Difference between revisions of "Synechia"

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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
+
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
 
  |init=GA
 
  |init=GA
 
  |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=
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==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 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 circumcised, as remains common 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 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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}}</ref>
 
}}</ref>
  
[[Doctors Opposing Circumcision]] offers information and aid to parents of boys who have been injured and/or traumatized by PFFR.<ref>{{REFweb
+
[[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/
 
  |url=https://www.doctorsopposingcircumcision.org/for-parents/help-with-forcible-foreskin-retraction/
 
  |title=Wrongful Foreskin Retraction
 
  |title=Wrongful Foreskin Retraction
 
  |last=
 
  |last=
 
  |first=
 
  |first=
  |publisher=Doctors Opposing Circumcision
+
  |publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
 
  |website=
 
  |website=
 
  |date=2016-04-01
 
  |date=2016-04-01
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  |format=
 
  |format=
 
  |quote=
 
  |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>
 
}}</ref>
  
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* [[Retraction of the foreskin]]
 
* [[Retraction of the foreskin]]
 
* [[Phimosis]]
 
* [[Phimosis]]
 +
* [[Uncircumcised]]
  
 
{{LINKS}}
 
{{LINKS}}
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  |date=2007-09-01
 
  |date=2007-09-01
 
  |accessdate=2019-10-09
 
  |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
 
}}
 
}}
  

Latest revision as of 07:36, 18 June 2024

Synechia is the medical name for an adhesion between body parts in any area of the body that are not normally adherent . The plural is synechiae. The word comes to us from Greek (συνέχεια).[1]

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,[2] which is called the balanopreputial lamina.

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.[3] 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.[4]

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 painful procedure.

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.[5] [6] 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.[7]

Doctors Opposing Circumcision (D.O.C.) offers information and aid to parents of boys who have been injured and/or traumatized by PFFR.[8]

Spontaneous disintegration of the synechia

The synechia spontaneously disintegrates to release the foreskin.[2] 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.[9]

See also

External links

References

  1. REFweb Synechia, The Free Dictionary, The Free Medical Dictionary. Retrieved 7 October 2019.
  2. a b REFjournal Deibart GA. The separation of the prepuce in the human penis. Anat Rec. November 1933; 57: 387-99. DOI. Retrieved 7 October 2019.
  3. REFjournal Øster J. Further Fate of the Foreskin: Incidence of Preputial Adhesions, Phimosis, and Smegma among Danish Schoolboys PDF. Arch Dis Child. 1968; 43(228): 200-3. PMID. PMC. DOI. Retrieved 18 June 2024.
  4. REFjournal Thorvaldsen MA, Meyhoff HH. Phimosis: pathological or physiological?. Ugeskr Læge. 2005; 167(17): 1858-62. PMID. Retrieved 7 October 2019.
  5. REFjournal Narvaez DF, Geisheker J. What Is the Greatest Danger for an Uncircumcised Boy?. Psychology Today. 23 October 2011; Retrieved 8 October 2019.
  6. REFjournal Narvaez DF, Geisheker J. Doctor Ignorance of Male Anatomy Harms Boys. Psychology Today. 30 October 2011; Retrieved 8 October 2019.
  7. REFjournal Wright JE. Further to the "Further Fate of the Foreskin.". Med J Aust. 1994; 160: 134-5. PMID. Retrieved 8 October 2019.
  8. REFweb (1 April 2016). Wrongful Foreskin Retraction, Doctors Opposing Circumcision (D.O.C.). Retrieved 9 October 2019.
  9. REFweb (February 2018). Foreskin separation, The Royal Children's Hospital Melbourne. Retrieved 15 August 2023.