Preputial Adhesion in 5-Year-Old Boys: Treatment Options

Hello, regarding the issue of penile adhesion in a 5-year-old boy?

The child is approximately 5 years and 1 month old.
Recently, I wanted to check the condition of the child's penis.
When retracting the foreskin, I noticed that it was adhered to the glans.
The area of adhesion is about 50%.
Although I have been gently retracting the foreskin over the past couple of days to see if the adhesion improves, there seems to be no noticeable effect.
I would like to know if applying petroleum jelly to the adhered area, while avoiding the urethral opening, could potentially improve the condition.
If there is no improvement after how long should we seek medical attention?

Lin Lin, 0~9 year old female. Ask Date: 2021/02/18

Dr. Li Xinyi reply Urology

It is advised not to separate them, as the foreskin and glans will gradually separate as the child grows.
Applying external force to pull them apart may cause injury, leading to true adhesions that could require surgical intervention.

Reply Date: 2021/02/18

More Info

Preputial adhesion, also known as phimosis, is a common condition in young boys where the foreskin is adhered to the glans (the head of the penis). This condition can vary in severity, and while many boys will naturally outgrow it as they develop, some may require intervention. In your case, your son is about 5 years old, and you have noticed that approximately half of his foreskin is adhered to the glans.

Firstly, it is important to understand that preputial adhesion is quite common in young boys, especially those under the age of 6. In many instances, the foreskin will separate from the glans naturally over time as the child grows. However, if the adhesion is significant or causing discomfort, it may require treatment.

You mentioned that you have been gently retracting the foreskin to see if the adhesion improves. This is a good initial approach, but it should be done carefully to avoid causing pain or injury. Applying a lubricant like petroleum jelly (Vaseline) to the area can help in some cases. The lubricant can make it easier to gently retract the foreskin and may help in separating the adhered skin. However, it is crucial to avoid applying the lubricant directly to the urethral opening to prevent any potential irritation or infection.

If you do not see any improvement after a few days of consistent gentle retraction and lubrication, it would be advisable to consult a pediatrician or a urologist. Signs that you should seek medical advice sooner include:
1. Pain or Discomfort: If your child is experiencing pain during urination or when you attempt to retract the foreskin, this is a sign that medical evaluation is necessary.

2. Signs of Infection: If you notice any redness, swelling, or discharge from the area, these could be signs of an infection that requires treatment.

3. Persistent Adhesion: If after a week of gentle attempts there is no change in the adhesion, it would be prudent to seek medical advice. A healthcare professional can assess the situation more thoroughly and may recommend treatments such as topical steroids to help with separation or, in some cases, a minor surgical procedure to release the adhesion.

4. Emotional Distress: If your child expresses anxiety or distress about the condition, it may be beneficial to consult a healthcare provider for reassurance and guidance.

In summary, while applying petroleum jelly and gently retracting the foreskin can be effective initial measures for managing preputial adhesion, it is essential to monitor the situation closely. If there is no improvement within a week or if any concerning symptoms arise, do not hesitate to seek medical advice. Early intervention can help prevent complications and ensure your child's comfort and health.

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