Name of the Condition

• Adhesions of Prepuce and Glans Penis
  
  • Common names: Penile adhesions, Preputial adhesions

Summary

Adhesions of the prepuce and glans penis occur when the foreskin (prepuce) sticks to the glans (tip) of the penis. This condition can affect the ability to retract the foreskin fully and may cause issues with hygiene or discomfort.

Causes

• Frequently, this condition arises from natural physiological adhesions in uncircumcised males that may persist beyond childhood.
• Inadequate cleaning can lead to inflammation and subsequent adhesion formation.
• Traumatic forces or improper foreskin retraction can also contribute to adhesive formation.

Risk Factors

• Being uncircumcised.
• Poor genital hygiene.
• History of recurrent penile infections.
• Forced retraction of the foreskin in children.

Symptoms

• Inability to fully retract the foreskin.
• Discomfort or pain during erections or urination.
• Accumulation of secretions between the foreskin and glans.
• Redness or swelling of the foreskin.

Diagnosis

• Physical examination by a healthcare professional.
• Observation of the foreskin's ability to retract and any signs of adhesion.
• Sometimes, further assessment can be done if infections or other complications are suspected.

Treatment Options

• Topical Steroids: Helps reduce inflammation and gradually separate adhesions.
• Gentle Manual Separation: In cases where the adhesion is mild and can be separated without much discomfort.
• Surgery (Circumcision or Preputioplasty): Recommended in severe or recurrent cases where other treatments fail. It helps in resolving adhesions entirely or modifying the foreskin to prevent future adhesions.

Prognosis and Follow-Up

• With appropriate treatment, most individuals achieve a full recovery without significant issues.
• Regular follow-up is essential to ensure proper genital hygiene and monitor for recurrence.

Complications

• Potential risk of infections due to trapped secretions.
• Painful erections and issues with sexual function.
• Scar tissue formation leading to further complications.

Lifestyle & Prevention

• Ensuring proper hygiene by gently retracting the foreskin to clean the glans.
• Avoiding forced retraction of the foreskin in infants and young children.
• Educating on proper penile care to avoid inflammation and subsequent adhesions.

When to Seek Professional Help

• Persistent pain or swelling in the genital area.
• Difficulty urinating or recurrent infections.
• Inability to retract the foreskin properly despite good hygiene practices.

Additional Resources

• American Urological Association (AUA)
• Family Doctor
  • Provides patient education on managing genital conditions.
• Local or online support groups for those affected by similar conditions.

Tips for Medical Coders

• Ensure coding accurately distinguishes between physiological adhesions and pathological cases requiring intervention.
• Common error: Confusing with phimosis (N47.1); ensure proper differentiation and documentation of symptoms and findings.