What is the cause of penile skin covering and adhering to the glans penis in a 34-year-old circumcised male, particularly when bending over or in certain positions?

From the Guidelines

This issue is likely related to penile adhesions or lichen sclerosus, which can cause the penile skin to stick to the glans, and I recommend gentle retraction of the skin during daily hygiene and applying a thin layer of petroleum jelly to prevent adhesions, as well as follow-up with a urologist or dermatologist for proper evaluation and treatment. The symptoms described, such as the penile skin covering and sticking to the head of the penis in certain positions, can be caused by various factors, including inflammation, minor trauma, or natural healing processes where skin surfaces come into contact 1. According to the British Association of Dermatologists guidelines for the management of lichen sclerosus, patients with active ongoing disease will require long-term follow-up, and symptoms, particularly urinary and sexual, should be assessed and any changes suggestive of disease progression should be biopsied 1.

Some key points to consider in this case include:

• Gentle retraction of the skin during daily hygiene to prevent adhesions
• Keeping the area clean and dry to reduce the risk of infection
• Applying a thin layer of petroleum jelly to prevent adhesions
• Regular gentle stretching during bathing to help prevent progression
• Follow-up with a urologist or dermatologist for proper evaluation and treatment, especially if there's any pain, bleeding, discharge, or difficulty urinating.

It's essential to note that lichen sclerosus can recur after many years, and patients should be aware of the signs of disease recurrence and seek referral to specialist services if necessary 1. In some cases, surgical treatment options such as division of coronal adhesions, frenuloplasty, and glans resurfacing with split-skin grafting may be required, and patients should be offered referral to discuss these options if medical treatment has failed 1.

From the Research

Possible Causes of Penis Skin Covering and Sticking to the Head

• The issue of penis skin covering and sticking to the head, particularly when bending over or in certain positions, may be related to a condition known as phimosis 2.
• Phimosis is a condition where the foreskin of the penis cannot be fully retracted over the glans (head) of the penis, which can cause the skin to cover and stick to the head in certain positions.
• However, since the individual in question is circumcised, phimosis is unlikely to be the cause.
• Another possible cause could be the formation of adhesions or scar tissue between the skin and the head of the penis, although there is no direct evidence in the provided studies to support this claim.

Urologic Disorders and Circumcision

• The provided studies discuss various urologic disorders and the management of circumcision-related complications 3, 2, 4.
• While these studies do not directly address the issue of penis skin covering and sticking to the head in circumcised individuals, they do highlight the importance of proper wound care and management after circumcision to prevent complications such as infection 4, 5.
• The study by 6 suggests that circumcision can decrease the colonization of periurethral bacterial pathogenic flora, which may be relevant to the prevention of certain urologic disorders.

Management and Prevention of Complications

• The studies emphasize the importance of trained and competent practitioners performing circumcision using sterile techniques to reduce the risk of complications 4.
• The use of antibiotic prophylaxis may not significantly reduce the risk of post-circumcision wound infection, as suggested by the study by 5.
• However, the study by 6 found that circumcision plus antibiotic prophylaxis can prevent recurrent and febrile urinary tract infections in boys with low-grade vesicoureteral reflux.