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Urology/skin attachment

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Expert: Arthur Goldstein, M.D. - 11/9/2009


Question

penis
My 9 month old son was circumcised at birth but I am concerned that it may not have been done correctly. The skin has attached itself to the head of his penis to the point that there is no separation or ridge behind the head of his penis. I have asked my doctor a few times if this was correct and she said it was not a problem. What is your opinion? If it is a problem is it correctable at this point and what would be the procedure.  

Answer
Larry, there is a normal anatomical groove behind the head of the penis (glans) which is termed the coronal sulcus.  In the first stage of a circumcision, the foreskin is retracted and the soft adhesions that obliterate this sulcus are separated.  Then the excessive foreskin (prepuce) is excised.  The cut end of the foreskin should then be manually retracted on a daily basis to expose the coronal sulcus until healing is complete (usually 2-3 weeks).  If not done, the raw cut edge of the foreskin can stick to the glans penis and again cover over this sulcus.  Also trapped in the sulcus are sweat glands and as there is no escape for their secretions, they may accumulate and possibly get infected.  Recurrent adhesions are a common problem that is not serious and generally easy to cure.  This is accomplished by  a minor procedure that the doctor can often do in the office called lysis of adhesions.  If the adhesions are still soft, they can usually just be pulled back manually to expose the sulcus.  If too dense for this, they occasionally require anesthesia (local or general depending on the circumstances) and sharp separation.  Regardless, retracting the foreskin daily until healed is necessary to prevent recurrence.  Take your son to a urologist for evaluation and treatment.  Good luck.
    Questioner's Rating
    Rating(1-10)Knowledgeability = 10Clarity of Response = 10Politeness = 10
    CommentThank you Doc for your expert advise. It makes me feel better to know what I need to do now. I will get an appointment ASAP to see what can be done. Thanks again. Larry


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Arthur Goldstein, M.D.

Expertise

Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

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