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Penile Adhesions and a 'Bad Circumcision'

Expert Q&A


Updated February 20, 2005

Q. My infant son is now 17 days old. He was circumcised before leaving the hospital. By now, it has totally healed. While bathing him we noticed about 75% of the skin immediately next to the glans has healed to the edge of the glans. My sister-in-law (an RN) said we were supposed to "pull" the skin of the shaft down away from the glans during the healing process. However, our pediatrician said the circumcision was fine - just leave it alone. Is this normal? Should we attempt to pull the skin away from the glans or will it separate on it's own? Marshall, Harrisburg, NC

A. It isn't really normal, but is a common complication after a circumcision.

In a situation like this, penile adhesions form when the skin on the shaft of the penis attaches itself to the glans or head of the penis. In extreme cases, it can look like the child was never even circumcised, leading parents to believe that the child had a 'bad circumcision.'

Adhesions are especially common in children who have a 'hidden penis,' in which the whole penis seems to disappear inside a large fat pad around their penis.

If the skin is attached only on the very base of the glans, then your child has a very mild case of penile adhesions and you can likely just leave it alone. It should eventually separate, especially once your child becomes older, and anyway, forcing it apart would be painful. Eventually, you may notice a white substance (smegma) coming out and forcing these adhesions apart on their own. If this happens, you can usually try to gently separate the adhesions and apply vaseline to the irritated area that has separated so that it doesn't become reattached.

Treatment for Penile Adhesions

If a child's penile adhesions don't go away on their own or if a parent wants to treat a child with extensive adhesions, one study recently has shown that applying a prescription steroid cream to the area three times a day for three weeks resulted in clearing the adhesions in almost 80 percent of infants. This makes sense when you consider that uncircumcised children that have a phimosis, in which their foreskin doesn't retract, are often successfully treated with topical steroid creams.

Some children with extensive adhesions do require surgery as treatment.

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