Infant Penile Adhesion: What is It, Why Does it Happen, and How to Treat It 21


infant penile adhesions adhesionWith all of our sons, my husband and I decided to circumcise. Within a month of our first baby boy’s circumcision, we noted it just didn’t look quite right. Less of the head of the penis appeared visible than we expected and when the remaining foreskin was pulled back the edges of the head could not be seen. After further research and a pediatrician visit, we found our son had a penile adhesion.

What is a penile adhesion?

A penile adhesion occurs when the remaining foreskin after a circumcision reattaches to the Glans or head of the penis. Penile adhesions vary in severity and can be located anywhere around the head of the penis. If you gently pull back the skin of a baby’s penis that has a penile adhesion you can see skin sticking to the edge of the head in locations or may not be able to see the edge of the head at all. Remember that a circumcised penis should resemble a mushroom. If it doesn’t, your baby may have an adhesion.

Can penile adhesions be prevented?

In my first sons case, he was born with an unusual amount of foreskin, so after his circumcision more than usual remained. I was told simply to place Vaseline on the diaper to prevent sticking and allow it to heal. What I was not told is after healing the remaining foreskin should be gently pulled back during diaper changes and baths until 18 months of age to prevent infant penile adhesion. Not only can this process greatly reduce the risk of penile adhesion, but many parents find it to be cleaner. It is a misconception that a circumcised penis requires no care. Even a circumcised infant will form smegma, or a white substance in the folds of skin around the penis, under the penis itself and under the remaining foreskin.Choosing not to circumcise will also not prevent the chance of adhesion. Both circumcised and uncircumcised boys suffer adhesion.

It should be noted even with regular retraction of the remaining foreskin infant penile adhesions can still form. With my second baby boy, I was more versed in how to care for an infant circumcision and my baby still developed minor adhesions, yet my third son had no issues.

How are penile adhesions treated?

Expert opinions on how infant penile adhesion should be treated vary. Some feel that the adhesion should be gently pulled free in an office visit to prevent the need for surgery later. Others feel most penile adhesions resolve themselves by the time the baby turns five. Studies currently support the later of the two opinions finding that of the 71 percent of infants that had penile adhesions shortly after birth, only 28 percent still had adhesions by age 5, 8 percent by age nine, and 2 percent beyond this.

It is recommended that all infant penile adhesions be evaluated by a pediatrician. While some adhesions will indeed resolve themselves, others will not. A medical professional is the best person to make this determination. With my first son, we opted to have the manual retraction. A numbing agent was placed on his penis and then an hour later his doctor gently pulled the attached skin free. He had some redness for a day or so, but didn’t even cry. The skin did reattach again. It’s not uncommon for a baby that has had a penile adhesion to experience a reoccurrence of penile adhesions. We had the skin unattached a second time, and kept Vaseline between the remaining foreskin and the head this time until redness faded entirely. The adhesion has not returned.

In our second son, the adhesion was less severe as he did not have an irregular amount of foreskin and we knew how to properly care for his circumcision. A pediatrician, in this case, recommended either leaving it alone or slow detachment. This should be done at the tail end of a bath. The bath will help soften the tissue. Place one thumb below the adhesion and another on the glans or head of the penis. Then you simply gently push in opposite directions. After a few baths, many adhesions are resolved. You can ask your pediatrician how to do this, and whether or not it is a good idea in your particular case.

In rare cases, penile adhesions exceed the fifth year of life. In these cases, surgery is usually recommended.

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21 thoughts on “Infant Penile Adhesion: What is It, Why Does it Happen, and How to Treat It

  • Fatty fatty

    Hi. I noticed my sons foreskin has attached back and a small part is still left unattached. I can see some smegma buildup under the attached skin and I have no way to clean it! any tips will help pls

    • unwirklich admin

      You could try the slow bathtub method (be very gentle), just let it ride if it doesn’t look like the buildup is going to cause issue, or probably the best route, speak with your pediatrician. A medical professional actually looking at the adhesion and the buildup can better access the best course of action as all cases are different.

  • Amae

    I am so glad you are touching on this! I believe it is much more common than we realize, but is never talked about. No one warned me about this complication of circs, nor told me how to care for it. I have two sons, one age 4 years, one age 4 weeks. Both are circumcised, both suffered adhesions. It is true, there are differing suggestions on care of adhesions. One, to forcibly retract, one to gently pull over time, one to let alone. With my first son’s adhesions at 9 months old, the pediatrician ripped it apart without even a warning or explanation until after it was done. My son screamed bloody murder when she did it and cried at every diaper change for months after. My poor baby! It readhered several times after that, no matter how diligent I was at putting Vaseline on the area. Before my second son’s birth, I did research on circumsicion. I was clueless with the first son and let my husband make the decision. After delving into it a little for the 2nd son, I became firmly against him getting circumcised. The foreskin serves multiple purposes, and circumcision is very painful. It is almost always done with no pain relief at all and has so many possible bad outcomes. The complications are so much worse than anything they said would possibly be prevented by it.
    When it came down to it, though, I was outmanned. I was pressured by the pediatricians at the hospital, my husband, and my OB to circumsize, so I folded. Come to find out, my husband was completely nieve on the subject, surprisingly not even knowing what the procedure was or what a foreskin even is. The pediatricians make a good chunk of money for this “5-10 minute procedure”, and my OB is Jewish. So I have to say that those who opposed my decision were biased. Also, I felt bullied. And a medical professional should ever pressure you into a cosmetic procedure. Long story short, here I am in the same boat again with the adhesions. I decided to research the heck out of it, before letting anyone rip at his delicate skin. When I truly researched this area, I found mounting evidence against circumsicion. As far as adhesions in the UNcircumsized, it is most often a complication of forcible retraction of the foreskin before it has naturally separated from the head of the penis. This isn’t supposed to be forcefully separated, which is why adhesions form. The same reason it readheres in the circumsized. The procedure for circumsicion involves ripping the foreskin away from the head of the penis, comparable to ripping off a fingernail. The skin there becomes damaged (could be described as a wound), and the body naturally tries to heal and protect it. Unfortunately, most of us in the United States are in the dark (or dark ages) on this subject. I now know there is a purpose for the foreskin. It is supposed to be there. I think we should stop manipulating our poor sons’ bodies unnecessarily, and we would save ourselves and most importantly our sons, much pain and grief! I’ve had to learn this the hard way, with much guilt.

  • Nmb

    This article was so helpfull!! I’ve been in a panic trying to figure out what was going on with my 4 year olds circumcised penis. He’s had redness and very sensitive around the head. When he was little he was really chubby and even with the pulling back gently and cleaning it partially reattached. Reading this article made me understand that it’s just separating back out on its own!! Thank you thank you thank you!!

  • Rachel

    Thank you for sharing! I cannot fathom why doctors don’t discuss penis care with parents more than they do. My youngest son is 9 months and currently has an adhesion, and I gently retract the skin as much as it will go (never forced) when changing his diaper before bed for cleaning. One side did come away during bath a while back, but the other side has not, and I have to keep reminding myself to be patient, that I do not need to rush into the doctor, I can bring it up again at the next well check, and it will likely resolve on it’s own with time. As parents, I think we can obsess and worry about things more than is warranted, or at least I do, and I constantly need that reminder that things are really okay 🙂

  • Anonymous

    Thank you for information!! My pediatrician was so vague about my sons adhesion, he didn’t even tell me that’s what it was! He just pulled it down and applied Betadine solution and told me to do the same for the next 3 days. I’ll also apply Vaseline to lubricate the area..I feel so horrible about not being informed enough about this! Thank you so much for such a clear explanation.

  • ENELSON

    So happy I ran across this! I just found an adhesion on my 2 year old son and had that moment of panic and, “Holy crap! How did this happen?” He is my 3rd boy but first time I’ve ever encountered this. And honestly I wouldn’t have noticed it if he hadn’t been exploring while potty training. I’m SO happy to find out this doesn’t necessarily mean that he has to have surgery and has the possibility of being a minor thing. Also, the comments from Benjamin led to this article being more reassuring! Your responses were well thought out and informed. Thank you again!

  • MJ

    I feel exactly like Cherie baby ^^^. This article was helpful and informative. I’m currently dealing with a mild penile adhesion issue with my son, second child but first boy. I was so worried he would need a surgical procedure to correct this but this posting has given me peace of mind and hope that all will be minimal and well. Thank you for the insight!

  • Cherie Baby

    I found this information very useful and am grateful to have come across your blog. It puts my mind at ease regarding my sons mild adhesion. I’ve been gently pulling the shaft down from the head after every second bath or so for the last couple weeks and see a huge improvement. I have heard that some doctor will aggressively pull the head away at your regular appointment if you mention penile adhesion which I would assume could be unessasarily painful. It’s unfortunate that you get slack there in some of those comments. I for one appreciate you sharing your experience and information on this subject and found it very reassuring.
    I am a very pleased mom of two circumcised sons and even consider this mild adhesion we’re experiancing to be a minimal concern and am still very confident with our descion

  • Chrissy

    This is an awesome, informative and extremely useful post. You presented the info for all sides and made the best choice for your sons. (I went through the exact same process with my two little boys.) as for the other comment. Wowza. I couldn’t imagine telling another parent what they should do for their own child. Clearly there’s much more going on over there.

  • Benjamin

    I don’t put Vaseline on my kids because it’s just a barrier, and it doesn’t have any healing properties. There are better products to use. I didn’t say anything about Vaseline so I don’t know where you got that assumption.

    I have 3 sons that are not circumcised, and they’ve never had adhesions or any other problems for that matter. I’m personally circumcised and I’ve had an adhesion and it was from my circumcision. It hurt like hell to retract.

    Most medical professionals believe that adhesions will clear up on their own without manual intervention.

    Did you post a link to the other entry? I don’t think it worked with the comments.

    • unwirklich admin

      Did you even read the article you’re commenting on? When a circumcision or adhesion that has been released is healing it’s recommended by pediatricians to place Vaseline on the area to prevent adhesion or re-adhesion. It states this in the article. It was brought up in comment because you brought up the care process as being “horrible.” I never said it had healing properties. It is a barrier, that’s the point.

      Had you actually read this article, it also states that 71% of the time adhesions resolves themselves and should be left alone, but that a trained medical doctor is the best person to advise on the best course of action in your particular case.

      You, or your sons, having or not having adhesions does not prove or disprove anything beyond your personal experience. Actual, documented studies (feel free to research this on your own) show that BOTH circumcised and uncircumcised boys experience adhesion. For circumcised boys the rate is higher in the first year, but for uncircumcised boys complications are more likely as adhesions aren’t often discovered until around age 3, and are found at the same rate as circumcised boys.

      The link should be in comment yes, it shows for me, if it doesn’t for you, it’s also linked in the article and shows at the bottom of the article as the next article published.

      • Bridget

        Girls get adhesions as well! It has nothing to do with circumcised or uncircumcised. While working in a pediatric office I saw more uncircumcised boys have adhesions than circumcised boys. But that’s my personal experience and not a scientific study.

    • Vbalencia

      Benjamin, how old were you when your adhesion retracted? I keep reading it will heal on its own but when. I feel terrible I did this to my son. Many sleepless nights. I just want it to be over and would like to know how much longer we have to deal with this.

  • Benjamin

    OUCH OUCH OUCH. This was so painful to read. I had a penile adhesion which was corrected with surgery later on in life.

    This article is the worst advice on the subject I have ever seen.
    Firstly, you can prevent penile adhesions by NOT CIRCUMCISING to begin with. That’s the easiest way to deal with this problem.

    The manual retraction you’re describing sounds AWFUL. You’re basically reopening a wound over and over again. I hope no one takes this horrid advice seriously.

    The best way to deal with a penile adhesion is to leave it alone. That area has been traumatized enough by surgery, why would you hurt it again?

    This blog entry is maddening, I hope you delete it.

    • unwirklich admin

      Actually, studies show adhesion happens just as frequently in uncircumcised babies as is circumcised ones, possibly more frequently. I have a post on both types of adhesion. Here is the other: I am sorry you feel your opinion is better than that of medical professionals, like the 3 that saw and taught me how to treat my sons adhesion. You aren’t “reopening a wound” it’s not like pulling off a scab, I have never seen an adhesion that presented with an open wound. Skin redness and irritation, yes, but an open wound no. I suppose you don’t believe on creams to help diaper rash heal or chapstick for that matter, if you feel putting a moisturizer like Vaseline on irritated skin is wrong.

      • jgen

        show us those “studies” penile adhesions are complications from circumcisions. thats why so many are trying to ban this stupid procedure. This only causes pain, damage and trauma to baby boys.

        Its a useless mutilation, not to mention a humans right violation.

        • unwirklich admin

          There aren’t studies that show adhesions are a result of circumcision, because they aren’t. I assume you mean “aren’t caused.” Again, both circumcised and uncircumcised infants get adhesions at about equal rates. If you don’t want to read the article, with citation, Google it yourself. Your first results for “uncircumcised adhesion” should be

          “Caring for the uncircumcised penis” from cirp,in which you will find extensive detail on the possible complications in uncircumcised boys, which are the same as those in circumcised.

          However, if you would like actual statistics on the comparison of adhesion rates, please look up, “Neonatal Circumcision and Penile Problems: An 8-Year Longitudinal Study by D. M. Fergusson,J. M. Lawton, F. T. Shannon” which can be quoted,

          “The prevalence of penile problems was examined in a birth cohort of more than 500 New Zealand children studied from birth to 8 years of age. By 8 years, circumcised children had a rate of 11.1 problems per 100 children, and uncircumcised children had a rate of 18.8 per 100. The majority of these problems were for penile inflammation including balanitis, meatitis, and inflammation of the prepuce. However, the relationship between risks of penile problems and circumcision status varied with the child’s age. During infancy, circumcised children had a significantly higher risk of problems than uncircumcised children, but after infancy the rate of penile problems was significantly higher among the uncircumcised. These associations were not changed when the results were adjusted statistically for the effects of a series of potentially confounding social and perinatal factors. ”

          Then, look up, “Herzog LW, Alvarez SR. The frequency of foreskin problems in uncircumcised children. Am J Dis Child 1986; 140: 254-256” which can be quoted, “We performed a retrospective survey to determine the frequency of problems of the foreskin among uncircumcised children. Among 545 boys aged 4 months to 12 years, there were 272 uncircumcised boys and 273 control patients who were circumcised at birth. The total frequency of complications was significantly higher in the uncircumcised group (14% vs 6%). Both balanitis (6% vs 3%) and irritation (4% vs 1%) were more frequent among the uncircumcised children, but the difference was not statistically significant. Problems with adhesions were uncommon (1.5%) and equal in both groups. Symptomatic phimosis was seen in eight patients. The frequency of medical visits for penile problems was significantly higher in the uncircumcised group (10% vs 5%).”

          Then, “Pediatrics Vol. 103 No. 3 March 1, 1999
          pp. 686 -693(doi: 10.1542/peds.103.3.686)” please scroll down and read the rather lengthy section on “penile problems,” which offers a side-by-side comparison of risks with either option. Unfortunately, their new recommendation from 2012 which actually states the benefits of circumcision outweigh the minor risks, does not offer this comparison.

          This article is not about whether to circumcise or not to circumcise, but the FACTS support that there are both benefits and risks to circumcision and choosing not to circumcise. This means like many parenting decisions from what to feed to what school they attend, parents are left making a parental CHOICE which affects their child permanently. Parents do this, every, single, day. If you are going to preach and attempt to sway a parent one way or another, at least do so with an informed, factual opinion. Here at Life with Gremlins you will never see opinion stated as fact. You will always see facts cited– and with unbiased sources. Facts will not be half presented to support opinions. We believe that there is no right or wrong way to parent. As such, we’d appreciate it if commenters kept to the subject matter of posts in the interest of keeping things relevant to the parents that are reading rather than paltry attempts at shaming being if a parent is on this page, chances are they already chose to circumcise. Perhaps focus on parenting your own child, rather than trying to legally regulate how others raise theirs.