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  |url=https://medical-dictionary.thefreedictionary.com/synechia
  |url=https://medical-dictionary.thefreedictionary.com/synechia
  |title=Synechia
  |title=Synechia
|trans-title=
|language=
|last=
|first=
  |publisher=The Free Medical Dictionary  
  |publisher=The Free Medical Dictionary  
  |website=The Free Dictionary
  |website=The Free Dictionary
|date=
  |accessdate=2019-10-07
  |accessdate=2019-10-07
|format=
|quote=
}}</ref>
}}</ref>


There are some synechiae that are natural.  Baby boys are born with the inner foreskin fused with the glans penis by a synechial membrane that is common to both parts.<ref>{{REFjournal
There are some synechiae that are natural.  Baby boys are born with the inner [[foreskin]] fused with the [[glans penis]] by a synechial membrane that is common to both parts,<ref name="deibart1933">{{REFjournal
  |last=Deibart
  |last=Deibart
  |first=GA
  |init=GA
|author-link=
|coauthors=
  |title=The separation of the prepuce in the human penis
  |title=The separation of the prepuce in the human penis
  |journal=Anat Rec
  |journal=Anat Rec
  |date=1933
  |date=1933-11
  |volume=57
  |volume=57
  |issue=
  |issue=
Line 31: Line 22:
  |DOI=https://doi.org/10.1002/ar.1090570409
  |DOI=https://doi.org/10.1002/ar.1090570409
  |accessdate=2019-10-07
  |accessdate=2019-10-07
}}</ref>  
}}</ref> which is called the ''balanopreputial lamina''.


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


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>{{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
|author-link=
|coauthors=
|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>{{REFjournal
  |last=Thorvaldsen
  |last=Thorvaldsen
  |first=MA
  |init=MA
  |author-link=
  |last2=Meyhoff
  |coauthors=Meyhoff HH
  |init2=HH
  |title=Phimosis: pathological or physiological?
  |title=Phimosis: pathological or physiological?
  |journal=Ugeskr Læge
  |journal=Ugeskr Læge
Line 73: Line 47:
==Synechia destruction prior to infant circumcision==
==Synechia destruction prior to infant circumcision==


When an infant boy is circumcised, as remains common in the United States, in preparation for the [[circumcision]], the preputial synechia must first be broken by passing a blunt probe under the foreskin in an intensely 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.  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
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
|init=DF
|last2=Geisheker
|init2=J
|author2-link=John Geisheker
|title=What Is the Greatest Danger for an Uncircumcised Boy?
|journal=Psychology Today
|date=2011-10-23
|volume=
|issue=
|pages=
|url=https://www.psychologytoday.com/us/blog/moral-landscapes/201110/what-is-the-greatest-danger-uncircumcised-boy
|quote=
|pubmedID=
|pubmedCID=
|DOI=
|accessdate=2019-10-08
}}</ref> <ref>{{REFjournal
|last=Narvaez
|init=DF
|last2=Geisheker
|init2=J
|author2-link=John Geisheker
|title=Doctor Ignorance of Male Anatomy Harms Boys
|journal=Psychology Today
|date=2011-10-30
|volume=
|issue=
|pages=
|url=https://www.psychologytoday.com/us/blog/moral-landscapes/201110/doctor-ignorance-male-anatomy-harms-boys
|quote=
|pubmedID=
|pubmedCID=
|DOI=
|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
  |last=Wright
  |last=Wright
  |first=JE
  |init=JE
|author-link=
|coauthors=
  |title= Further to the "Further Fate of the Foreskin."  
  |title= Further to the "Further Fate of the Foreskin."  
  |journal=Med J Aust
  |journal=Med J Aust
Line 95: Line 103:
  |accessdate=2019-10-08
  |accessdate=2019-10-08
}}</ref>
}}</ref>
[[Doctors Opposing Circumcision (D.O.C.)]] offers information and aid to parents of boys who have been injured and/or traumatized by PFFR.<ref>{{REFweb
|url=https://www.doctorsopposingcircumcision.org/for-parents/help-with-forcible-foreskin-retraction/
|title=Wrongful Foreskin Retraction
|last=
|first=
|publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
|website=
|date=2016-04-01
|accessdate=2019-10-09
|format=
|quote=
}}</ref>
==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.
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
|url=https://www.rch.org.au/kidsinfo/fact_sheets/penis_and_foreskin_care/#foreskin-separation
|title=Foreskin separation
|last=
|first=
|init=
|publisher=The Royal Children's Hospital Melbourne
|date=2018-02
|accessdate=2023-08-15
}}</ref>
{{SEEALSO}}
* [[Retraction of the foreskin]]
* [[Phimosis]]
* [[Uncircumcised]]
{{LINKS}}
* {{REFdocument
|title=Answers to Your Questions About Premature (Forcible) Retraction of Your Young Son's Foreskin
|url=http://www.nocirc.org/publish/6pam.pdf
|contribution=
|last=Milos
|first=Marilyn
|author-link=Marilyn Fayre Milos
|publisher=National Organization of Circumcision Information Resource Centers
|format=Pamphlet
|date=2007-09-01
|accessdate=2019-10-09
}}
* {{REFdocument
|title=Freeing of Preputial (Foreskin) Adhesions
|url=https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Preputial%20adhesions.pdf
|contribution=
|last=
|first=
|publisher=British Association of Urological Surgeons(BAUS)
|format=PDF
|date=2017-06
|accessdate=2021-03-03
}}


{{REF}}
{{REF}}


[[Category:Parental information]]
[[Category:Penile anatomy]]
[[Category:Penile anatomy]]
[[Category:Penis]]


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