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Dr. A. Clark
Dr. A. Clark, Pediatrician
Category: Pediatrics
Satisfied Customers: 4437
Experience:  33 years of experience as a general pediatrician in private practice and in pediatric urgent care.
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My grandson was circumcised at birth. He is now 6 years old.

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My grandson was circumcised at birth. He is now 6 years old. I noticed early on that his circumcision was growing back. I was keenly aware because I had the first boy in our family and it almost happened to him because no one had instructed me on how to avoid this. Luckily my son's situation was caught just in time to prevent a re-circumcision.
Unfortunately, this has not been dealt with for my grandson. I notice that he complains of it hurting when touched for cleaning. I'm afraid of what happens or will happen when he he has erections. What should be done?

Thank you.

Dr. A. Clark :

I'm happy that you have asked me to assist you with your grandchild and hope that you can benefit from my many years of helping grandparents like you.

Dr. A. Clark :

I see you are offline and unable to chat but I'll go ahead and post an answer here and then watch to see if you return.

Dr. A. Clark :

Most of the time the adhesions that form around the head of the penis will break on their own but if he is having a lot of pain with erections then he needs to be seen by his doctor to determine if he has a problem that can be fixed in the office or if he needs to see a urologist. Most of the time the foreskin can be manually retracted, even if a bit painful, until the adhesions break but sometimes they are too tight and a urologist can do it more easily.

Customer:

Hello Dr. Clark and thank you for answering so quickly. I'm sorry I was on a call when you responded. This, in my opinion, is not something that can be remedied easily. As I mentioned I went through this with my son as an infant and my grandsons condition is different. The skin is perfectly smooth and there is no definition around the head. I can surmise from your response already that he will need to see a urologist. Can you please tell me what would be the consequences if this condition continues to be ignored? Thanks again.

Dr. A. Clark :

Nothing much will happen if nothing is done but improper breaking (called lysis) of the adhesions can lead to some deformity and future problems. It really isn't a matter of re-circumcising him but rather just carefully separating the foreskin that is adhered to the head of the penis now that it has attached so tightly (unfortunately).

Dr. A. Clark :

The whole issue is really unfortunate since it is preventable. When circumcisions are done the doctors now leave a lot more foreskin than before and infants often look uncircumcised later. The reason they do the procedure this way is to prevent an even worse problem where the penis grows in a bent fashion (called a chordee) due to too aggressive removal of too much foreskin and one side cannot grow as fast as the other with the skin tighter on that side. Unfortunately, pediatricians don't emphasize the importance of retracting the circumcised foreskin with every diaper change to prevent reattachment to the corona, or head of the penis.

Customer:

Yes, very unfortunate. I'll never forget (now 31 years ago) when I first discovered something wasn't right with my first born son. I was sick to my stomach but very relieved that it wasn't too far gone.

Customer:

I'm confused when you say that nothing much will happen yet "lysis" can cause deformity and future problems. What problems would those be? I'm sorry to press for further information but I've been trying to get this addressed for some time and now that I have found just answer I have the opportunity to offer my advice to have it dealt with along with professional support.

Dr. A. Clark :

Forcefully pulling the foreskin back improperly can lead to scarring so best left to a urologist unless his pediatrician can do it easily. The urologist can accomplish this with little or no risk of complications I assure you.

Dr. A. Clark :

Please let me know if you have any further questions and if not I trust you will take advantage of the opportunity to rate my advice when you leave chat. Thanks.

Customer:

Absolutely I will ! First, please forgive me, I'm afraid I wasn't clear. If nothing is ever done about this, what could happen?

Dr. A. Clark :

It could create lots of problems for him when he needs to use it for more than urination! He would have a lot of pain at the minimum with erections and even have problems with growth of his penis, at least in a straight line, and develop the permanent curve called a chordee.

Customer:

Thank you! I knew it couldn't be good but I need to pass along the facts about the dangers of continuing to avoid this problem.

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