A hood of skin, called the foreskin, covers the head (or glans) of the penis. In circumcision, the foreskin is surgically removed, exposing the end of the penis. Some families choose to circumcise based on cultural or religious beliefs. Others choose to for hygiene or appearance.
With non-vascularized adhesions the foreskin naturally adheres to the head/glans of the penis and sometimes happens again after circumcision. This type of adhesion often resolves without treatment because of natural exfoliation of the skin.
Circumcision is a surgical procedure to remove the skin covering the end of the penis, called the foreskin. In many cultures, circumcision is a religious rite or a ceremonial tradition. It is most common in Jewish and Islamic faiths.
The penis, the outer reproductive organ of the male, consists of two parts — the shaft and the head (called the glans). All boys are born with a foreskin, a layer of skin that covers the shaft and the glans. Some boys are circumcised, and the skin covering the glans is removed.
Circumcision ranks among the world's most common surgeries (and one of the oldest). After its removal, most foreskin is tossed as biological waste — but when they're kept around, the leftover cells have proven a vital asset to medical research.
Normal Circumcision Healing
The scab at the incision line comes off in 7 to 10 days. If a Plastibell (plastic ring) was used, it should fall off by 14 days. 10 days is the average. While it can't fall off too early, pulling it off can cause bleeding.
This is called foreskin retraction. Most boys will be able to retract their foreskins by the time they are 5 years old, yet others will not be able to until the teen years. As a boy becomes more aware of his body, he will most likely discover how to retract his own foreskin.
Smegma should be cleaned frequently in uncircumcised boys by the mother during childhood and by the boy himself later on. Circumcised boys, especially those with excess skin remnants, may have a marked smegma secretion and attention should be paid to clean it as in uncircumcised boys (Fig. 10.19).
The smegma appears as accumulations of opaque-white or yellow substance composed of dead cells and skin oils, which is malodorous [1]. It constitutes the emission of the sebaceous gland that accumulates between the foreskin and the glans [2].
During childhood, the foreskin gradually starts to separate from the glans, so children can start to pull it back. But even at 10 years, the foreskin often can't be fully pulled back because the opening at the end is too tight. The foreskin might not fully separate from the glans until after puberty.
Phimosis is where the foreskin is too tight to be pulled back over the head of the penis (glans). Phimosis is normal in babies and toddlers. It isn't usually a problem unless it causes the symptoms described. Take your child to your GP if they have these symptoms.
It sounds like you are suffering from a phimosis, where the foreskin cannot be pulled back to expose the head (glans) of the penis. This can be caused by a few conditions but most commonly, a skin condition known as BXO (otherwise called lichen sclerosis) is responsible.
Penile adhesions happen for a variety of reasons, including: Too much foreskin left behind after circumcision. Not pulling back the foreskin often enough, or a foreskin that cannot be retracted at all. Fat pushing the penile skin forward.
By age 17, most boys will be able to fully retract their foreskin. Phimosis can also occur if the foreskin is forced back before it is ready. This can cause a fibrous scar to form. This can stop the foreskin from retracting in the future.
Answered by urologist Chris Deibert MD, MPH:
The foreskin should be able to retract readily at all points in life after infancy. It should be able to retract to allow for full erections.
Phimosis is defined as the inability to retract the skin (foreskin or prepuce) covering the head (glans) of the penis. Phimosis may appear as a tight ring or “rubber band” of foreskin around the tip of the penis, preventing full retraction. Phimosis is divided into two forms: physiologic and pathologic.
If there is a fungal infection which is causing mild tight foreskin, it can be treated with a combination antifungal medications and steroid cream. In adults with high blood glucose levels (diabetes mellitus) with phimosis, circumcision is the suggested treatment due to recurrent fungal infection or possible BXO.
In adulthood, the foreskin is normally loose enough to be fully retracted. In this case, the glans (including its root) should be fully exposed. During erection, the foreskin retracts by itself, exposing the entire glans or at least part of it.
What are the main treatments? A doctor can manually retract the foreskin under local or general anaesthesia. You may also be shown how to gradually retract the foreskin after a bath, using petroleum jelly (Vaseline) or some other form of lubrication. But if the problem persists, circumcision may be necessary.
There are a few ways to go about self-circumcision, but it is generally not recommended. The most common method involves using a sharp object to remove the foreskin, but this can be extremely dangerous and result in serious injury. Even if done correctly, there is a risk of infection and scarring.