Penile adhesion: the hidden complication of circumcision

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A penile or prepuce adhesion can occur after a circumcision if the remaining skin is not retracted after the circumcision has healed. When a circumcision is done, tissue which would normally be intact is split. Unless proper care is taken, the epithelium of the inner prepuce at the point where the foreskin was removed can reattach to the epithelium of the glans. The result of this is a penile adhesion. Usually the adhesions can be released by simple retraction. Sometimes, however, the fusion is so complete that simple retraction will not work, and the child must be referred to a urologist. Another problem is that smegma or bacteria can collect under the adhesion if it covers the preputial cavity and cause infection. Professionals must look for this problem, and parents must be taught how to care for the normal circumcised penis so that penile adhesions do not develop. This article discusses the formation and identification of penile adhesions, the process by which adhesions can be released, when a referral to a urologist is necessary and the proper care for the circumcised penis.