Uncircumcised Penile Adhesion: Information and Advice for Parents

Many parents who don’t support circumcision believe that uncircumcised children can’t have penile adhesion. While this article is not aimed at supporting circumcision, it is important parents considering it, planning against it, or that have already settled against it and ran into a problem, have accurate information on uncircumcised penile adhesion. Both circumcised and uncircumcised males can suffer from adhesion or an un-retractable foreskin in the later case. You can read about adhesion in circumcised boys here.

Phimosis and adhesions:

Phimosis is a broad term used to describe an inability to retract the foreskin of an uncircumcised penis. While causes vary, the most common include infection, tight foreskin, adhesion that doesn’t naturally release, and scaring from forcible retraction or injury. Though rates of phimosis based on current research vary from about 9 to 27 percent, on average it appears about 10 percent of uncircumcised males suffer from the condition. It should be noted that at an early age, it’s normal for the foreskin to not retract; rates for phismosis are based on patients varying in age from 6 to 18. An adhesion in an uncircumcised male is the same as one in a circumcised male. The foreskin bonds to the glans of the penis to a varying degree. Several studies have found that uncircumcised males have a higher rate of penile problems after the first year of life than those who have been circumcised, though it should be noted most of these studies were done in the ’80s and have not been challenged.

What you need to know as a parent about uncircumcised penile adhesion:

If your baby is uncircumcised, his foreskin should be fused at birth. You shouldn’t forcibly retract it, as this could actually cause penile problems later on. Only clean what you can see until the foreskin easily retracts. If the urine stream is blocked by the foreskin, causing infection, pain, or bubbling, speak with your pediatrician as this is indicative of a problem. 90 percent of all children over the age of 3 have a retractable foreskin, if your child is significantly older than this he may have phimosis or adhesion. Though circumcision is one treatment, there are non-surgical alternatives including manual separation, foreskin stretching, and steroid treatment.

Weighing in on your decision to circumcise:

The rate of penile complications is about the same in both circumcised and uncircumcised males overall. Circumcised infants do tend to have a higher rate of incident in the first year, but uncircumcised males have a higher rate of medical need for complications after that point. While risk of adhesion and complication is a common stone thrown at parents that choose to circumcise, the actual documented studies on the subject don’t logically support this argument. On both sides, most complications are minor and resolve on their own.

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