>Dan: >Is it not possible that the reason that these adhesions have required >surgery is that other well-intentioned folk also forcibly lysed the >adhesions, years before you saw them? After all, it was common practice >here in Virginia in years past to recommend forcible retraction of the >foreskin remnants in the first week of life. Since we stopped >recommending any manipulation of the healing circumcision except gentle >cleansing, we appear (anecdotally) to be seeing many less patients with >any adhesions. >Dave Arkin, MD >Richmond, VA >3. i used to rip, tear, whatever horrible word you want to fit in here, >penile adhesions, but i really think it's cruel and unusual punishment, and >when you traumatize them that much they are bound to heal together. now i >tell parents to treat them like they are not circ'd and show them how to do >gentle retraction and instruct them to do it during the bath. as they >start to >be able to pull back they should apply vaseline, but just go >slowly. i also warn about seeing smegma (one of my favorite words) and >tell them it is not pus, or infection. no problems with this approach so far Finally someone has posted the sensible approach to these penile adhesions that occur in circucized kids..my consulting pediatric urologist agreed with me that these adhesions are natural they would be there if not circumcized until maturation led to complete ability to retract the foreskin and that if forcibly retracted could lead to a more permanent scarring adhesion and by the way smegma is one of my favorite words too, wouldn't it make a great name for a rock band...<g> F. Wayne van Saun, MD http://schoolhouserdpeds.com "Life is just a tireswing" J Buffett "Only a life lived for others is worth living." - Albert Einstein "The fruit of love is service. The fruit of service is peace." Mother Theresa F. Wayne van Saun, M.D.