Difference between revisions of "Synechia"

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'''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.<ref>{{REFweb
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'''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).<ref>{{REFweb
 
  |url=https://medical-dictionary.thefreedictionary.com/synechia
 
  |url=https://medical-dictionary.thefreedictionary.com/synechia
 
  |title=Synechia
 
  |title=Synechia
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|trans-title=
 
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|language=
 
−
|last=
 
−
|first=
 
 
  |publisher=The Free Medical Dictionary  
 
  |publisher=The Free Medical Dictionary  
 
  |website=The Free Dictionary
 
  |website=The Free Dictionary
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|date=
 
 
  |accessdate=2019-10-07
 
  |accessdate=2019-10-07
−
|format=
 
−
|quote=
 
 
}}</ref>
 
}}</ref>
  
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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>{{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==
  
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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">{{REFjournal
 
  |last=Øster
 
  |last=Øster
 
  |first=Jakob
 
  |first=Jakob
−
  |author-link=
+
  |init=J
−
|coauthors=
 
 
  |title=Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys
 
  |title=Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys
 
  |journal=Arch Dis Child
 
  |journal=Arch Dis Child
Line 52: Line 42:
 
  |DOI=10.1136/adc.43.228.200
 
  |DOI=10.1136/adc.43.228.200
 
  |accessdate=2019-10-08
 
  |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
+
}}</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
−
  |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 70: Line 60:
 
  |accessdate=2019-10-07
 
  |accessdate=2019-10-07
 
}}</ref>
 
}}</ref>
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 +
==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.
 +
 +
==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
 +
|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
 +
|init=JE
 +
|title= Further to the "Further Fate of the Foreskin."
 +
|journal=Med J Aust
 +
|date=1994
 +
|volume=160
 +
|issue=
 +
|pages=134-5
 +
|url=http://www.cirp.org/library/normal/wright2/
 +
|quote=
 +
|pubmedID=8295581
 +
|pubmedCID=
 +
|DOI=
 +
|accessdate=2019-10-08
 +
}}</ref>
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 +
[[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>
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 +
==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]]
  
 
[[de:Synechie]]
 
[[de:Synechie]]

Latest revision as of 14:37, 25 December 2023

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. Arch Dis Child. 1 April 1968; 43: 200-3. PMID. PMC. DOI. Retrieved 8 October 2019.
  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.
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