A penile adhesion occurs when the foreskin is attached to the base of the head of the penis. It happens most often in babies, whether they have been circumcised or not. It is also called a penile skin bridge. The term skin bridge is mainly used for larger penile adhesions.
What is a Penile Adhesion?
There are three kinds of penile adhesions:
Glanular adhesion. This is a smaller adhesion that occurs when the skin of the shaft attaches to the glans (head) of the penis. This type often goes away by itself.
Penile skin bridge. This is a more permanent type of adhesion. It usually requires treatment because it doesn't resolve on its own.
Cicatrix adhesion. This occurs when the penis contracts into the pubic pad of fat. It is also called a trapped penis because you will not be able to expose the head of the penis at all.
What Is the Cause of Penile Adhesions?
Penile adhesions happen for a variety of reasons, including:
- Too much foreskin left behind after circumcision
- Not pulling back the foreskin often enough, or a foreskin that cannot be retracted at all
- Fat pushing the penile skin forward
- Diaper rash or other irritation
What Are the Symptoms of a Penile Adhesion?
There are usually no symptoms of penile adhesion besides skin from the penile shaft attaching to the glans (head). If your child has an adhesion, they might feel some pulling when they have an erection. Otherwise, it doesn't usually cause pain. Rarely, an adhesion causes redness or irritation.
You may notice a white discharge called smegma forming under your child's penile adhesion. This is normal and not a sign of an infection. It is a result of dirt, dead skin cells, and oils trapped under the skin.
What Are the Treatments for a Penile Adhesion?
Some penile adhesions go away without any treatment. However, if you do notice one on your child, you should mention it to your doctor.
Treatments include:
Petroleum jelly. This works best for more minor penile adhesions. Your doctor may tell you to apply a small amount of petroleum jelly to the adhesion. This helps soften the skin. As your child gets spontaneous erections, the softened adhesions will break up more easily.
Petroleum jelly is also sometimes recommended after adhesion removal surgery to prevent new ones from forming.
Steroid cream. Other penile adhesions require the application of a steroid cream twice a day for six weeks. This makes the skin thinner, so the adhesions may eventually separate when the penile skin is pulled back during erections or diaper changes.
If you notice the steroid cream is making your child's skin lighter or darker, stop using it and let your doctor know.
Penile adhesion surgery. Penile adhesions that didn't go away with petroleum jelly or steroid cream will need surgery. The procedure is usually done with topical anesthesia. It is performed in a urologist's office in just a few minutes. Your child's urologist will put a numbing cream on your child's penis about a half-hour before the procedure. Then they will separate the adhesion, allowing the skin to retract properly. They may use dissolving sutures or surgical glue to close the incision.
Some larger skin bridges can be cut using the same quick procedures. However, more serious bridges may require a longer surgery in an operating room.
If the cause of the adhesion was circumcision, your doctor might recommend a revision to the original circumcision.
Can You Prevent a Penile Adhesion?
If your child has already had a penile adhesion, your doctor may recommend using petroleum jelly on the penis to keep the skin soft and movable. They will also ask you to retract your child's foreskin a few times each day to prevent new adhesions from forming. This is especially important if your child still wears diapers, because the warm and wet environment can cause adhesions.
