Fusions and adhesions: Difference between revisions

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|title=The Ulcerated Meatus in the Circumcised Child

|journal=Am J Dis Child

|date=1921

|date=1921-01

|volume=21

|issue=

|issue=1

|pages=38-47

|doi=10.1001/archpedi.1921.01910310043003

|format=PDF

|accessdate=2025-12-04

}}</ref> Boys with a protective foreskin do not develop [[meatal stenosis]].

The fusion of the balanopreputial lamina gradually breaks down over a widely variable period of years, so the foreskin can be retracted. Thorvaldsen & Meyhoff (2005) reported the mean age of first foreskin retraction to be 10.4 years.<ref name="thorvaldsen2005">{{REFjournal

The fusion of the balanopreputial lamina gradually breaks down over a widely variable period of years, so the foreskin can be retracted.

When the fusion is separating, it is normal for an [[intact]] boy to report feeling pain when he urinates. When the separation is complete, he will no longer feel pain during [[urination]].

Thorvaldsen & Meyhoff (2005) reported the mean age of first foreskin retraction to be 10.4 years.<ref name="thorvaldsen2005">{{REFjournal

|last=Thorvaldsen

|init=MA

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==Adhesion==

Adhesions of the residual [[skin]] to the [[glans penis]] usually occur after the [[circumcision]] of an infant boy. They are a pathological condition. When a young boy is to lose his [[foreskin]] to [[amputation]] by the surgical operation euphemistically known as "circumcision", the first step is to break the normal, healthy fusion described above. The surgeon does this in an incredibly brutal manner that causes extreme [[pain]] by passing a blunt probe under the foreskin to break the normal fusion with the [[glans penis]]. This preliminary step leaves the [[glans penis]] in a raw condition. After the [[foreskin]] is cut away, the residual shaft skin of the [[penis]] is also left with raw ends.

Adhesions of the residual [[skin]] to the [[glans penis]] usually occur after the [[circumcision]] of an infant boy. They are an iatrogenic, pathological condition. When a young boy is to lose his [[foreskin]] to [[amputation]] by the surgical operation euphemistically known as "circumcision", the first step is to break the normal, healthy fusion described above. The surgeon does this in an incredibly brutal manner that causes extreme [[pain]] and [[trauma]] by passing a blunt probe under the foreskin to break the normal fusion with the [[glans penis]]. This preliminary step leaves the [[glans penis]] in a raw condition. After the [[foreskin]] is cut away, the residual shaft skin of the [[penis]] is also left with raw ends.

The surgical wound is not commonly closed with sutures after [[circumcision]] of young boys, so the residual shaft skin is left to fall where it may. If the raw end of the shaft [[skin]] is in contact with the raw [[glans penis]], the two are likely to heal together, which creates a pathological adhesion.<ref>{{REFjournal

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|accessdate=2025-12-04

}}</ref>

Adhesion may also result after premature forcible foreskin retraction (PFFR).

Adhesions take many possible forms. The [[skin bridge]] is a common one.

~~Unlike fusions~~, ~~adhesions do not spontaneously dissolve~~. ~~The services of a pediatric urologist~~ are ~~needed to release the adhesion~~.

==The difference==

The <b>fusion</b> with which one is born has a synechial membrane between the [[glans penis]] and the [[foreskin]]. The synechial membrane breaks down with increasing maturity and releases the foreskin, so that it can be retracted and have [[gliding action]]. Fusions are normal and healthy.

The <b>adhesion</b> forms when two raw tissues heal together. There is no synechial membrane to dissolve and release the connection. The adhesion is pathological and requirs a surgeon to separate the adhesed tissue.

* [[Forced foreskin retraction]]

* [[Synechia]]

@@ Line 24: / Line 24: @@
   |title=The Ulcerated Meatus in the Circumcised Child
   |journal=Am J Dis Child
-  |date=1921
+  |date=1921-01
   |volume=21
-  |issue=
+  |issue=1
   |pages=38-47
+ |doi=10.1001/archpedi.1921.01910310043003
   |format=PDF
   |accessdate=2025-12-04
 }}</ref> Boys with a protective foreskin do not develop [[meatal stenosis]].
-The fusion of the balanopreputial lamina gradually breaks down over a widely variable period of years, so the foreskin can be retracted. Thorvaldsen & Meyhoff (2005) reported the mean age of first foreskin retraction to be 10.4 years.<ref name="thorvaldsen2005">{{REFjournal
+The fusion of the balanopreputial lamina gradually breaks down over a widely variable period of years, so the foreskin can be retracted.
+When the fusion is separating, it is normal for an [[intact]] boy to report feeling pain when he urinates. When the separation is complete, he will no longer feel pain during [[urination]].
+Thorvaldsen & Meyhoff (2005) reported the mean age of first foreskin retraction to be 10.4 years.<ref name="thorvaldsen2005">{{REFjournal
   |last=Thorvaldsen
   |init=MA
@@ Line 56: / Line 61: @@
 ==Adhesion==
-Adhesions of the residual [[skin]] to the [[glans penis]] usually occur after the [[circumcision]] of an infant boy. They are a pathological condition. When a young boy is to lose his [[foreskin]] to [[amputation]] by the surgical operation euphemistically known as "circumcision", the first step is to break the normal, healthy fusion described above. The surgeon does this in an incredibly brutal manner that causes extreme [[pain]] by passing a blunt probe under the foreskin to break the normal fusion with the [[glans penis]]. This preliminary step leaves the [[glans penis]] in a raw condition. After the [[foreskin]] is cut away, the residual shaft skin of the [[penis]] is also left with raw ends.
+Adhesions of the residual [[skin]] to the [[glans penis]] usually occur after the [[circumcision]] of an infant boy. They are an iatrogenic, pathological condition. When a young boy is to lose his [[foreskin]] to [[amputation]] by the surgical operation euphemistically known as "circumcision", the first step is to break the normal, healthy fusion described above. The surgeon does this in an incredibly brutal manner that causes extreme [[pain]] and [[trauma]] by passing a blunt probe under the foreskin to break the normal fusion with the [[glans penis]]. This preliminary step leaves the [[glans penis]] in a raw condition. After the [[foreskin]] is cut away, the residual shaft skin of the [[penis]] is also left with raw ends.
 The surgical wound is not commonly closed with sutures after [[circumcision]] of young boys, so the residual shaft skin is left to fall where it may. If the raw end of the shaft [[skin]] is in contact with the raw [[glans penis]], the two are likely to heal together, which creates a pathological adhesion.<ref>{{REFjournal
@@ Line 82: / Line 87: @@
   |accessdate=2025-12-04
 }}</ref>
+Adhesion may also result after premature forcible foreskin retraction (PFFR).
 Adhesions take many possible forms. The [[skin bridge]] is a common one.
-Unlike fusions, adhesions do not spontaneously dissolve. The services of a pediatric urologist are needed to release the adhesion.
+==The difference==
+The <b>fusion</b> with which one is born has a synechial membrane between the [[glans penis]] and the [[foreskin]]. The synechial membrane breaks down with increasing maturity and releases the foreskin, so that it can be retracted and have [[gliding action]].  Fusions are normal and healthy.
+The <b>adhesion</b> forms when two raw tissues heal together.  There is no synechial membrane to dissolve and release the connection. The adhesion is pathological and requirs a surgeon to separate the adhesed tissue.
+{{SEEALSO}}
+* [[Forced foreskin retraction]]
+* [[Synechia]]
 {{REF}}