If you are the parent of a baby boy, one of the urologic conditions you are likely to hear about, particularly from other parents with young sons, are penile adhesions. Following are a few basic facts. During the first few years of life, it is common for the penile shaft skin to stick to the glans or head of the penis. This is called a penile adhesion. Penile adhesions can occur in both circumcised and uncircumcised boys.
Your Child's Urology Surgery. Occasionally the cicrumcision around the adhesions can become red and irritated. In many situations the skin bridge can be divided during an outpatient procedure. Here's what you need to know. Saunders Co. Katharine A. How do I prevent this from happening?
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All Rights Reserved. Overview Management and Treatment. This is the purple line that separates the glans from the shaft of the penis. These adhesions can be pulled apart with gentle Girly decorations. Other things that can happen are injuries to the glans or the urethra if the clamp that is used for circumcision is not placed correctly. Key Points in Understanding Circumciion Sexuality. Consultation with a pediatric urologist is the only way to determine if a revision is necessary. Fenwick, CEO. Your Email required. For Patients. Why is Infant circumcision adhesions penis appearing to be sunken in? Let me try to answer many of them and hopefully put your mind at ease.
A penile or prepuce adhesion can occur after a circumcision if the remaining skin is not retracted after the circumcision has healed.
- Penile adhesions in circumcised boys occur when the penile shaft skin sticks, or adheres, to the glans of the penis.
- With all of our sons, my husband and I decided to circumcise.
- My sisters were both told that they should have been retracting the foreskin at every diaper change and this problem would never have happened.
- If you are the parent of a baby boy, one of the urologic conditions you are likely to hear about, particularly from other parents with young sons, are penile adhesions.
If you are the parent of a baby boy, one of the urologic conditions you are likely to hear about, particularly from other parents with young sons, are penile adhesions. Following are a few basic facts. During the first few years of life, it is common for the penile shaft skin to stick to the glans or head of the penis. This is called a penile adhesion. Penile adhesions can occur in both circumcised and uncircumcised boys. The adhesions can be located anywhere around the head of the penis and vary in severity.
The adhesions are generally benign and cause no discomfort. In infants and young boys, a penile adhesion usually resolves on its own without any treatment. Adhesions may develop due to an excess of residual foreskin following a circumcision or when the foreskin is unable to be retracted in uncircumcised boys. Adhesions can also form as an infant develops more fat in his pubic or lower abdominal area. The fat pad above the penis grows a lot during the infant years.
This makes the penis appear to shrink and be swallowed up by the fat pad, causing the skin of the penis to rub against the head of the penis. This may result in small irritations on the skin surface that stick to the surrounding tissues. Most penile adhesions cause no obvious symptoms. Occasionally the area around the adhesions can become red and irritated.
You may also notice a white cheesy substance coming from the area of the adhesions. This is called smegma, and it occurs as the cells on the surface of the glans and inside the foreskin are discarded normally, like other cells of the body. This accumulation may help in naturally pushing the adhesion apart. Sometimes it is mistaken for a cyst or pus under the skin, but it is not an infection and does not require antibiotics.
This should be done a few times a day. Penile adhesions may be more common if a circumcision left an excess amount of residual foreskin.
It is normal to be unable to fully retract the foreskin in an uncircumcised newborn. This is called physiologic phimosis, and the foreskin typically loosens and is able to be retracted once the child is several years of age. However, if the foreskin tightens again later in life when the uncircumcised boy is more than a few years old, this may be the result of irritation from chronic adhesions, and requires medical evaluation.
In both cases, retracting the skin is best done at the tail end of a bath. The bath will help soften the tissue. All infant penile adhesions should be evaluated by a physician. While some adhesions will indeed resolve themselves, others will not. A medical professional is the best person to make this determination. Treatment may include a topical steroid cream that will weaken the tissues and help break down the adhesions. If the cream does not work to release them, your provider may recommend a short procedure to separate the adhesions.
This may be done in the office with a topical anesthetic or at the hospital with a brief general anesthetic. You should also know that it is not uncommon for a baby that has had a penile adhesion to experience a reoccurrence. To prevent this, you should continue to regularly retract the skin of the penis shaft once the adhesion site has healed.
The pediatric urology specialists at Anne Arundel Urology have extensive experience providing urologic care for children.
No matter what type of urologic problem your child may be experiencing, we can help. Contact us. My baby is almost 6 weeks old and I just noticed a partial glandular adhesion. I was able to separate a small area but the rest of the adhesion seems to be more stuck. Hi Chelsea. Kern or Dr. McDermott Sr. There is a prescription cream that can be used to treat adhesions.
If you wish to make an appointment please call Thank you. My son has the penile adhesion, noticed it since 2 months but now he is 5 months old and the foreskin still swallows the head of the penis, he is fat around his penile area though and I also notice the white discharge which you described as smegma.
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Subject required. Your Message required. Penile Adhesions — What Parents Should Know By Adam Kern, MD If you are the parent of a baby boy, one of the urologic conditions you are likely to hear about, particularly from other parents with young sons, are penile adhesions. What are penile adhesions? What causes penile adhesions? What are the symptoms? Can penile adhesions be prevented? How are penile adhesions treated? Sarah Cummings says:. September 21, at am. Chelsea Redman says:.
April 27, at pm. Anne Arundel Urology says:. May 8, at am. Sharon says:. September 15, at pm. Leave a Reply Cancel Reply. All Rights Reserved. Contact Us.
Complications of the procedure -- tightening of the foreskin, a concealed penis, excess skin, a little inflammation or irritation -- are very infrequent and generally minor. McNamara, MD, MPH , discusses the complications associated with circumcision, why a revision is necessary and when to see a pediatric urologist. Load More Comments. I was told simply to place Vaseline on the diaper to prevent sticking and allow it to heal. The 7 Best Pads for Postpartum Bleeding of But if that doesn't work, here are six other hacks to try.
Infant circumcision adhesions. What are the common complications of a neonatal circumcision?
Penile Adhesions - What Parents Should Know - Anne Arundel Urology
It is widely recognized by pediatric urologists that male circumcision reduces the risk of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV.
Although the majority of circumcisions in infants occur without complication, a percentage of children require urology intervention.
McNamara, MD, MPH , discusses the complications associated with circumcision, why a revision is necessary and when to see a pediatric urologist. When a child is circumcised, sometimes the skin from the penis attaches to the head of the penis and forms adhesions.
The extra skin covers the head of the penis, and it can cause mild adhesions or completely cover the penis to the point where it no longer looks circumcised. It depends on how much extra skin is left behind. The redundant skin also can be uneven with more extra skin on one side versus the other side.
Often, a revision is done because the redundant skin may lead to irritation or infection. These infections may be due to the adhesions or if the adhesions are so dense penile skin bridges that they can actually cause discomfort or curvature of the penis with erections. These are the only health indications for doing a revision. Hypospadias : Rarely, a patient will have a hypospadias, which goes undetected until after the circumcision.
This is unfortunate because urologists use the foreskin to fix the hypospadias. Incomplete circumcision : More commonly, too little skin is removed also called an incomplete circumcision , and there is redundant foreskin.
When this occurs, the child may have a build up of normal skin cells, or smegma, underneath the extra skin, which leads to irritation, infection or adhesions of the skin to the head of the penis. If he has had any skin infections or the parents have concerns about the circumcision, the child should see a specialist. Some pediatric urologists can lyse the adhesions in the clinic with local numbing medicine. However, if extra skin is causing the problem, this will need to be addressed in the operating room under anesthesia.
Consultation with a pediatric urologist is the only way to determine if a revision is necessary. Once under anesthesia, we put local anesthetic near the penis to minimize post-procedure pain. At this point, we safely lyse or remove the penile adhesions. If the adhesions are dense, we cut them and remove the extra skin so there is no redundant skin left behind. We make sure there are no small vessels bleeding and place small stitches. Sometimes a dressing is placed with bacitracin and the child is woken up and goes to the recovery room.
They go home that same day. Fortunately, this is a very minor procedure. Anesthesia is safe in this age group, and a revision circumcision does not take a long time. The adhesions will continue to come back unless the extra skin is removed. The extra skin that is removed will make the penis look like a circumcised penis. Once the circumcision has been revised, it is extremely rare for any further problems to occur.
For Patients. Find A Doctor. Why is a circumcision revision necessary? What are the common complications of a neonatal circumcision? Occasionally, a child can have bleeding that either stops with a pressure dressing. Very rarely, a suture needs to be placed to stop the bleeding. Other things that can happen are injuries to the glans or the urethra if the clamp that is used for circumcision is not placed correctly.
Another rare complication is taking too much skin off during a circumcision, so the shaft of the penis is not covered with skin.
This will sometimes need to be fixed in the operating room. When should the child be seen by a pediatric urologist? How do you perform a circumcision revision?
Is there anything else parents should know about circumcision revision? For years, families have come from around the corner and across the world, looking to Boston Children's for answers.
This is the place where the most difficult challenges are faced head on, where the impossible becomes possible, and where families in search of answers find them. Sandra L. Fenwick, CEO. Connect with Boston Children's Hospital. How can we help?