By: Hatim Thaker, MD, FAAP
A penile adhesion is a condition where the skin of the penis, or the foreskin in uncircumcised boys, sticks to head of the penis. When these adhesions become dense, they can permanently fuse the skin to the head of the penis. This is called a skin bridge.
While this is not a dangerous condition, penile adhesions and skin bridges can sometimes cause discomfort and differences in cosmetic appearance. Here are answers to common questions parents may have.
What causes penile adhesions or skin bridges in babies and children?
After a circumcision, any excess foreskin or penile skin may "ride up" along the shaft of the penis and get stuck to the head. Similarly, if a boy has excess fatty tissue at the base of the penis (or suprapubic region), the head of the penis can "sink in" and become surrounded by extra skin (sometimes referred to as "buried" or hidden penis). In both situations, there is a risk of adherence between the two skin surfaces.
For
uncircumcised infants, it is normal that the foreskin does not retract completely to expose the head of the penis. However, if the foreskin does not become supple enough to fall back naturally, this may lead to more troublesome adhesions.
A consultation with your pediatrician, or a
pediatric urologist, can help distinguish which conditions require treatments, and which do not.
What are the symptoms of penile adhesions and skin bridges?
This condition typically has no symptoms, though in some cases, the foreskin may become irritated or inflamed. In older boys, dense adhesions may cause discomfort during erections.
How do I take care of and treat penile adhesions?
Not all penile adhesions need therapy, as some children may outgrow the condition naturally. If needed, a topical steroid ointment can be applied to the adhesions twice daily for six weeks. This will soften the foreskin to make it easier to retract the skin and expose the head of the penis.
Some dense adhesions, especially skin bridges, may not improve with topical ointments. These adhesions can be removed in the office with a topical anesthetic, or in the operating room under anesthesia.
Mild adhesions can develop into permanent skin bridges after circumcision. As a parent, ensuring that penile skin does not tether itself to the head of the penis during the healing process after circumcision will help prevent adhesions. This can be done by gently pulling the penile skin down.
In addition, general penile hygiene is always important. In the areas beneath the adhesion, dead skin cells can accumulate and form a white paste. This is called "smegma". This should be gently wiped away during
diaper changes or cleansed during
baths.
More information
About Dr. Thaker
Hatim Thaker, MD, FAAP, is a pediatric urologist at Boston Children's Hospital/Harvard Medical School. He completed his residency training at the University of Southern California/LA County Medical Center, and a 3-year fellowship at Boston Children’s Hospital. Dr. Thaker has a clinical interest in robotic reconstructive surgery, genitourinary oncology, neurogenic bladder and urodynamics. Within the American Academy of Pediatrics, he is a member of the Section on Urology. |