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Penile Adhesions

Penile adhesions refer to when the foreskin becomes attached to the head–or glans–of the penis. This can happen in either uncircumcised or circumcised boys. In uncircumcised boys, penile adhesions are often associated with phimosis. In circumcised boys, adhesions are still possible when the residual portion of the foreskin contacts the glans and becomes adherent. The majority of adhesions are minor and resolve on their own; however, in extreme cases, if left unchecked, chronic adhesions can lead to formation of scar tissue or bridges of new skin.

Adhesions are much more likely in children who are still wearing diapers, but can happen in older children as well, especially in the setting of poor hygiene. When adhesions become dense, a buildup of skin secretions underneath the entrapped skin can occur. The resulting whitish residue is called smegma, and is sticky, leading to ever increasing adhesions. It is important to maintain hygiene by cleaning away any entrapped smegma.

Treating Penile Adhesions

Dr. Kern recommends treating penile adhesions if they are discovered, to prevent a scenario where they become dense and lead to scarring. The vast majority of adhesions are easily treated in the office, and recurrence can be prevented by following proper hygiene. However, there are a small group of young boys in which adhesions recur despite parents’ best efforts.

For children younger than age 2, minor adhesions are usually gently treated in the office after application of topical lidocaine. Children older than age 2 tend to be fearful of small procedures, and so it is often preferable to treat adhesions in this age range at home by using topical steroid creams, meticulous hygiene and by having the parents and child gently retract the foreskin several times per day.

Dr. Kern is also an expert in treating conditions resulting from scar tissue formation from penile adhesions. In rare cases, this can lead to skin bridges which can tether the penis during erections, or non-cosmetic complications of scarring of the head of the penis. Dr. Kern uses a variety of plastic surgical techniques to treat these conditions, and to perform circumcision revision, and is available for consultation to determine if your child may benefit from any of these approaches.