From the Research
Penile adhesions in pediatric patients are best managed by pediatric urologists, who may recommend a combination of topical steroid therapy and manual retraction, with surgical intervention reserved for severe cases that do not respond to conservative treatment 1.
Treatment Approach
The treatment of penile adhesions in children depends on the severity of the adhesion. Mild cases may resolve with gentle retraction during bathing and application of petroleum jelly or other emollients. More significant adhesions might require manual separation under local anesthesia in the office setting.
- Topical steroid therapy, such as betamethasone cream, has been shown to be effective in managing penile adhesions, with a success rate of 79% in one study 2.
- Manual retraction, either at home or in the office, can also be effective in resolving adhesions, especially in cases where the adhesion covers less than 50% of the glans penis 1.
- Severe cases, or those that do not respond to conservative treatment, may require surgical intervention under general anesthesia.
Specialist Care
Pediatric urologists have specialized training in genital conditions and are better equipped to evaluate and treat penile adhesions. They can also evaluate for other conditions that might be present, such as phimosis or balanitis, and provide comprehensive management.
- The choice of specialist is important because pediatric urologists have specific expertise in the anatomy and development of male genitalia in children.
- Parents should avoid forceful retraction of the foreskin, as this can cause pain, bleeding, and scarring.
Evidence-Based Recommendations
The most recent and highest quality study on the topic, published in 2022, suggests that conservative management of post-circumcision adhesions is not effective over a 6-month time frame, with the great majority of patients eventually undergoing lysis of adhesions (LOA) in the office 1.
- This study found that the effectiveness of home therapy varied depending on the severity and extent of adhesions, with patients whose adhesions covered less than 25% of the glans penis having the greatest likelihood of improvement.
- The study's findings suggest that LOA might be better suited for patients with more severe adhesions.