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UPDATED....My long letter to the doctor about penile adhesions...

Posted by on Oct. 28, 2009 at 2:26 PM
  • 14 Replies

Here is the reply I received from my son's pediatrician.  I am impressed how quickly he got back to me.

 

Ms., 

Thank you for your letter and I appreciate the concern that you have.  The penile adhesions that Evan has are very common in infants who have been circumcised.  One recent reference mentioned 71% of infants will have adhesions following this procedure.  There is nothing that really can be done to guarantee that they won't happen.  If you were to forcefully pull the foreskin back to try to prevent the adhesions we may still be in this situation.  Sometimes by pulling the skin back it irritates the tissue and just promotes another adhesion to form.  The standard of care today in Pediatrics is to not force the foreskin back.  In times past this was the recommendation, but the advice has changed.  By pulling the foreskin back you can cause pain, bleeding, increased risk of infection and recurrent adhesions.  If you let the natural process take place, 90+% of adhesions will work their way back on their own by 3 years of age.  At this point, my advice would still be to wait for this natural process to take place and there is no real need for any other concern at this time.

Thank you,
Luke

 

So what do you think ladies?  Should I send it? 

Hello Doctor, 

I just saw you for Evan's six month appointment and wanted to address something I needed to think about a little more concerning his penile adhesions.

After Evan's circumcision I was told to do no other care than put Vaseline on it for diaper changes so it wouldn't stick.  Being a first-time mom, I have never seen a newborn penis before and other than your observation that it was a little "rotated" I assumed it was fine.  I understand now that his circumcision is loose and I would rather it be that way than too much skin taken. However, I really wish I had been instructed on the importance of pulling the foreskin back to help prevent penile adhesions.  With all the things new mothers have to think about, I didn't hear about this and never even knew to do this from the very beginning. In fact, I thought that pulling foreskin back was only important for cleaning an uncircumcised penis.  

I kind of figured it out on my own as time went on that there seemed to be a lot of skin and it was a good idea to pull it back, but it was probably after adhesions had already formed.  I feel guilty for not knowing what to do...but, at the same time, how was I to know?  Books only cover so much and all my close friends have girls.  Now I am told that for "most" babies this will go away on its own as they get older.   

However, I do know that it doesn't go away for all babies and can be a problem.  Now I am concerned about what I (well, Evan) may have to deal with if these adhesions don't "correct themselves".  I guess I have to wait and find out...but considering his penis is already a little "different", it makes me sad to worry about this for him as well.  I end up putting so much faith in the ever-so-popular reassurance that "well, most babies"...and I am overwhelmed by that.  Always holding onto hope that my baby will fall into what is seen in most babies....and knowing we'll have to deal with the consequences if he doesn't.

 

So, the purpose of this letter to you is to ask you a favor.  Please tell all parents that it is important for them to pull the foreskin back (what is left after circumcision) and to put Vaseline there as well with the purpose to prevent adhesions.  I never knew this, so I am sure there are other parents who don't as well.  I know it isn't a guarantee that Evan wouldn't have any if I had known to do this, but at least I would have felt informed on what to look for and proper care.  I just don't want other parents to not be aware of this and find out down the road like I did - after adhesions have formed.  I know that these things "are quite common"...but maybe they wouldn't be so common if doctors knew to tell parents what could happen and the steps to take to make it less likely.  It's too late for Evan - his adhesions will either correct themselves or he will have to go through a possibly painful procedure in the future.  

The reason I felt it important to write this is because I think sometimes doctors forget that new parents really don't know about some of these things - and we trust in you to keep us educated.   

Sincerely

Christy

 

by on Oct. 28, 2009 at 2:26 PM
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Replies (1-10):
lyranightshade
by Ruby Member on Oct. 28, 2009 at 2:31 PM

As a young child, I had vaginal adhesions. My hymen would grow back, and my vagina was almost totally occluded at one point. They had to surgically remove my hymen at the tender age of 7. It grew back, and after my ex and split up, I went so long with no intercourse that it actually grew back. Again. It's fairly common, but I'm sorry your son's going through this. I wasn't aware that most 'grew out of it'. I was told that if left untreated, my entire vagina would grow together and it would need to be surgically seperated. This is part of the reason why I didn't have my son circ'd (no debate starting, just mentioning it played a part in my decision). But even then, awareness of that sort of thing is necessary. I hope your doctor takes your advice. I had no clue about little boys and boy parts when I had my son. He was the first boy in 22 years. It's a trial and error process, if you ask me. Good luck, One on the way! Update us to let us know if your little man is doing ok.

one_on_the_way
by on Oct. 28, 2009 at 2:40 PM


Quoting lyranightshade:

As a young child, I had vaginal adhesions. My hymen would grow back, and my vagina was almost totally occluded at one point. They had to surgically remove my hymen at the tender age of 7. It grew back, and after my ex and split up, I went so long with no intercourse that it actually grew back. Again. It's fairly common, but I'm sorry your son's going through this. I wasn't aware that most 'grew out of it'. I was told that if left untreated, my entire vagina would grow together and it would need to be surgically seperated. This is part of the reason why I didn't have my son circ'd (no debate starting, just mentioning it played a part in my decision). But even then, awareness of that sort of thing is necessary. I hope your doctor takes your advice. I had no clue about little boys and boy parts when I had my son. He was the first boy in 22 years. It's a trial and error process, if you ask me. Good luck, One on the way! Update us to let us know if your little man is doing ok.


 

Thank you for your input and personal story.  The thing that is frustrating to me is that I was the one that had to bring this up.  I had taken my son to the ER a couple weeks ago and the pediatrician on call, AFTER examining my son, asked me if he was circumcized.  I thought that was a strange question for a pediatrician (who sees baby penises all the time) to ask.

After looking into things I found out that he probably has a "loose" circumcision (I just thought it looked that way because he's not a "man" yet, but a baby...but apparently I was wrong).  Then I read that loose circumcisions can possibly lead to adhesions.

So, today I told my son's pediatrician about the question the other doctor had and he found that strange as well (he was like "what, he couldn't tell?" - my thoughts exactly).  So then he checked him over and said, "Well, he does have quite a bit of foreskin and a small amount of adhesion.  We don't pull those back anymore as they usually correct themselves on their own.  We'll just keep an eye on it".  I was thankful for him to not pull it back because that can be excruciating (from what I've read from other parents who's babies have gone through this).  In fact, if he said he wanted to I would have told him NO...and decide to set up an actual procedure or something.

I'm just pissed that I never knew about all this -- and that I was the one to bring it up.  Would he have even said anything about the adhesions it if I wasn't concerned?  I didn't even know my son actually HAD adhesions...I just knew they COULD happen.  And then he tells me he does.  Grrrr.  My poor baby.

Laura1229
by on Oct. 28, 2009 at 2:49 PM

That totally sucks!  I thought ALL doctors sent home a "care sheet" that includes a little "things to look for" section.  Looks like someone dropped the ball on this one.

Just a "btw".... just in case you have another boy & decide to leave him intact..... (since you've already discovered some drs are morons!!  LOL), you don't retract the foreskin on an uncircumcised penis.  That can lead to serious problems.

one_on_the_way
by on Oct. 28, 2009 at 3:05 PM


Quoting Laura1229:

That totally sucks!  I thought ALL doctors sent home a "care sheet" that includes a little "things to look for" section.  Looks like someone dropped the ball on this one.

Just a "btw".... just in case you have another boy & decide to leave him intact..... (since you've already discovered some drs are morons!!  LOL), you don't retract the foreskin on an uncircumcised penis.  That can lead to serious problems.

Thanks...I wonder why you don't on an uncircumcised penis?  How do you clean it properly?  I guess I can leave that part out of my letter (the part where I said I thought you only had to do that with uncircumcised penises...don't want to look completely stupid for the doctor!) 

Also - with all the "care sheets" I hope I didn't just miss it.  I am an information junkie (sometimes to my detriment) and read ALL the things that are sent home with me.  I hope there wasn't something that said to do this - but I'm pretty sure there wasn't.  Besides - verbally he and the other staff simply said "put vaseline on it so it won't stick to the diaper until it heals" - otherwise to "leave it alone". 

BoxerMomma
by on Oct. 28, 2009 at 3:07 PM

They pulled back my sons and it was not fun at all.  They used a qtip to open up my daughter once and that wasn't fun either.  I was never informed to keep a check on either of them.

Quoting one_on_the_way:

 

Quoting lyranightshade:

As a young child, I had vaginal adhesions. My hymen would grow back, and my vagina was almost totally occluded at one point. They had to surgically remove my hymen at the tender age of 7. It grew back, and after my ex and split up, I went so long with no intercourse that it actually grew back. Again. It's fairly common, but I'm sorry your son's going through this. I wasn't aware that most 'grew out of it'. I was told that if left untreated, my entire vagina would grow together and it would need to be surgically seperated. This is part of the reason why I didn't have my son circ'd (no debate starting, just mentioning it played a part in my decision). But even then, awareness of that sort of thing is necessary. I hope your doctor takes your advice. I had no clue about little boys and boy parts when I had my son. He was the first boy in 22 years. It's a trial and error process, if you ask me. Good luck, One on the way! Update us to let us know if your little man is doing ok.


 

Thank you for your input and personal story.  The thing that is frustrating to me is that I was the one that had to bring this up.  I had taken my son to the ER a couple weeks ago and the pediatrician on call, AFTER examining my son, asked me if he was circumcized.  I thought that was a strange question for a pediatrician (who sees baby penises all the time) to ask.

After looking into things I found out that he probably has a "loose" circumcision (I just thought it looked that way because he's not a "man" yet, but a baby...but apparently I was wrong).  Then I read that loose circumcisions can possibly lead to adhesions.

So, today I told my son's pediatrician about the question the other doctor had and he found that strange as well (he was like "what, he couldn't tell?" - my thoughts exactly).  So then he checked him over and said, "Well, he does have quite a bit of foreskin and a small amount of adhesion.  We don't pull those back anymore as they usually correct themselves on their own.  We'll just keep an eye on it".  I was thankful for him to not pull it back because that can be excruciating (from what I've read from other parents who's babies have gone through this).  In fact, if he said he wanted to I would have told him NO...and decide to set up an actual procedure or something.

I'm just pissed that I never knew about all this -- and that I was the one to bring it up.  Would he have even said anything about the adhesions it if I wasn't concerned?  I didn't even know my son actually HAD adhesions...I just knew they COULD happen.  And then he tells me he does.  Grrrr.  My poor baby.


butterflyblu
by on Oct. 28, 2009 at 3:51 PM

I think it's a good idea to inform parents to look out for this.  I never knew much about it and after my son's circumcision, the doctor said nothing about that, nor was it ever mentioned by his pediatrician.  Thankfully, he has never had an adhesion and I check to make sure that nothing is reattaching.  I don't do anything special as far as care though.  He does have some extra skin, but that's normal since he's still growing.


 


           

sallymoon
by on Oct. 29, 2009 at 11:27 AM

You do not pull back the foreskin of a baby who has been left intact because at birth the foreskin is attached to the glans as a protective function.  It can take several years, sometimes until puberty, for the foreskin to naturally separate and become retractable.  Until natural separation occurs, you just gently wipe off the outside ("only clean what is seen").  It makes diaper changes really, really easy.  Pulling back the foreskin of an intact boy before natural retraction is possible is much like pulling off a scab before it is ready to fall off - it can cause pain, bleeding, infection, and scarring.  The majority of issues that intact males have are caused by or related to forced retraction in infancy or early childhood.  Once the foreskin becomes easily retractable, the male just has to gently pull it back at shower time and rinse underneath (soap can cause irritation, like it can to the vagina).

Quoting one_on_the_way:

 

Quoting Laura1229:

That totally sucks!  I thought ALL doctors sent home a "care sheet" that includes a little "things to look for" section.  Looks like someone dropped the ball on this one.

Just a "btw".... just in case you have another boy & decide to leave him intact..... (since you've already discovered some drs are morons!!  LOL), you don't retract the foreskin on an uncircumcised penis.  That can lead to serious problems.

Thanks...I wonder why you don't on an uncircumcised penis?  How do you clean it properly?  I guess I can leave that part out of my letter (the part where I said I thought you only had to do that with uncircumcised penises...don't want to look completely stupid for the doctor!) 

Also - with all the "care sheets" I hope I didn't just miss it.  I am an information junkie (sometimes to my detriment) and read ALL the things that are sent home with me.  I hope there wasn't something that said to do this - but I'm pretty sure there wasn't.  Besides - verbally he and the other staff simply said "put vaseline on it so it won't stick to the diaper until it heals" - otherwise to "leave it alone". 



Not.So.Virginal
by on Oct. 29, 2009 at 11:30 AM

its good to take your concerns to the doctor... however, do NOT pull the foreskin back. That could make things a LOT worse..... even with an uncirced penis you don't pull it back


masesmom
by Silver Member on Oct. 29, 2009 at 11:37 AM

when my first was born i had a heck of a time keeping his skin from adhering down there. i was constsntly having to pull the skin apart.  In the end i failed and a good part had reattached.  hes now 4 and theres no sign of it healing itself.  but it doesnt seem to affect him, and doc says its nothing more than cosmetic, but i cant help but feel like i let him down.  I had no trouble at all with my second child, infact i was almost obsesive in making sure it didnt reattach.  how old is your LO??

Kasie85
by on Oct. 29, 2009 at 11:44 AM

You know I thought I was crazy to worry abou tmy sons penis so much. After he had his curcumsicion I was paranoid. The ped he goes to is a big group of dr. so sometimes we would have to see different ones and each time I saw someone different I would make them look at it. Just to make sure. At one point the skin started attatch itself back and they just popped it back. It was like OMG what did you do but after that I made sure that every time he was changed I made sure to check it. Well he's 2 1/2 now and FINALLY everything seems to be right. I think. lol But you are absolutly right about no one really informing me on the whole process. Nom Im pregnant with boy # 2 and my first thought (besides being excited or course) was Oh JEEZ not the whole penis drama again. Good luck with everything :)

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