Foreskin
In mammals, the foreskin or prepuce is the retractable double-layered
fold of skin and mucous membrane that covers the head of the penis, (the glans penis). It serves as a sheath to protect the glans penis. In a female, the
clitoral foreskin, or hood, covers and protects the glans clitoris in a similar manner.
The human foreskin
In humans, the foreskin, a part of the penis,
is a double-folded tube of skin and mucous membrane (similar to the
inside of the mouth) which attaches at the crested end of the glans at the sulcus, and
to the body above the pubic bone and
scrotum. Whereas the skin on most of the body is attached to the underlying tissue,
the foreskin, like the eyelid, is free to move. Smooth muscle fibres keep the foreskin close to the glans penis but make it
highly elastic.[1] (http://www.cirp.org/library/anatomy/lakshmanan/)
The inner surface of the foreskin is usually fused with the glans penis at birth.[2]
(http://www.cirp.org/library/anatomy/deibert/) The fusion gradually breaks down over a
period of up to 17 years, releasing the foreskin and allowing it to become retractable.[3]
(http://www.cirp.org/library/general/oster/) 44 percent of boys have fully retractable
foreskins by age ten, 90 percent by age 16, and 99 percent by age 18.
The coverage of the glans by the foreskin in adults is a highly variable characteristic. Some men have abundant overhang when
flaccid, while others do not have complete glans coverage. In a German study, Schoeberlein (http://www.male-initiation.net/library/medicus/schoeberlein.html#start) found that approximately
50% of uncircumcised young men had full coverage of the glans, 42% had partial coverage, and the remaining 8% were both glans and
sulcus free. After adjusting for circumcision, he established that in 4% of the young men the foreskin had spontaneously
atrophied (shrunk).
One of the functions of the foreskin is to protect the glans of the penis. It is normal for the foreskin to be fused with the
glans in babies and not to fully retract until around puberty. Forcible retraction of the foreskin should be avoided and the
child himself should be the first person to retract the foreskin.[4] (http://www.cirp.org/library/normal/wright2/) Premature retraction, which is painful, can result in
infection. Regular washing under the foreskin becomes important only when the foreskin becomes detached from the glans.
Conditions
Meatal stenosis is a narrowing of the opening of the urethra, and
can be caused by factors that include early mechanical retraction of the foreskin and circumcision. Foreskin coverage protects
the glans penis during infancy from irritation from wet diapers that have a high ammonia contect,[5] (http://www.cirp.org/library/complications/freud1/)[6] (http://www.cirp.org/library/complications/brennemann1/), which may lead to narrowing at the point
where urine is discharged from the penis and subsequent discomfort in urination in circumcised boys and those uncircumcised boys
in whom a portion of the glans is naturally exposed. (See: [7] (http://www.emedicine.com/ped/topic2356.htm) for more information.)
Phimosis is a condition, usually considered abnormal in an adult, in which the
foreskin cannot be retracted fully or at all. In humans, phimosis is treated through the use of topical steroid ointments, stretching, preputioplasty, or circumcision. In some cases, a dorsal slit is made in the foreskin.
See phimosis for more information on treatment of phimosis. Both retractile and
non-retractile foreskin are normal conditions prior to puberty. [8] (http://www.cirp.org/library/normal/kayaba/)
Where the foreskin is partially retractable, a condition called paraphimosis may occur where the foreskin becomes trapped behind the glans. This is a serious condition which
must be treated as a medical emergency.
Plastic surgical modification
In addition to its use as a treatment for phimosis, circumcision, among other procedures, is also practiced for religious,
aesthetic, health, or hygiene reasons (see medical analysis of circumcision).
Preputioplasty is an
alternative surgical treatment for non-retractile foreskin[9] (http://www.cirp.org/library/treatment/phimosis/south1/) [10] (http://www.cirp.org/library/treatment/phimosis/saxena1). Non-surgical treatments also exist for
this condition.
Religious and Cultural Views
Both Jews and Moslems, in most interpretations
of religious doctrine, practice ritual circumcision whereby the foreskin of
a young boy is cut away permanently. In Judaism, an expert circumcisor known as a
mohel performs the ritual, known as brit
milah on an eight day old baby boy. It is considered to be religiously mandated by the Torah as the mark of the Covenant between God and Abraham, the forefather of both the ancient Hebrews, and the sons of Ishmael. The purported foreskin of Jesus, known as the Holy Prepuce, has been
venerated as a Christian relic in various
places at various times.
Many infant circumcisions, particularly in the United States, are
carried out for non-religious reasons. As adults, some men undergo circumcision for comfort, appearance, or a sense of
completion. Other men may choose foreskin restoration for
similar reasons, which provides a man with a replacement of the lost foreskin, usually through non-surgical tissue expansion techniques.
See also
External links
- Anatomy and
Functions of the Male Foreskin (http://www.noharmm.org/anatomy.htm) by Marilyn F. Milos, R.N. and
Donna Macris, C.N.M.; (1994)
includes photos and animations - Note: The website is strongly anti-circumcision.
- Fleiss P, Hodges F, Van Howe RS. Sex. Trans. Inf. 74(5): 364-367 (1998). Immunological functions of the human prepuce (http://www.cirp.org/library/disease/STD/fleiss3/) - Note: the authors hold a strong
anti-circumcision point of view, and also rely upon poor scholarship (for example, they rely on their 10th reference for Tyson's
glands, which were disproven by their 37th).
- C.J. Cold and J.R. Taylor. British Journal of Urology 83, Suppl. 1: 34-44 (1999) The
Prepuce (http://www.cirp.org/library/anatomy/cold-taylor/) - Note: the authors hold
a strong anti-circumcision point of view.
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