removed by him. Is one of those options better than the other in terms of healing this permanently?

Answered by Dr. Ashish Verma (18 minutes later)

Brief Answer: non absorbable monofilament will be better Detailed Answer: Hi, Yes that can be due to the lack of adequate subcutaneous tissue. You can get that excised, and if you are going for it then in my opinion a monofilament nonabsorbable suture will be better if you are going for it, as chances of a reoccurrence should be least with it. Regards Dr. Ashish Verma

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj