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Synechia
,using template OesterJ 1968
'''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
|title=Synechia
|publisher=The Free Medical Dictionary
|website=The Free Dictionary
|accessdate=2019-10-07
}}</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.,<refname="deibart1933">{{REFjournal
|last=Deibart
|firstinit=GA |author-link= |coauthors=
|title=The separation of the prepuce in the human penis
|journal=Anat Rec
|date=1933-11
|volume=57
|issue=
|DOI=https://doi.org/10.1002/ar.1090570409
|accessdate=2019-10-07
}}</ref> which is called the ''balanopreputial lamina''. ==Penile synechia in childhood== [[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 synechial membrane gradually breaks down separation and breakdown and releases the foreskin so it can be retractedsynechia is natural, normal, spontaneous, and requires no special care. About Thorvaldsen & Meyhoff (2005) report about 50 percent of boys can retract their [[foreskin ]] by age 10.4, thus confirming Øster's report.<refname-"thorvaldsen2005">{{REFjournal
|last=Thorvaldsen
|firstinit=MA |author-linklast2=Meyhoff |coauthorsinit2=Meyhoff HH
|title=Phimosis: pathological or physiological?
|journal=Ugeskr Læge
|accessdate=2019-10-07
}}</ref>
==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>
[[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}}
[[Category:Parental information]]
[[Category:Penile anatomy]]
[[de:Synechie]]