Foreskin
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In
male Male (symbol: ♂) is the sex of an organism that produces the gamete (sex cell) known as sperm, which fuses with the larger female gamete, or ovum, in the process of fertilization. A male organism cannot reproduce sexually without access to ...
human anatomy, the foreskin, also known as the prepuce, is the double-layered fold of
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...
,
mucosal A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...
and
muscular Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscle ...
tissue at the distal end of the
human penis The human penis is an external male intromittent organ that additionally serves as the urinary duct. The main parts are the root (radix); the body (corpus); and the epithelium of the penis including the shaft skin and the foreskin (prepuce) c ...
that covers the
glans The glans (, plural "glandes" ; from the Latin word for "acorn") is a vascular structure located at the tip of the penis in male mammals or a homologous genital structure of the clitoris in female mammals. Structure The exterior structure ...
and the
urinary meatus The urinary meatus, (, ) also known as the external urethral orifice, is the opening of the urethra. It is the point where urine exits the urethra in both sexes and where semen exits the urethra in males. The meatus has varying degrees of sensit ...
. The foreskin is attached to the glans by an elastic band of tissue, known as the
frenulum A frenulum (or frenum, plural: frenula or frena, from the Latin ''frēnulum'', "little bridle", the diminutive of ''frēnum'') is a small fold of tissue that secures the motion of a mobile organ in the body. In human anatomy Frenula on the h ...
. The outer skin of the foreskin meets with the inner
preputial mucosa The preputial mucosa of the penis is the epithelium of the inside of the prepuce, or foreskin. To differentiate it from the cutaneous skin of the outside of the prepuce, it is sometimes referred to as the inner mucosa. It starts at the ridged ba ...
at the area of the
mucocutaneous junction A mucocutaneous junction, or mucocutaneous boundary, is a region of the body in which mucosa transitions to skin. Mucocutaneous zones occur in animals, at the body orifices. In humans, mucocutaneous junctions are found at the lips, nostrils, conju ...
. The foreskin is mobile, fairly stretchable and sustains the glans in a moist environment. Except for humans, a similar structure, known as
penile sheath Almost all mammal penises have foreskins or prepuce, although in non-human cases the foreskin is usually a sheath (sometimes called the ''preputial sheath'', ''praeputium'' or ''penile sheath'') into which the whole penis is retracted. In koalas ...
, appears in the male sexual organs of all
primate Primates are a diverse order of mammals. They are divided into the strepsirrhines, which include the lemurs, galagos, and lorisids, and the haplorhines, which include the tarsiers and the simians (monkeys and apes, the latter including huma ...
s and the vast majority of
mammal Mammals () are a group of vertebrate animals constituting the class Mammalia (), characterized by the presence of mammary glands which in females produce milk for feeding (nursing) their young, a neocortex (a region of the brain), fur or ...
s. In humans, foreskin length varies widely and coverage of the glans in a flaccid and erect state can also vary. The foreskin is fused to the glans at birth and is generally not retractable in infancy and early childhood. Inability to retract the foreskin in childhood should not be considered a problem unless there are other symptoms. Retraction of the foreskin is not recommended until it loosens from the glans before or during puberty. In adults, it is typically retractable over the glans, given normal development. The male prepuce is anatomically homologous to the
clitoral hood In the female human body, the clitoral hood (also called preputium clitoridis and clitoral prepuce) is a fold of skin that surrounds and protects the clitoral glans, glans of the clitoris; it also covers the external shaft of the clitoris, develop ...
in females. The foreskin may become subject to a number of pathological conditions, although most of these are rare and easily treatable.


Structure


External

The outside of the foreskin is a continuation of the shaft skin of the penis and is covered by a
keratin Keratin () is one of a family of structural fibrous proteins also known as ''scleroproteins''. Alpha-keratin (α-keratin) is a type of keratin found in vertebrates. It is the key structural material making up scales, hair, nails, feathers, ho ...
ized stratified squamous epithelium. The inner foreskin is a continuation of the epithelium that covers the
glans The glans (, plural "glandes" ; from the Latin word for "acorn") is a vascular structure located at the tip of the penis in male mammals or a homologous genital structure of the clitoris in female mammals. Structure The exterior structure ...
and is made up of
glabrous Glabrousness (from the Latin '' glaber'' meaning "bald", "hairless", "shaved", "smooth") is the technical term for a lack of hair, down, setae, trichomes or other such covering. A glabrous surface may be a natural characteristic of all or part of ...
squamous
mucous membrane A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It i ...
, like the inside of the eyelid or the mouth. The mucosal aspect of the prepuce has a great capacity for self-repair. The area of the outer foreskin measures 7–100 cm2, and the inner foreskin measures 18–68 cm.2 The mucocutaneous zone occurs where the outer and inner foreskin meet. The foreskin is free to move after it separates from the glans, which usually occurs before or during
puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a girl, the testes in a boy. ...
. The inner foreskin is attached to the glans by the
frenulum A frenulum (or frenum, plural: frenula or frena, from the Latin ''frēnulum'', "little bridle", the diminutive of ''frēnum'') is a small fold of tissue that secures the motion of a mobile organ in the body. In human anatomy Frenula on the h ...
, a highly
vascularized Angiogenesis is the physiological process through which new blood vessels form from pre-existing vessels, formed in the earlier stage of vasculogenesis. Angiogenesis continues the growth of the vasculature by processes of sprouting and splitt ...
tissue of the penis. The World Health Organization states that "the frenulum forms the interface between the outer and inner foreskin layers, and when the penis is not erect, it tightens to narrow the foreskin opening.


Subcutaneous

The human foreskin is a
laminar Laminar means "flat". Laminar may refer to: Terms in science and engineering: * Laminar electronics or organic electronics, a branch of material sciences dealing with electrically conductive polymers and small molecules * Laminar armour or "band ...
structure made up of outer skin, mucosal epithelium, lamina propia,
dartos fascia The dartos fascia or simply dartos is a layer of connective tissue found in the penile shaft, foreskin, scrotum and labia. The penile portion is referred to as the superficial fascia of penis or the subcutaneous tissue of penis, while the scrotal ...
and dermis. The superficial dartos fascia, formerly called the ''peripenic muscle'', is one of the two sheaths of
smooth muscle tissue Smooth muscle is an involuntary non- striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit ...
found below the penile skin, along with the underlying Buck's fascia or ''deep'' ''fascia of the penis''. The dartos fascia extents within the skin of the prepuce and contains an abuncance of elastic fibers. These fibers form a whorl at the tip of the foreskin, known as the preputial orifice, which is narrow during infancy and childhood. The dartos fascia is sensitive to temperature and reacts to temperature changes by expanding and contracting. The fascia is only loosely connected with the underlying tissue, so that it provides the mobility and elasticity of the penile skin.
Langerhans cell A Langerhans cell (LC) is a tissue-resident macrophage of the skin. These cells contain organelles called Birbeck granules. They are present in all layers of the epidermis and are most prominent in the stratum spinosum. They also occur in the ...
s are immature dendritic cells that are found in all areas of the penile epithelium, but are most superficial in the inner surface of the foreskin. As a continuation of the human penile skin, the prepuce receives
somatosensory In physiology, the somatosensory system is the network of neural structures in the brain and body that produce the perception of touch (haptic perception), as well as temperature (thermoception), body position (proprioception), and pain. It i ...
innervation A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
from the bilateral
dorsal nerve of the penis The dorsal nerve of the penis is the deepest division of the pudendal nerve; it accompanies the internal pudendal artery along the ramus of the ischium; it then runs forward along the margin of the inferior ramus of the pubis, between the superio ...
and branches of the
perineal nerve The perineal nerve is a nerve of the pelvis. It arises from the pudendal nerve in the pudendal canal. It gives superficial branches to the skin, and a deep branch to muscles. It supplies the skin and muscles of the perineum. Its latency is t ...
, and autonomic innervation from the
pelvic plexus The inferior hypogastric plexus (pelvic plexus in some texts) is a network () of nerves that supplies the organs of the pelvic cavity. The inferior hypogastric plexus gives rise to the prostatic plexus in males and the uterovaginal plexus in female ...
. The somatosensory
receptors Receptor may refer to: *Sensory receptor, in physiology, any structure which, on receiving environmental stimuli, produces an informative nerve impulse *Receptor (biochemistry), in biochemistry, a protein molecule that receives and responds to a n ...
that are found in the prepuce are both
nociceptor A nociceptor ("pain receptor" from Latin ''nocere'' 'to harm or hurt') is a sensory neuron that responds to damaging or potentially damaging stimuli by sending "possible threat" signals to the spinal cord and the brain. The brain creates the sens ...
s and
mechanoreceptor A mechanoreceptor, also called mechanoceptor, is a sensory receptor that responds to mechanical pressure or distortion. Mechanoreceptors are innervated by sensory neurons that convert mechanical pressure into electrical signals that, in animals, ...
s, with a predominace of
Meissner's corpuscles Tactile corpuscles or Meissner's corpuscles are a type of mechanoreceptor discovered by anatomist Georg Meissner (1829–1905) and Rudolf Wagner. This corpuscle is a type of nerve ending in the skin that is responsible for sensitivity to pressu ...
. Blood supply of the prepuce is provided by the preputial artery, a division of the axial and
dorsal artery of the penis The dorsal artery of the penis is an artery on the top surface of the penis. It is a branch of the internal pudendal artery. It runs forward on the dorsum of the penis to the glans, where it divides into two branches to the glans penis and the ...
. The axial and dorsal arteries that run within the penile skin
unite Unite may refer to: Arts, entertainment, and media Music Albums * ''Unite'' (A Friend in London album), 2013 album by Danish band A Friend in London * ''Unite'' (Kool & the Gang album), 1993 * ''Unite'' (The O.C. Supertones album), 2005 Songs ...
through perforating branches and give off the preputial arteries before they reach the corona of the glans. The preputial vein, an extension of the superficial dorsal vein, receives blood from the prepuce and connects to the larger
dorsal veins of the penis In human anatomy, the dorsal veins of the penis comprise the superficial dorsal vein of the penis and the deep dorsal vein of the penis. Superficial dorsal vein The ''superficial dorsal vein of the penis'' drains the prepuce and skin of the p ...
that drain the rest of the penile shaft. In 1996, following a study of 22 cadavers, retired pathologist John Taylor published a paper in which he proposed that the pleated skin of the distal foreskin, which he called
ridged band The ridged band is a band of mobile skin at the most distal end of the foreskin. It is part of the ''akroposthion:'' the portion which extends beyond the glans. It has, especially in regard to phimosis and preputioplasty, been called the preputia ...
, was a distinct anatomical structure that played an important role in sexual function. A 2015 review by Cox and colleagues said that the feature was particular to some men and that his illustrations had been inconsistent.


Development


Gestation

The penis develops from a primordial phallic structure that forms in the
embryo An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male spe ...
during the early weeks of pregnancy, known as the
genital tubercle A genital tubercle or phallic tubercle is a body of tissue present in the development of the reproductive system. It forms in the ventral, caudal region of mammalian embryos of both sexes, and eventually develops into a primordial phallus. In t ...
. Initially undifferentiated, the tubercle develops into a penis depending on the exposure to
male hormones Sex hormones, also known as sex steroids, gonadocorticoids and gonadal steroids, are steroid hormones that interact with vertebrate steroid hormone receptors. The sex hormones include the androgens, estrogens, and progestogens. Their effects are ...
secreted by the
testes A testicle or testis (plural testes) is the male reproductive gland or gonad in all bilaterians, including humans. It is homologous to the female ovary. The functions of the testes are to produce both sperm and androgens, primarily testoster ...
. The differentiation of the external sexual organs will be evident between twelve and sixteen weeks of
gestation Gestation is the period of development during the carrying of an embryo, and later fetus, inside viviparous animals (the embryo develops within the parent). It is typical for mammals, but also occurs for some non-mammals. Mammals during pregna ...
. Preputial development is initiated at around eleven weeks or earlier and continues up to eighteen weeks. Historically, the theories regarding the stages of preputial development during gestation fall into two main ideas. The earliest report by Schweigger-Seidel (1866) and later Hunter (1935) suggested the formation of the prepuce out of dorsal skin and its progressive distal extension to completelly cover and eventually fuse with the
epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...
of the glans. Glenister (1956) expanded the theory suggesting that the preputial fold results as an ingrowth of the cellular lamina, which rolls outwards over the glans, but with the resultant preputial lamina also expanding backwards to form an ingrowing fold at the coronal sulcus. The same idea was also described by Cold & Taylor (1999), Johnson (1920) and others. By eleven and twelve weeks of gestation, the process of preputial formation is evident as a thickening of the
epidermis The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water rele ...
that separates from the penis creating a raised fold, known as the preputial fold. On the underside of this structure forms the preputial lamina, which expands dorsolaterally over the base of the developing glans. At thirteen weeks, the prepuce has not yet extended to the distal tip of the glans covering only a part of its surface. By sixteen weeks, the bilateral preputial folds cover most of the glans and the ventral sides of the prepuce fuse in the midline. The
penile raphe The penile raphe is a visible line or ridge of tissue that runs on the ventral side of the human penis beginning from the base of the shaft and ending in the prepuce. The line is typically darker than the rest of the shaft skin, even though its s ...
, the continuation of the
perineal raphe The perineal raphe is a visible line or ridge of tissue on the body that extends from the anus through the perineum to scrotum (male) or labia majora (female). It is found in both males and females, arises from the fusion of the urogenital folds, ...
in human males, occurs on the ventral side of the penis as a manifestation of the fusion of the urethral and preputial folds. The dorsal nerve of the penis, which is present as early as nine weeks of gestation, completely expands through branches to the distal end of the glans and prepuce by sixteen weeks. At nineteen weeks, foreskin development is complete. Towards the end of the second trimester, the glans and the prepuce have completely fused together by the preputial or balanopreputial lamina. At birth, this shared membrane is physiologically adherent to the glans preventing retraction in infancy and early childhood. The phenomenon of non-retractile foreskin in children is known as physiologic phimosis and it naturally starts to resolve in varying ages; in childhood, preadolescence or puberty. By the end of puberty, most boys have a fully retractable foreskin.


Variability

In children, the foreskin usually covers the glans completely but in adults it may not. During erection, the degree of automatic foreskin retraction varies considerably; in some adults, when the foreskin is longer than the erect penis, it will not spontaneously retract upon erection. In this case, the foreskin remains covering all or some of the glans until retracted manually or by
sexual activity Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) ...
. The foreskin can be classified as long, when the preputial orifice extents beyond the glans, medium, when the preputial orifice is located around the meatus, and short, when most of the glans is exposed. The variation of long foreskin was regarded by Chengzu (2011) as 'prepuce redundant'. Frequent retraction and washing under the foreskin is suggested for all adults, particularly for those with a long or 'redundant' foreskin. Some males, according to Xianze (2012), may be reluctant for their glans to be exposed because of discomfort when it chafes against clothing, although the discomfort on the glans was reported to diminish within one week of continuous exposure. Guochang (2010) states that for those whose foreskins are too tight to retract or have some adhesions, forcible retraction should be avoided since it may cause injury.


Function

The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
(WHO) stated in 2007 that there was "debate about the role of the foreskin, with possible functions including keeping the glans moist, protecting the developing penis in utero, or enhancing sexual pleasure due to the presence of nerve receptors". The foreskin helps to provide sufficient skin during an erection. The foreskin protects the glans. In infants, it protects the glans from ammonia and feces in diapers, which reduces the incidence of
meatal stenosis Urethral meatal stenosis is a narrowing ( stenosis) of the opening of the urethra at the external meatus , thus constricting the opening through which urine leaves the body from the urinary bladder. Symptoms and signs * Abnormal strength and ...
. And the foreskin helps prevent the glans from getting abrasions and trauma throughout life. The fold of the prepuce produces sub-preputial wetness, helping to maintain the naturally moisturized state of the glans penis. The foreskin contains
Meissner's corpuscles Tactile corpuscles or Meissner's corpuscles are a type of mechanoreceptor discovered by anatomist Georg Meissner (1829–1905) and Rudolf Wagner. This corpuscle is a type of nerve ending in the skin that is responsible for sensitivity to pressu ...
, which are nerve endings involved in fine-touch sensitivity. A study of skin samples found that, compared to other hairless skin areas on the body, the Meissner's index was highest in the finger tip (0.96) and lowest in the foreskin (0.28) suggested that the foreskin has the least sensitive hairless tissue of the body.


Evolution

The foreskin is present in the vast majority of mammals, including non-human primates, such as the chimpanzee. In primates, the foreskin is present in the genitalia of both sexes and likely has been present for millions of years of evolution. The evolution of complex penile morphologies like the foreskin may have been influenced by females. In modern times, there is controversy regarding whether the foreskin is a vital or
vestigial structure Vestigiality is the retention, during the process of evolution, of genetically determined structures or attributes that have lost some or all of the ancestral function in a given species. Assessment of the vestigiality must generally rely on co ...
. In 1949, British physician Douglas Gairdner noted that the foreskin plays an important protective role in newborns. He wrote, "It is often stated that the prepuce is a vestigial structure devoid of function... However, it seems to be no accident that during the years when the child is incontinent the glans is completely clothed by the prepuce, for, deprived of this protection, the glans becomes susceptible to injury from contact with sodden clothes or napkin." During the physical act of sex, the foreskin reduces friction, which can reduce the need for additional sources of lubrication. The College of Physicians and Surgeons of British Columbia has written that the foreskin is "composed of an outer skin and an inner mucosa that is rich in specialized sensory nerve endings and erogenous tissue." "Some medical researchers... claim circumcised men enjoy sex just fine and that, in view of recent research on HIV transmission, the foreskin causes more trouble than it's worth." In the March 2017 publication of the ''Global Health Journal: Science and Practice'', Morris and Krieger wrote, "The variability in foreskin size is consistent with the foreskin being a vestigial structure."


Hygiene

Hygiene Hygiene is a series of practices performed to preserve health. According to the World Health Organization (WHO), "Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases." Personal hygiene refer ...
routine of uncircumcised males can vary depending on the age of the individual. In infancy and early childhood, hygiene of the penis includes gentle washing of only the external genitalia with water and non-irritating soap.
Cotton swabs Cotton is a soft, fluffy staple fiber that grows in a boll, or protective case, around the seeds of the cotton plants of the genus ''Gossypium'' in the mallow family Malvaceae. The fiber is almost pure cellulose, and can contain minor perce ...
or other special cleansers, like
antiseptics An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
, are not necessary. During the first years of life, the inner foreskin is fused to the glans making them hard to manually separate. At that time, forced retraction can cause pain or microtearing and is thus not recommended. The phenomenon of non retractile or tight foreskin in childhood is known as physiologic phimosis and it may resolve before, during or after puberty. When the foreskin starts to become retractile, a pediatrician can recommend careful retraction at home and rinsing with water during bath. Mild soap may be used, but can be avoided, if it causes irritation. If full retraction is hard to achieve, the child may only wash the exposed area of the glans. Since there is no specific age when physiologic phimosis begins to resolve, the time of foreskin retraction can vary considerably among children. During
puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a girl, the testes in a boy. ...
, as the male begins to
sexually mature Sexual maturity is the capability of an organism to reproduce. In humans it might be considered synonymous with adulthood, but here puberty is the name for the process of biological sexual maturation, while adulthood is based on cultural definiti ...
, foreskin retractability gradually increases and the penis begins to release natural fluids like
semen Semen, also known as seminal fluid, is an organic bodily fluid created to contain spermatozoa. It is secreted by the gonads (sexual glands) and other sexual organs of male or hermaphroditic animals and can fertilize the female ovum. Semen i ...
, pre-ejaculatory fluid and
smegma Smegma (Ancient Greek σμῆγμα : ''smēgma'') is a combination of shed skin cells, skin oils, and moisture. It occurs in both male and female mammalian genitalia. In females, it collects around the clitoris and in the folds of the labia ...
. Gentle washing under the foreskin during shower and maintaining good genital hygiene is sufficient to prevent smegma buildup. Smegma is an oily secretion in the genitals of both
sexes Sex is the trait that determines whether a sexually reproducing animal or plant produces male or female gametes. Male plants and animals produce smaller mobile gametes (spermatozoa, sperm, pollen), while females produce larger ones ( ova, of ...
that maintains the moist texture of the mucosal surfaces and prevents friction. In boys, it helps resolve the natural adhension of the glans and inner prepuce. Even though the fluids are harmless, if not cleaned properly, they may dry and appear as white spots or substance on the genitals. If smegma appears, it can easily be removed with shower immediately or dissolve after a few days. Washing of the genitals should be done gently, preferably with mild soap.


Clinical significance

The foreskin can be involved in
balanitis Balanitis is inflammation of the glans penis. When the foreskin is also affected, the proper term is balanoposthitis. Balanitis on boys still in diapers must be distinguished from redness caused by ammoniacal dermatitis. The word ''balanitis'' ...
,
phimosis Phimosis (from Greek φίμωσις ''phimōsis'' 'muzzling'.) is a condition in which the foreskin of the penis cannot stretch to allow it to be pulled back past the glans. A balloon-like swelling under the foreskin may occur with urination. In ...
, sexually transmitted infection and
penile cancer Penile cancer is cancer that develops in the skin or tissues of the penis. Symptoms may include abnormal growth, an ulcer or sore on the skin of the penis, and bleeding or foul smelling discharge. Risk factors include phimosis (inability to retr ...
. The American Academy of Pediatricians' 2012 technical report on circumcision found that the foreskin tends to harbor micro-organisms that can lead to urinary tract infections in infants and tend to contribute to the transmission of sexually transmitted infections in adults.. The technical report was published in conjunction with an updated statement of policy on circumcision: In some cases of recurrent pathologies, excessive soap washing may irritate the mucosa, therefore washing of the area should be done gently. Frenulum breve is a
frenulum A frenulum (or frenum, plural: frenula or frena, from the Latin ''frēnulum'', "little bridle", the diminutive of ''frēnum'') is a small fold of tissue that secures the motion of a mobile organ in the body. In human anatomy Frenula on the h ...
that is insufficiently long to allow the foreskin to fully retract, which may lead to discomfort during intercourse.
Phimosis Phimosis (from Greek φίμωσις ''phimōsis'' 'muzzling'.) is a condition in which the foreskin of the penis cannot stretch to allow it to be pulled back past the glans. A balloon-like swelling under the foreskin may occur with urination. In ...
is a condition where the foreskin of an adult cannot be retracted properly. Phimosis can be treated by using topical steroid ointments and using lubricants during sex; for severe cases circumcision may be necessary.
Posthitis Posthitis (pronounced pos-THI-tis) is the inflammation of the foreskin (prepuce) of the penis. It is characterised by swelling and redness on the skin and it may be accompanied by a smelly discharge. The term posthitis comes from the Greek "post ...
is an inflammation of the foreskin. A condition called
paraphimosis Paraphimosis is an uncommon medical condition in which the foreskin of a penis becomes trapped behind the glans penis, and cannot be ''reduced'' (pulled back to its normal flaccid position covering the glans). If this condition persists for several ...
may occur if a tight foreskin becomes trapped behind the glans and swells as a restrictive ring. This can cut off the blood supply, resulting in ischemia of the glans penis.
Lichen sclerosus Lichen sclerosus (LS) is a chronic, inflammatory skin disease of unknown cause which can affect any body part of any person but has a strong preference for the genitals (penis, vulva) and is also known as balanitis xerotica obliterans (BXO) when ...
is a chronic, inflammatory skin condition that most commonly occurs in adult women, although it may also be seen in men and children. Topical
clobetasol propionate Clobetasol propionate is a corticosteroid used to treat skin conditions such as eczema, contact dermatitis, seborrheic dermatitis, and psoriasis. It is applied to the skin as a cream, ointment, or shampoo. Use should be short term and only if ot ...
and
mometasone furoate Mometasone, also known as mometasone y 3 s, is a steroid medication used to treat certain skin conditions, hay fever, and asthma. Specifically it is used to prevent rather than treat asthma attacks. It can be applied to the skin, inhaled, or use ...
were proven effective in treating genital lichen sclerosus. Some birth defects of the foreskin can occur; all of them are rare. In
aposthia Aposthia is a rare congenital condition in humans, in which the foreskin of the penis is missing. Toward the end of the nineteenth century, E. S. Talbot claimed that aposthia among Jews was evidence for the now-discredited Lamarckian theory of e ...
there is no foreskin at birth, in micropathia the foreskin does not cover the glans, and in macroposthia, also called and congenital megaprepuce, the foreskin extends well past the end of the glans. It has been found that larger foreskins place uncircumcised men at an increased risk for HIV infection most likely due to the larger surface area of inner foreskin and the high concentration of Langerhans cells.


Society and culture


Modifications

Circumcision Circumcision is a surgical procedure, procedure that removes the foreskin from the human penis. In the most common form of the operation, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin ...
is the removal of the foreskin, either partially or completely. It is most commonly performed as an elective procedure for
prophylactic Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
,
cultural Culture () is an umbrella term which encompasses the social behavior, institutions, and Social norm, norms found in human Society, societies, as well as the knowledge, beliefs, arts, laws, Social norm, customs, capabilities, and habits of the ...
, or
religious Religion is usually defined as a social system, social-cultural system of designated religious behaviour, behaviors and practices, morality, morals, beliefs, worldviews, religious text, texts, sacred site, sanctified places, prophecy, prophecie ...
reasons. Circumcision may also be performed on children or adults to treat phimosis, balanitis, and other pathologies. The
ethics of circumcision Male circumcision is the surgical removal of the foreskin (prepuce) from the human penis. The ethics of circumcision in neonates and children is a source of much controversy. There is substantial disagreement amongst economists, bioethicists, th ...
in children is a source of controversy. As of 2012, no successful technique to reconstruct a circumcised foreskin had been published. Some men have used weights to stretch the skin of the penis to regrow a foreskin; the resulting tissue does cover the glans but does not replicate the features of a foreskin. Other cultural or aesethetic practices include
genital piercing Genital piercing is a form of body piercing that involves piercing a part of the genitalia, thus creating a suitable place for wearing different types of jewellery. Nevertheless, the term may also be used '' pars pro toto'' to indicate all body pi ...
s involving the foreskin and slitting the foreskin.
Preputioplasty Preputioplasty or prepuce plasty, also known as "limited dorsal slit with transverse closure", is a plastic surgical operation on the prepuce or foreskin of the penis, to widen a narrow non-retractile foreskin which cannot comfortably be drawn ba ...
is the most common foreskin reconstruction technique, most often done when a boy is born with a foreskin that is too small; a similar procedure is performed to relieve a tight foreskin without resorting to circumcision.


Foreskin restoration and regeneration

Foreskin restoration is the process of expanding the skin on the penis to reconstruct an organ similar to the foreskin, which has been removed by circumcision or injury. Foreskin restoration is of ancient origin, when surgical means were taken to lengthen the foreskin of individuals born with either a short foreskin that did not cover the glans completely or a completely exposed glans as a result of circumcision. Foreskin restoration has been reported as having beneficial emotional results in some men, and has been proposed as a treatment for feelings of sexual violation or mutilation in adult men for circumcisions that were performed on them without consent. Foreskin restoration is primarily accomplished by stretching the residual skin of the penis, but surgical methods also exist. Some forms of restoration involve only partial regeneration in instances of a high-cut wherein the circumcisee feels that the circumciser removed too much skin and that there is not enough skin for erections to be comfortable. Restoration creates a facsimile of the foreskin, but specialized tissues removed during circumcision such as the
ridged band The ridged band is a band of mobile skin at the most distal end of the foreskin. It is part of the ''akroposthion:'' the portion which extends beyond the glans. It has, especially in regard to phimosis and preputioplasty, been called the preputia ...
and
frenulum A frenulum (or frenum, plural: frenula or frena, from the Latin ''frēnulum'', "little bridle", the diminutive of ''frēnum'') is a small fold of tissue that secures the motion of a mobile organ in the body. In human anatomy Frenula on the h ...
cannot be reclaimed. Actual regeneration of the foreskin is experimental at this time.


Foreskin-based products

Foreskins obtained from circumcision procedures are frequently used by biochemical and micro-anatomical researchers to study the structure and proteins of human skin. In particular, foreskins obtained from newborns have been found to be useful in the manufacturing of more human skin. Foreskins of babies are also used for
skin graft Skin grafting, a type of graft surgery, involves the transplantation of skin. The transplanted tissue is called a skin graft. Surgeons may use skin grafting to treat: * extensive wounding or trauma * burns * areas of extensive skin loss du ...
tissue, and for β-interferon-based drugs. Foreskin-derived fibroblasts have been used in biomedical research, and cosmetic applications.


Sexual practices

The foreskin plays a role in the sexual practice of docking. Docking is a gay sexual practice, which involves
mutual masturbation Non-penetrative sex or outercourse is sexual activity that usually does not include sexual penetration. It generally excludes the penetrative aspects of vaginal, anal, or oral sexual activity, but includes various forms of sexual and non-sex ...
, by inserting the glans penis into the foreskin of another penis.


History

Foreskin was considered a sign of
beauty Beauty is commonly described as a feature of objects that makes these objects pleasurable to perceive. Such objects include landscapes, sunsets, humans and works of art. Beauty, together with art and taste, is the main subject of aesthetics, o ...
,
civility Civility comes from the word ''civis'', which in Latin means " citizen". Merriam Webster defines civility as civilized conduct (especially: courtesy or politeness) or a polite act or expression. Historically, civility also meant training in the hu ...
, and masculinity throughout the
Greco-Roman world The Greco-Roman civilization (; also Greco-Roman culture; spelled Graeco-Roman in the Commonwealth), as understood by modern scholars and writers, includes the geographical regions and countries that culturally—and so historically—were di ...
. In
ancient Greece Ancient Greece ( el, Ἑλλάς, Hellás) was a northeastern Mediterranean civilization, existing from the Greek Dark Ages of the 12th–9th centuries BC to the end of classical antiquity ( AD 600), that comprised a loose collection of cult ...
, foreskins were valued, especially those that were longer in length. The earliest known illustrative depiction of the foreskin dates back to Egyptian kingdoms. The foreskin has also been depicted in art from different historical ages: File:'David'_by_Michelangelo_Fir_JBU002.jpg,
David David (; , "beloved one") (traditional spelling), , ''Dāwūd''; grc-koi, Δαυΐδ, Dauíd; la, Davidus, David; gez , ዳዊት, ''Dawit''; xcl, Դաւիթ, ''Dawitʿ''; cu, Давíдъ, ''Davidŭ''; possibly meaning "beloved one". w ...
Marble sculpture, 1504 A.D. File:Orestes_Delphi_BM_GR1917.12-10.1.jpg, "
Orestes In Greek mythology, Orestes or Orestis (; grc-gre, Ὀρέστης ) was the son of Clytemnestra and Agamemnon, and the brother of Electra. He is the subject of several Ancient Greek plays and of various myths connected with his madness an ...
at Delphi". Painting of two naked males, ca. 330 B.C. File:NAMA X15118 Marathon Boy 3.JPG, ''The Marathon Youth'',
National Archaeological Museum, Athens The National Archaeological Museum ( el, Εθνικό Αρχαιολογικό Μουσείο) in Athens houses some of the most important artifacts from a variety of archaeological locations around Greece from prehistory to late antiquity. It i ...
, ca. 340-330 B.C.


Notes


References


External links


Infant foreskin care
at Kidshealth.org.nz *
''Management of foreskin conditions''
– Statement from the British Association of Paediatric Urologists on behalf of the British Association of Paediatric Surgeons and The Association of Paediatric Anaesthetists (2007). {{Authority control Sexual arousal Pelvis Penis Human penis anatomy Human male reproductive system Mammal penis Urinary system Human anatomy