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A call from the school nurse during the day is always alarming. Given the current global pandemic, such calls are even more unsettling. Recently, I received a call that plunged me into unfamiliar territory. My seven-year-old son was in the nurse’s office, in tears; he had gone to the bathroom and was bleeding from his penis. It was a frightening situation for him and incredibly distressing for me. I hurried to the school, and when I arrived, his little freckled face looked up at me and whispered, “Mom, I’m scared.” My heart shattered at that moment.
We were able to see the pediatrician right away, and they took us to a bathroom for a urine sample. I thought this was reasonable; I’ve dealt with my share of UTIs and bladder infections, so seeing blood in urine wasn’t foreign to me. When he urinated, there was a small amount of blood on his underwear, but nothing severe. He grimaced, mentioning it burned. I was confident he just needed a quick antibiotic, and we’d be on our way.
After returning to the examination room, we waited for the doctor. When he arrived, he informed us that my son’s urine was clear. I was puzzled. How could that be? The doctor then examined him and asked if he had experienced any pain, injuries, or inappropriate incidents. My son replied no. The doctor quickly stated, “He has a penile adhesion.” As a mom of three boys, I had never heard of this before, but it turns out it’s quite common—though it can be uncomfortable.
Types of Penile Adhesions
Penile adhesions can occur in both circumcised and uncircumcised boys and come in three types:
- Glandular Adhesion: This occurs when the skin attached to the head of the penis covers the coronal margin.
- Penile Skin Bridge: A thicker adhesion that can be permanent and might require surgical intervention.
- Cicatrix: This is scar tissue that can trap the penis due to the surgical area contracting.
While penile adhesions are often visible during diaper changes or baths, they usually don’t cause pain in infants. Discomfort tends to arise as the child matures, but they often resolve naturally.
In uncircumcised boys, the foreskin typically separates from the glans over time. Once this happens, the penis should be gently retracted to prevent adhesions. For circumcised boys, adhesions can occur if the skin isn’t retracted enough during care. As a child grows, a doctor will monitor for signs of adhesion.
Most commonly, adhesions develop in infants during their growth phases. Each type of adhesion requires different treatments. For a glandular adhesion, keeping the area moisturized with something like petroleum jelly aids in softening the tissue. This encourages the development of smegma, a harmless mix of dead skin and oil secretions, which might look like pus but is perfectly normal. Always consult a pediatrician if you have concerns. Spontaneous erections can also help release adhesions naturally.
My son had a glandular adhesion that likely went unnoticed until now. The pediatrician explained that as he grows, the adhesion began to tear, causing bleeding and discomfort. The area is dry and lacks oil glands, which is why the tearing hurts. We treat it with antibiotic ointment to keep it moisturized and prevent infection, and thankfully, the irritation subsides quickly. The doctor assured us that surgery isn’t necessary, as it will eventually resolve itself—it just takes time.
In general, penile adhesions are a common aspect of development and usually don’t warrant concern. However, if they cause pain, irritation, or signs of infection, reaching out to your pediatrician is always wise. It’s better to be cautious, especially with such a delicate area.
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Summary
My son faced a penile adhesion that caused fear and discomfort, but with proper treatment and understanding, it’s manageable. Such conditions are common in growing boys and usually resolve naturally. Always consult a healthcare professional for guidance.