Q & A off AAP site

November 29, 2006

Off the Amer. Academy of Pediatrics site:

Q.

My circumcised 2-year-old son has been having a problem with penile

adhesion for over a year. Some doctors tell me to pull the excess skin

back on a regular basis, and others tell me not to do it at all. Is

this a common problem in little boys? Does he need another circumcision?

A. Sometimes after a routine newborn circumcision, excess foreskin

remains. Since newborn circumcision is not medically necessary, it's

certainly better to leave a little extra than to take off too much and

damage the child's penis.

Adhesions between the glans and foreskin are normal in infants and, by

age 1, only half of the boys have retractable foreskin. Never try to

forcibly strip the foreskin back because that's unnecessarily painful

and may cause a raw surface and subsequent scarring. Any small, whitish

lumps beneath the foreskin only represent normal skin shedding and need

not be removed.

By the time he's 4 the adhesions should release on their own, and he

can be taught to retract any remaining foreskin while bathing.

So, it's a common occurrence in little boys for adhesions to develop

under any remaining foreskin, although it's rarely a problem and

practically never requires a repeat circumcision.

For more information about circumcision and related resources, visit

your doctor's Web site on the Medem network. Feel free to visit Medem

for additional information.

Dr.

Gil Fuld is a pediatrician at Dartmouth-Hitchcock Keene, a

multispecialty group practice in Keene, NH. He has been a primary care

and developmental pediatrician in this group since 1971 and is a member

of the adjunct pediatric faculty at Dartmouth Medical School. A past

president of the New Hampshire Pediatric Society, he served six years

as District I Chairperson and on the Board of Directors of the AAP. He

also is the AAP representative to the Medem Editorial Advisory Board.

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