Synechia: Difference between revisions

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==Penile synechia in childhood==
==Penile synechia in childhood==


[[Jakob Øster| Øster]] (1968) was a school physician in [[Denmark]] where boys are not usually [[circumcised]]. Øster conducted regular examinations of school boys from age 6 through age 17 and recorded his results. Øster reported that 63% of 6-7 year old boys; 48% of 10-11 year old boys; and 3% of 16-17 year old boys had a prepuce that was not fully separated.<ref name="Øster1968">{{REFjournal
[[Jakob Øster| Øster]] (1968) was a school physician in [[Denmark]] where boys are not usually [[circumcised]]. Øster conducted regular examinations of school boys from age 6 through age 17 and recorded his results. Øster reported that 63% of 6-7 year old boys; 48% of 10-11 year old boys; and 3% of 16-17 year old boys had a prepuce that was not fully separated.<ref name="Øster1968">{{OesterJ 1968}}</ref> The separation and breakdown and the synechia is natural, normal, spontaneous, and requires no special care. Thorvaldsen & Meyhoff (2005) report about 50 percent of boys can retract their [[foreskin]] by age 10.4, thus confirming Øster's report.<ref name-"thorvaldsen2005">{{REFjournal
|last=Øster
|first=Jakob
|init=J
|title=Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys
|journal=Arch Dis Child
|date=1968-04-01
|volume=43
|issue=
|pages=200-3
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2019851/pdf/archdisch01557-0066.pdf
|quote=
|pubmedID=5689532
|pubmedCID=2019851
|DOI=10.1136/adc.43.228.200
|accessdate=2019-10-08
}}</ref> The separation and breakdown and the synechia is natural, normal, spontaneous, and requires no special care. Thorvaldsen & Meyhoff (2005) report about 50 percent of boys can retract their [[foreskin]] by age 10.4, thus confirming Øster's report.<ref name-"thorvaldsen2005">{{REFjournal
  |last=Thorvaldsen
  |last=Thorvaldsen
  |init=MA
  |init=MA
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==Synechia destruction prior to infant circumcision==
==Synechia destruction prior to infant circumcision==


When an infant boy is to be circumcised, as remains a practice in the United States, in preparation for the [[circumcision]], the preputial synechia must first be forcibly separated by passing a blunt probe under the foreskin in an intensely [[Pain| painful]] procedure.
When an infant boy is to be [[circumcised]], as remains a practice in the [[United States]], in preparation for the [[circumcision]], the preputial synechia must first be forcibly separated by passing a blunt probe under the foreskin in an intensely [[Pain| painful]] procedure.


==Premature forcible foreskin retraction==
==Premature forcible foreskin retraction==


Premature forcible foreskin retraction (PFFR) of a boy's foreskin will rip the boy's synechia apart and cause severe pain and injury to the boys.<ref>{{REFjournal
Premature forcible foreskin retraction (PFFR) of a boy's [[foreskin]] will rip the boy's synechia apart and cause severe pain and injury to the boys.<ref>{{REFjournal
  |last=Narvaez
  |last=Narvaez
  |init=DF
  |init=DF
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  |DOI=
  |DOI=
  |accessdate=2019-10-08
  |accessdate=2019-10-08
}}</ref> Unfortunately, many American physicians are ignorant of normal penile anatomy and cause severe pain and grave injury to boys whom they examine in their practice. The first person to retract a boy's foreskin should be the boy himself.<ref>{{REFjournal
}}</ref> Unfortunately, many American physicians are ignorant of normal penile anatomy and cause severe pain and grave injury to boys whom they examine in their practice. The first person to retract a boy's [[foreskin]] should be the boy himself.<ref>{{REFjournal
  |last=Wright
  |last=Wright
  |init=JE
  |init=JE
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==Spontaneous disintegration of the synechia==
==Spontaneous disintegration of the synechia==


The synechia spontaneously disintegrates to release the foreskin.<ref name="deibart1933" /> The disintegration usually occurs in childhood but will persist into adolescence in a few cases.
The synechia spontaneously disintegrates to release the [[foreskin]].<ref name="deibart1933" /> The disintegration usually occurs in childhood but will persist into adolescence in a few cases.


Some [[intact]] boys will report pain when they urinate during the period in which separation is occurring. The condition is temporary and will end when separation is complete.<ref>{{REFweb
Some [[intact]] boys will report pain when they urinate during the period in which separation is occurring. The condition is temporary and will end when separation is complete.<ref>{{REFweb
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[[Category:Parental information]]
[[Category:Parental information]]
[[Category:Penile anatomy]]
[[Category:Penile anatomy]]
[[Category:Penis]]


[[de:Synechie]]
[[de:Synechie]]