I'm back, looking for some more info. about adhesion

[cornflower_3]

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[Yoshua]

I never inspected my brothers penis but he also had a botched Circumcision.


I guess that my mom broke in and ripped him out of the straddle or something, she has a dramatic story about it and before you start saying 'go mom' he is older than me and the second time around she left the hospital so she wouldnt hear me cry.

Anyways. on to the relevant information.


I guess I am told that he had a piece of the forskin that was not cut so there was anover hang on to his glans at one point. He never had it corrected but I do not get the impression that the piece of skin was very large.


How is the circ healing? Is it infected? does he look deformed now?

Not a dr here, but my brother performs perfectly normal, if not better than normal if you ask his string of ex's and he has a botched circumcision and is now 27.


oh, an glad ta see ya around again cornflower.

[LeosMama]

I don't have anything medically useful to add.

But about the without consent part: Tell her to get a lawyer. The original doctor's malpractice insurance needs to pay for any reconstructive surgery the boy may need. This boy was mutilated illegally (most RIC mutilations are legal in this country) and the family should punish the doctor for this.

[cornflower_3]

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[Bm31]

From my personal experience, the absolute LAST thing she should do is consent to a re-circ.

[pdx.mothernurture]

If they don't have a consent form signed, she has a case and I don't think it would take a lot to win it...please, please, please have her contact arclaw or nocirc for a local referral.

http://www.arclaw.org/

http://www.nocirc.org/

If he's having complications and possibly facing additional surgery, that's all the more reason to sue.

Jen

PS. Some adhesion info:

J Urol. 2001 Mar;165(3):915.

Penile adhesions after neonatal circumcision.

Ponsky LE, Ross JH, Knipper N, Kay R.

Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

“In these groups we noted an adhesion rate of 71%, 28%, 8% and 2%, respectively. The rate of adhesions more severe than grade 1 was 30%, 10% and 0% in boys 12 months old or younger, 13 to 60 and 61 months old or older, respectively. The oldest patient with grade 3 adhesions was 31 months old. Skin bridges in 6 cases involved the circumcision line in 4.”

"CONCLUSIONS: Penile adhesions develop after circumcision and the incidence decreases with patient age. Although there is debate on whether to lyse these adhesions manually, our findings suggest that adhesions resolve without treatment. Based on our results we do not recommend lysing penile adhesions, except perhaps those involving the circumcision line."

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

“Penile adhesions occur frequently after circumcision. Some physicians advocate manual lysis of the adhesions. This procedure can be painful and traumatic. Penile adhesions are normal in uncircumcised boys and normally resolve without treatment.”

http://www.kidsgrowth.com/resources/...il.cfm?id=3420

Gil Fuld, M.D., F.A.A.P.

“Sometimes after a routine newborn circumcision, excess foreskin remains. Since newborn circumcision is not medically necessary, it's certainly better to leave a little extra than to take off too much and damage the child's penis.”

“So, it's a common occurrence in little boys for adhesions to develop under any remaining foreskin, although it's rarely a problem and practically never requires a repeat circumcision.”

http://www.medem.com/medlb/article_d...NC&sub_cat=474

Vincent Iannelli, M.D.

“It isn't really normal, but is a common complication after a circumcision. In a situation like this, penile adhesions form when the skin on the shaft of the penis attaches itself to the glans or head of the penis. In extreme cases, it can look like the child was never even circumcised, leading parents to believe that the child had a 'bad circumcision.'”

“If the skin is attached only on the very base of the glans, then your child has a very mild case of penile adhesions and you can likely just leave it alone. It should eventually separate, especially once your child becomes older, and anyway, forcing it apart would be painful.”

http://pediatrics.about.com/od/weekl...l_adhesion.htm

“The foreskin will almost always detach itself in time as a boy develops. It should not be forcibly retracted. This may lead to scarred adhesions that will not detach without surgery. Penile growth is not usually influenced by adhesion of the foreskin to the glans penis.”

http://www.henryfordhealth.org/19160.cfm

[Quirky]

She should leave the adhesion alone. Don't let them lyse (separate) it or recirc. That will only make a bad situation worse. It should release over time.

She should definitely get the records from the hospital stay (and talk to a lawyer about how to do this). Even if she doesn't want to sue now, her son will have a two- to three-year window of opportunity to sue himself when he turns 18 and she should have all his records for him. She should also write down and notarize a statement now of everything she recalls that did and didn't happen. (This is why she should consult with a lawyer, so they can tell her what details she needs to fill in.) It will be much more credible to have her current recollection than it will be in 18 years when she might not recall the facts and context so well. Also, something might happen to her in the next 18 years, and she needs to get her story in writing now in case it does.

[cornflower_3]

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[Frankly Speaking]

Originally Posted by cornflower_3

I just got of the phone with a good friend who lives in the same area I do. We had never had a circ. conversation before, but today it came up. Anyway, her son was circed, without her consent, in the local hospital, and they botched it.

I agree with others. We have one of the pre-eminet circumcision lawyers in the US here as a member. Look up "Dave2GA." His name is David Llewellyn. If there is no consent form signed by her or her husband, it's going to be a slam-dunk case. The circumcision will be in her son's medical records and the doctor's and hospital's malpractice insurer is going to want to settle the case rather than go to court. It would mean that this would consume little of her time or resources. She should use a lawyer like David who is well experienced because he will know how much settlement will be swallowed by the insurance company without going to court. If you have any problem finding where David posted his address, phone number or e-mail address, PM me and I'll have it for you.

Now, on the adhesion . . . If it doesn't involve the circumcision scar, tell her not to worry about it. It will disolve when her son is around 3 or 4 years old all on it's own. If it does involve the circumcision scar, it will need to be lysed or pulled or cut apart some time during his life. A circumcision is definitely not needed or desired to resolve this problem. He could end up with far worse problems if she allows him to be circumcised again.

She should absolutely not use the steroid. It's to stretch the preputial sphincter and that's been cut off.



Frank

[LeosMama]

My understanding is that using a steroid cream on a young child will do no good. The adhesion may release, but then it is likely to readhere after treatment is discontinued. If she waits for it to release on its own during the child's normal course of development, then it will be a permanent resolution.
Basically, there will come a developmental time when the body sloughs enough skin in between the foreskin and the glans and will separate the two parts. Until that time, the body is treating them like connected tissues. If you separate your nail from the bed, it will reattach, it is meant to be attached to the nail bed.
Once the body is developmentally ready for the foreskin to separate from the glans, it will likely do so. If it does not separate by mid- to late-puberty, then a steroid cream may be indicated and useful.

I hope that made sense: if you use the cream too soon, the adhesion will likely readhere. If you wait, it may separate on its own. Failing separation without help, at a more mature developmental phase, the adhesion will respond better to the steroid cream because the body will stop trying to re-adhere the two pieces of skin.

It's a maturity thing. Babies have adhered foreskins. Adults do not. There is a wide range of normal in there, but it's a good generalization.

HTH, and that if I've gotten any details wrong, somebody more knowledgeable will correct me.
-Lindsay

[cornflower_3]

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[Yoshua]

other than a larger scar as well as a circ that will be tight as hell?


those should be reason enough, the scar on a mans penis from a circumcision, well at least mine, is almost completely numb to feeling. I have a ring around my penis that has little to no feeling except where it comes in contact with where the frenulum would be.


cant speak much more than that, not to mention all the normal complications with a cosmetic surgery, all the reasons you shouldnt have a circ in the first place. and there are little to no reasons, in fact i think no reasons have been listed for a good reason to re circ for this reason?

just my 2 cents, wish I had more info and reasons.


death is a possiblity of every surgeries, not to mention this hospital may be trying to get her to sign a consent form to prove she was originally good with having a circumcision done in the first place?

no one has put that out as a possible reason for them pushing the circ so heavily.

[Frankly Speaking]

Other than the usual complications of surgery, there is a considerably heightened risk of degloving, (removing too much and denuding the penis) and buried penis syndrome. In circumcised adults, it is common to have penises that curve in one direction or the other because the skin has not been evenly removed. It is also very common that there is not enough penile shaft skin and a considerable portion of the penis is held in the pubic mound. Men who are restoring commonly report gains in erectile length of 3/4" to 1" and occasionally as much as 1 1/2". Some men are so tightly cut that their skin rips during intercourse.


Frank

[cornflower_3]

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[Frankly Speaking]

Absolutely! That "excess" foreskin will serve him well as an adult. It will give him enough skin to reach his full erectile potential. It will in no way keep his penis from growing. The adhesions usually release on their own around 3 or 4 years old and the remnant foreskin will retract permanently behind the glans and then they will have the cosmetic result they seem to find so vitally important.



Frank