Adhesions (circumcision adhesions) - Mothering Forums

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#1 of 6 Old 01-31-2007, 06:39 PM - Thread Starter
 
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Oh, how do you deal with this.... keep in mind that in formulating a resonse I have to comply with certain guidelines against speaking out against circumcision.

This is a mother dealing with circumcision adhesions, I'm paraphrasing as required. I already posted the links and information from the recent adhesions post that came up here (basically that the AAP recommends leaving alone, and this is a common occurance, and a re-circ is unnecessary) to try to help, but she went back to the doctor this morning and the doctor ripped the adhesions.

Background:
son is 7 months old and is circumcised.
problem is the skin on his shaft reattaching to the head.
They still having to keep Vaseline on it.
It will reattach even if missed at one diaper change
Someone else watched the baby and didn't use Vaseline

Every time mother goes to ped he has to "fix" it by gently pulling the skin back down
Poor baby screams bloody murder

Baby is a bit chunky down so maybe that is half the problem?
Wonders if the doc who did it not take off enough skin?
The last time mother went to the ped I asked and he said basically he will grow out of it.

Posting an update after today's appointment

The ped "fixed" the problem, by pulling down the skin and seperated it.
He basically said, like he always says, that it is better he do it now rather than later.
Ped explaining how he had do to a recirc on a 5 year old becasue the parents didn't want to fool with pulling the skin down etc. and the boy is now so scared and timid. Poor thing.
Pedi did however say that if I choose to leave it alone he will be just fine.
(contradiction, but wait, then the pedi says......

He will be able to have "relations" but when he starts to have erections it can be painful and therefor son may not tell parents because of embarrasement.

Mother decided that she needs to have him fix the problem should it happen again, but will avoid the adhesions reforming (vaseline, etc)

Further information and we find out that she didn't research and doctor didn't tell her any information either, and some posters wanted to know what type of circ, because maybe if a certain type of method leads to more adhesions, less people would use that method.

Mother says, "I don't know what type of circ he had, to be honest I had no idea there was several types. I never did research because for me getting a circ was the "thing" to do KWIM? I wonder if there is a way to find out?"

And then the pedi explains to the mother that the same thing can happen to girls. Where the labia will fuse together just like penile adhesion.
-----------------------

Where do you even start?

Jessica

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#2 of 6 Old 01-31-2007, 06:54 PM
 
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I don't know if this would help, but just one experience. The boy I nanny had adhesions all the way around his penis. We left it completely alone and last week I noticed that they were almost all gone (he is 16 months). Nothing tramatic about that.
My heart aches for that little boy. He has to endure being abused over and over and yet it's "ok" and "just what you do." My nephew went through the same thing and it's what actually drove me to look into circ. Even though I didn't know, I feel horribly guilty for holding him down while they "cleaned" it (I didn't look at what they were doing, but I now know they were tearing it apart. I just remember his histerical screams) :

Mama to my little social butterfly 6/13/09

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#3 of 6 Old 01-31-2007, 07:18 PM
 
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I'm not the expert (I'm sure they'll be by soon...) Isn't this just the equivalant of the remainder foreskin trying to do what it is supposed to? Why is the thing to separate? Sounds like forced retraction on top of everything else... I did check out this top recently on Dr. Sears and he also seems to advocate this ripping apart thing but also said if it is really resistant, to let it alone and revisit when they are older. Which to me sounds like it is the remainder of the foreskin doing what it is supposed to and once the child is older (like natural retraction) the adhesions will go away...

Ange. Mama to boys. Yup. All Boys. All Intact. A bunch of other NFL, crunchy credentials too.
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#4 of 6 Old 01-31-2007, 07:20 PM
 
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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

---

You could also find some resources on betamethasone cream/adhesions.

She could request the medical records from the circumcision to determine the method of circumcision performed if she really wants to know.

Jen
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#5 of 6 Old 02-01-2007, 12:06 AM
 
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My mother said it was a losing battle to try and keep the adhesions from re-forming; they would do so inside of a day's time. From my perspective, I would leave them alone if she can't keep them from re-forming. I think all the constant re-separating was nothing but regular torture that resulted in a build-up of scar tissure that basically obliterated about 2/3 of the coronal ridge of my glans. And for the love of God, I hope she does NOT think she can fix it by having the child re-circ'd. I think there's a tendency for doctor's to go overboard when they do, and then that child will have even worse problems...i.e. tight, painful erections, possible buried/trapped penis.

I wonder if any of this dawns on circ'ing parents how much it flies in the face of their expectations of a pretty, maintenance-free penis....:
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#6 of 6 Old 02-01-2007, 01:09 AM - Thread Starter
 
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Jen sorry for your repost-- your post was the one that I was referring to on the current threads that I had taken information from and posted.

She did get some information on the stretching cream but I think she's going to use vaseline and try to go that route... hopefully this would stop the readhearance so the doctor won't ever rip again.

The update is that she made a comment on umbilical cord care (how they didn't tell her to put alcohol on it till the day they left the hospital) and I replied, lol that my drs' told me to do nothing.

She replied something along the lines of... See, bet you can tell I'm a first time mom because I've just learning that if you ask 2 doctors a question you'll get 2 answers.

Sigh.... and she did comment that at least she'll know for baby #2 what to do/not to do, but unfortunatly since she's on that kind of board she'll never know about the option to do nothing.

And she still hasn't figured out that she needs to take charge herself.

At least she is angry that the doctors didn't tell her the infor ahead of time- nor did they give her proper after-care information.

Grrr..

Jessica (treading carefully in the Lion's Den)

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