From the Research
Management of post-circumcision readherence involves gentle retraction of the adhesions during diaper changes or bath time, followed by application of petroleum jelly to prevent recurrence. For mild adhesions, parents should gently pull back the skin from the glans penis 1-2 times daily, applying petroleum jelly afterward to keep the surfaces separated while healing. This approach is typically sufficient for most cases and can be continued for several weeks until the adhesions resolve. Some key points to consider in the management of post-circumcision readherence include:
- Gentle retraction of adhesions during diaper changes or bath time
- Application of petroleum jelly to prevent recurrence
- Use of prescription steroid cream such as betamethasone 0.05% for moderate to severe adhesions
- Referral to a pediatric urologist if adhesions are extensive or persist despite conservative management, as seen in studies such as 1 which demonstrated the effectiveness of topical betamethasone in managing trapped penis, a condition related to post-circumcision readherence. Readherence occurs because the raw surfaces of the recently circumcised penis can heal together if kept in prolonged contact during the healing process. Prevention through proper post-circumcision care with petroleum jelly application until the circumcision site is fully healed (typically 7-10 days) is the best approach to avoid this common complication, as highlighted in various studies including 2, 3, and 4, although the most recent and highest quality study on this specific topic is not directly provided, the principles of wound care and prevention of adhesions are well-established in medical literature. In cases where readherence does occur, a stepwise approach starting with gentle retraction and petroleum jelly, progressing to steroid cream if necessary, and finally considering surgical intervention if all else fails, is a reasonable and evidence-based strategy, considering the potential risks and benefits as well as the impact on morbidity, mortality, and quality of life.