Monday, March 4, 2013

Complication, risk or benefit of circumcision: Adhesions - AKA skin bridges

One common complication of circumcision are adhesions. Adhesions occur because the remnant of the foreskin tries to heal and in the process it may become adhered to the glans, becoming a skin bridge. This is not only a cosmetic problem, but it can also cause pain during erections and sex.

The American Academy of Pediatrics on their technical report on circumcision (released August 27th of 2012) state that:

Late complications do occur, most commonly adhesions, skin bridges, and meatal stenosis. There are 2 schools of thought regarding the cause of penile adhesions, which are common after circumcision. One is that fine adhesions represent incomplete lysis of physiologic adhesions at the time of circumcision; the other is that the fine adhesions occur because of raw serosa surfaces. It is unknown how often these late complications require surgical repair; this area requires further study.


In 1 outpatient-based study of 214 boys with poor evidence, the complications seen included adhesions (observed in 55 boys [25.6%]), redundant residual prepuce (44 boys [20.1%]), balanitis (34 boys [15.5%]), skin bridge (9 boys [4.1%]), and meatal stenosis (1 boy [0.5%]).76


There is good evidence that circumcision of a premature infant is associated with an increased risk of later-occurring complications (ie, poor cosmesis, increased risk of trapped penis, adhesions). There is also good evidence that circumcision of a newborn who has a prominent suprapubic fat pad or penoscrotal webbing has a higher risk for the same long-term complications.187 One prospective study with fair evidence examined the natural course of penile adhesions after circumcision and found that adhesions disappeared at some point 6 months postcircumcision without intervention, except for thick adhesions (called “bridging adhesions”). The authors recommended lysis for skin bridges.188

Had you heard about adhesions or skin bridges? Many families find that they have to deal with these and this often means sedation and surgery. Check this link:

And exactly what an adhesion or bridge looks like? Check

And if this is too upsetting to see, maybe babies should not be exposed to this risk!

But again, the AAP stated in August 27th that the benefits of circumcision outweigh the risks. Perhaps adhesions are another benefit - for the doctor who has to perform the additional surgery.

No comments:

Post a Comment