Most Penile Adhesions Resolve Spontaneously After Neonatal Circumcision
WESTPORT, Aug 03 (Reuters Health) - Penile adhesions are common after neonatal circumcision, but most do not require any intervention, according to researchers from the Cleveland Clinic Foundation, in Ohio.
Dr. Lee E. Ponsky and colleagues looked for penile adhesions in all circumcised boys who presented to their pediatric urology clinic. In total, 254 boys were examined, ranging in age from 1 month to 19 years, 8 months.
The prevalence of penile adhesions declined with age, the investigators found. All told, 71% of infants had adhesions compared with 28% of boys ages 1 to 5 years, 8% of those ages 5 to 9 years and 2% of older boys. About one third of infants had adhesions more severe than grade 1, compared with 10% of boys ages 1 to 5 years and none of the boys older than 5 years.
Seven of the patients had been treated for adhesions, and three of these had recurrences, Dr. Ponsky and colleagues note.
The findings indicate that most penile adhesions resolve spontaneously with time, the researchers write. Although the study did not address the reasons for spontaneous resolution, they point out that possible mechanisms include "an increased number of erections with age, penile growth, hormonal influence on local tissue and keratin pearl formation."
Based on their findings, the Cleveland researchers advise against routine lysing of penile adhesions, except perhaps when they involve the circumcision line. "Adhesions that involve the circumcision line may be more likely to cause skin bridges," they note.
J Urol 2000;164:495-496.
http://www.cirp.org/news/ponsky2/