Synechiae of the foreskin
In most boys, after birth, the phenomenon of synechia of the foreskin is found. In other words - fusion of the glans penis and the inner side of the foreskin, which prevents the glans from being exposed. Fusion can be observed from the coronal groove of the glans penis to the opening of the urethra.
This is not a diagnosis, but just a statement of the fact that boys have a kind of protective mechanism that reduces the risk of infection of the preputial sac and the formation of an inflammatory process. Only in a small number of children under three years of age, the head of the penis is completely or half exposed without painful sensations. Usually synechiae in boys does not require special treatment, over time this "problem" is independently resolved.
Under the skin of the foreskin, limited to the adhesions, you can see a sebaceous gland called smegma. With age, up to puberty, with the active production of sex hormones, the skin becomes more elastic and extensible, the adhesions are independently separated under the influence of enzymes of the sebaceous glands and from spontaneous erections, which allows the head of the penis to move out unhindered.
With a favorable course of the process, special medical prescriptions are not required. But situations are known when the accumulation of smegma can cause an inflammatory process. At the same time, there is significant swelling and hyperemia of the foreskin and glans penis. This entails the release of a liquid substance from the opening of the preputial ring, the child experiences pain when urinating, and later the disease develops - balanoposthitis.
Synechial adhesions can contribute to the formation of scars and the risk of cicatricial phimosis. Phimosis is found in both boys, young men and adult men. Narrowing of the foreskin, brings the difficulty of exposing the glans penis. Cicatricial phimosis is possible when the head of the child's penis is exposed, which is hastily produced by the parents. The defect is treated by a surgeon who excises the foreskin.
Boys get rid of synechia until 6-7 years old, this is the period when it becomes possible to completely strip the head of the penis. The indications for the separation of adhesions with the help of a doctor are frequent inflammation, cicatricial phimosis and age 12 years. The elimination of adhesion is carried out under local anesthesia. Sometimes a special probe is used to free the glans penis and the inner layer of the foreskin from the adhesions. To exclude repeated relapse, after the procedure, daily hygiene of the penis is necessary for several days.
The very process of separating adhesions is extremely painful and traumatic, and it can cause complications. Parents cannot solve this natural physiological factor on their own if there is no difficult and painful urination, no edema, redness. No need to delay, develop or rinse at home. You can gently, with light massage movements, wash the flesh with warm water, sometimes using soap.
What should be done with synechia of the foreskin?
Quite often, parents, due to their ignorance of the anatomical and physiological characteristics of the body of little boys, are concerned that the head of the penis is not removed from the son. They rush to the clinic, demanding unreasonable and traumatic manipulation. An experienced specialist will not act rashly and will try to explain the situation during the consultation.
If we consider the formation of the fetus in the intrauterine period, then the development of the preputial sac, that is, the area between the glans penis and the inner layer of the foreskin, begins between the 3rd and 5th months of pregnancy. Closer to the moment of birth, the foreskin closes the head of the penis to the external opening of the urethra, and this condition persists after birth and until the age of three.
Smegma formation (keratinization of epithelial cells) begins at birth or from 3-4 months of a baby's life and is the formation of whitish clusters that shine through the sheets of the foreskin. By adolescence, boys usually begin hormonal changes, the adhesions become loose, which contributes to the free exposure of the glans penis.
Today, pediatric surgeons and pediatric urologists, as a conservative treatment for children over 3 years of age, who have a delay in the removal of the glans penis, suggest using the foreskin stretching technique. The desired result is achieved in 3-5 months.
It is recommended to open the head of the penis every day while bathing without causing discomfort and without causing pain to the baby, rinse with water and close it back so that the head of the penis is not pinched. After carrying out hygiene procedures, the skin is lubricated with baby cream. A careful attitude to the issue of the child's health allows not to waste time and correct the problems in time.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
