Spectrum and the management of glanular-preputial adhesions after ritual male circumcision.

Abstract

Background: Complications after male circumcision are numerous and may be presented as an adhesion between the glans penis and the preputial remnants, these adhesions may acquire different forms and troublesome the affected children.

Patients and methods: This is a retrospective study of 95 consecutive children of presumed glanular-preputial adhesions referred for correction of circumcision. They were assessed and classified as having either an early preputial adhesion or a well-formed skin bridge into 2 groups; group (A) who have a simple adhesion that was resolved through a conservative preputial adhesiolysis while those in the group (B) had a well-formed skin bridge, which deserves surgical correction. Histopathology done for 30 cases from group B. All cases were followed up till resolution of the adhesion.

Results: A wide diversity of the Glanular-Preputial Adhesions (GPA) was recognized with a different form ranged from a simple fibrinous adhesion which was diagnosed in 55 cases (group A), these adhesions were resolved with medical treatment, and a well-formed single or multiple skin bridges formed 3-4 months after circumcision; which were detected in 40 patients (group B) with a smegma pearls in 15, all required a surgical adhesiolysis. Mean age of patients was 3 years (6 months to 12 years). Three cases were diagnosed with penile scleroatrophic lichen balanitis.

Conclusion: Glanular-Preputial Adhesions is not a rare complication after MC. It could be a simple fibrinous; which resolves with topical corticosteroid or a well-formed skin bridge which needs surgical adhesiolysis.