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Penile adhesions occur when a part of the foreskin adheres to the penis head or glans. While there is much discussion regarding the role circumcision has in their development, the frequency of penile adhesions is approximately equal in circumcised and uncircumcised boys. Most occurrences are reported during youth, although grown men may also develop them. Fortunately, penile adhesions do not adversely affect overall health, though they can be problematic if not treated properly.

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How Do Penile Adhesions Form?

When a male embryo develops, the skin of the glans fuses with the prepuce or shaft skin. Over time, these fused layers begin to separate. This is a natural occurrence and can take anywhere from a few months to several years. Upon completion of this process, the glans and the shaft skin or foreskin become two separate anatomical parts. However, if these two layers do not maintain separate mobility, they may grow back together and form penile adhesions.

Penile adhesions form ninjaMonkeyStudio / Getty Images
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What Causes Penile Adhesions in Uncircumcised Males?

In uncircumcised males, the shaft skin must be moved away from the glans manually, a process known as retraction, during the time it takes for the two layers to completely separate. Failing to do this consistently and until the process is complete will lead to the two layers of skin eventually growing back together.

uncircumcised Penile adhesions males RichLegg / Getty Images
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What Causes Penile Adhesions in Circumcised Males?

In circumcised males, the process hastens the total separation of these two layers of skin. The process requires the doctor to manually move the shaft skin away from the glans to prevent reattachment. Also, if the shaft skin was inadequately removed during circumcision, that excess skin can reattach to the glans and create penile adhesions. Finally, the penis may get trapped between the surgical area of the circumcision and the group of fatty cells at the pubic area, restricting the shaft skin from moving and eventually causing its reattachment to the glans.

Penile adhesions circumcised
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Glanular Adhesions

There are three basic types of penile adhesions: glanular, skin bridges and cicatrix. Glanular adhesions occur when the shaft skin covers the glans. It is identifiable as a glanular adhesion when the shaft skin covers the purple ring around the glans, the coronal margin. These types of adhesions are usually benign and at-home treatment can resolve them if they do not naturally correct.

Penile adhesions glanular ericsphotography / Getty Images

Penile Skin Bridges

When penile adhesions become so dense that a thick connection of skin forms between the shaft skin and the glans, the condition is known as a skin bridge. These are more serious than glanular adhesions and do not resolve naturally or respond to at-home treatment. Most often, the removal of skin bridges requires intervention by a doctor, typically a urologist.

penile skin bridges Penile adhesions

Cicatrix

Cicatrix is the medical term for when the penis gets caught between the group of fat cells in the pubic region, the pubic fat pad, and the surgical area of the circumcision. This occurs when the pubic fat pad grows so large that it traps the penis between it and the surgical area when the latter contracts. The penis becomes "hidden" and shaft skin movement is restricted until it eventually re-attaches to the glans.

cicatrix Penile adhesions

Symptoms of Penile Adhesions

The symptoms of penile adhesions can vary. They are visible without the need for special equipment, and in cases where the penis is buried within the pubic fat pad, the mere presence of that issue is indicative of the adhesions. While there is usually no pain associated with penile adhesions, pain could develop during erection, when the skin is aggressively pulled by the growth of the penis. If the adhesions are severe enough, the penis may develop a curvature. Often, a white substance called smegma indicates the condition; this combination of oils and dead skin cells accumulate under the adhesions.

symptoms of Penile adhesions vchal / Getty Images

Treatment Options for Penile Adhesions

If not naturally resolved, treatment for glanular penile adhesions can most often be carried out at home. Usually, the movements of spontaneous erection and the growth of the penis are enough to separate the adhesions. Retraction with the aid of numbing creams or petroleum jelly will also separate the tissue if done consistently and throughout the process of separation.

treatment options Penile adhesions

Surgically Repairing Penile Adhesions

When penile adhesions become too dense or problematic, they may require surgical removal. This is often a doctor's office procedure; after applying numbing cream, the doctor makes an incision at the point of connection. In some cases, an entire recircumcision is necessary. In the most severe cases, usually with older boys and adult males, surgery under anesthesia may be necessary to separate the fused skin.

surgically repairing Penile adhesions

Preventing Penile Adhesions

Whether circumcised or not, parents can take steps to prevent the formation of penile adhesions on their baby. In uncircumcised males, retracting the shaft skin from the glans regularly throughout the separation process is a must, as is maintaining good personal hygiene. In circumcised males, parents should ensure appropriate post-surgical care, including applying topical creams and doing manual retractions continually during the healing process.

preventing Penile adhesions

Disclaimer

This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.