Penile adhesions develop frequently after circumcision. Up to 71% of circumcised boys develop adhesions, although they are usually mild and very rarely require treatment. Most adhesions will release in their own in time, and the current recommendation is to leave them alone. If your son develops adhesions, it does not mean that the circumcision was botched, nor are they an indication for recircumcision. The following resources should provide reassurance and empower you to ensure your son's adhesions are not unnecessarily released manually (lysed, or 'torn back') by a well meaning-but inadequately informed-care provider.
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."
"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."
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."
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."
"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."