A penile adhesion develops when the skin of the penis shaft adheres or sticks to the skin of the penis head, also known as the glans. This condition can develop in males who are circumcised or, more commonly, uncircumcised.
A thicker attachment that forms when the shaft skin attaches to the coronal margin is known as a skin bridge. The coronal margin is the edge that protrudes around the base of the glans. The connection that forms with a skin bridge may include a “tunnel” under the skin that is connecting the shaft to the coronal margin and glans.
In infants and young boys, a penile adhesion usually resolves on its own without any treatment. In other cases, topical creams may help. In very serious cases, surgery may be needed to separate the attached sections of skin.
When an infant boy is circumcised, it’s important to gently pull back any excess skin of the penis shaft away from the glans during the healing process. This should be done a few times a day.
Ask the doctor who does your baby’s circumcision when you should start doing this and for how long. If it doesn’t happen, the skin of the shaft can start to adhere to the glans. Penile adhesions may be more common if a circumcision left an excess amount of residual foreskin.
For a boy who hasn’t been circumcised, the foreskin may not be fully retractable until they’re older. Once the foreskin is able to be easily retracted, it may adhere to the glans if you or your child does not periodically gently retract it.
Penile adhesions can also occur in grown men. If the skin of the shaft is pushed forward by a large pad of fat in the pubic area, adhesions and skin bridges can form.
In infants and young boys, there may be no obvious symptoms.
A man who feels a tugging sensation during an erection may have penile adhesions. That sometimes is the first sign of the condition. Penile adhesions and skin bridges can sometimes become somewhat painful if left untreated.
Other symptoms include the presence of smegma, a white discharge made up of dead cells under the skin. Smegma isn’t a sign of infection, but it may suggest a need for better hygiene and treatment of any adhesions.
Penile adhesions and skin bridges are usually visible to the naked eye. If you see one or more forming on your own penis, see a urologist soon for treatment. If you notice them forming on your son’s penis, see a pediatrician soon. Treatment usually doesn’t require surgery or any invasive procedure if diagnosed early.
There are three main types of penile adhesions and skin bridges, each with its own set of treatments. They include:
Penile skin bridge
When the shaft skin becomes attached to the coronal margin, so that a thick skin bridge forms, a procedure may be necessary to make the separation. The division can often be done as an outpatient procedure in a doctor’s office.
If it’s decided that treatment is necessary for a baby boy, a numbing cream is placed on the area to be treated and then the bridge is carefully cut apart.
Thicker bridges, especially in older boys and men, may require surgery in an operating room under general anesthesia.
Glanular adhesions
A glanular adhesion is less serious than a skin bridge. It can also involve a connection between the shaft skin and the coronal margin, or an adhesion between the skin of the shaft and the glans, or head, of the penis. These adhesions are usually benign, and often resolve without any intervention.
You may be able to help the adhesions divide on their own by rubbing petroleum jelly (Vaseline) directly on them. Spontaneous erections may also help break up the adhesions.
For a baby boy, adhesions may develop after circumcision. If it’s determined they need to be treated, your pediatrician may need to apply a numbing cream first before the release of an adhesion is attempted. The cream should be on for 20 to 30 minutes before retracting the skin. Six weeks of twice-daily steroid cream application may be recommended after this procedure.
Older boys and men with adhesions may also benefit from this approach. Your doctor can advise you.
Cicatrix
After a circumcision, a child’s penis may move back into the pubic fat pad, while the shaft skin contracts around the head of the penis. This contraction of scar tissue is called a cicatrix.
You may be advised to apply a topical steroid cream to the area to help free the head of the penis. If the glans doesn’t reemerge, a circumcision revision or other surgical remedy may be necessary to free the glans.
It’s important that you consult with a doctor before using any medicated creams or trying to retract the skin away from the glans or coronal margin yourself. Never use topical steroid creams in your baby’s diaper area unless directed by your doctor.
If you’re unsure how to properly retract the skin of your son’s penis, even if there are no signs of adhesions, talk with a doctor. Sometimes, a boy’s foreskin cannot be fully retracted until puberty. If they have no symptoms and do not develop an infection of the foreskin, this may be normal and not necessarily a sign of adhesions. Never forcibly retract the foreskin.
When your child is still in diapers, gently retracting the skin during bath time is appropriate. Using a little petroleum jelly during each diaper change can help prevent adhesion formation while a circumcision is healing.
A penile adhesion is usually a benign condition. Even though it may resolve on its own, it’s still a condition worth noting to a doctor.
If your son develops one, learn how to properly care for their hygiene to avoid additional cases of adhesions later on. And don’t be embarrassed or feel guilty if your son develops an adhesion. Bringing it to a doctor’s attention and learning how to help prevent them in the future is smart, responsible parenting.