Difference between revisions of "Synechia"

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(Add Section on PFFR)
(Synechia destruction prior to infant circumcision: Wikify.)
 
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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=
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  |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">{{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
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  |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
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==Synechia destruction prior to infant circumcision==
 
==Synechia destruction prior to infant circumcision==
  
When as 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 119:
 
  |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]]
  
 
[[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.