A dorsal slit (often referred to in

anthropology Anthropology is the scientific study of humanity, concerned with human behavior, human biology, cultures, societies, and linguistics, in both the present and past, including past human species. Social anthropology studies patterns of be ...

as superincision or supercision) is a single incision along the upper length of the

foreskin In male human anatomy, the foreskin, also known as the prepuce, is the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis that covers the glans and the urinary meatus. The foreskin is attached to the ...

from the tip to the corona, exposing the glans without removing any tissue. An ancient practice, it has been a traditional custom among a number of peoples, particularly

Filipinos Filipinos ( tl, Mga Pilipino) are the people who are citizens of or native to the Philippines. The majority of Filipinos today come from various Austronesian ethnolinguistic groups, all typically speaking either Filipino, English and/or other ...

and

Pacific Islander Pacific Islanders, Pasifika, Pasefika, or rarely Pacificers are the peoples of the Pacific Islands. As an ethnic/ racial term, it is used to describe the original peoples—inhabitants and diasporas—of any of the three major subregions of O ...

s, probably for thousands of years. In Western medicine, it was used as an alternative to

circumcision Circumcision is a 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 excised. Top ...

to relieve conditions such as failure of the foreskin to retract ( phimosis) or failure to cover the glans penis (

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 ...

), although a perception of poor appearance limited its popularity. While it is a less invasive surgery than circumcision, it is more invasive than preputioplasty since it leaves the incision open. It is still used when circumcision or other measures are considered impractical or undesirable.

Traditional custom

Since superincision and circumcision are both forms of genital cutting that expose the glans, it can often be difficult to know which procedure is being described or depicted. Opinion is divided on whether a 4,000-year-old image from

Egypt Egypt ( ar, مصر , ), officially the Arab Republic of Egypt, is a List of transcontinental countries, transcontinental country spanning the North Africa, northeast corner of Africa and Western Asia, southwest corner of Asia via a land bridg ...

, often described as the first depiction of circumcision, may in fact be of a superincision. Superincision has been widely practised by people of the

Pacific The Pacific Ocean is the largest and deepest of Earth's five oceanic divisions. It extends from the Arctic Ocean in the north to the Southern Ocean (or, depending on definition, to Antarctica) in the south, and is bounded by the contine ...

, stretching from

Hawaii Hawaii ( ; haw, Hawaii or ) is a state in the Western United States, located in the Pacific Ocean about from the U.S. mainland. It is the only U.S. state outside North America, the only state that is an archipelago, and the only stat ...

to the

Philippines The Philippines (; fil, Pilipinas, links=no), officially the Republic of the Philippines ( fil, Republika ng Pilipinas, links=no), * bik, Republika kan Filipinas * ceb, Republika sa Pilipinas * cbk, República de Filipinas * hil, Republ ...

. With increasing urbanisation, traditional rituals have been giving way in many places to medically performed circumcision, and almost entirely so among Islanders living in

New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island coun ...

, where a recent survey found there was "a strong cultural demand from parents". The most notable exception to Pacific superincision is the

Māori Māori or Maori can refer to: Relating to the Māori people * Māori people of New Zealand, or members of that group * Māori language, the language of the Māori people of New Zealand * Māori culture * Cook Islanders, the Māori people of the Co ...

, who do not circumcise or superincise, although they have an indigenous term for the latter (''ure haea'' or "split penis") and their tradition is that they stopped the practice when they arrived in

Medical practice

Phimosis

Dorsal slit has a long history as a treatment for adult phimosis, since compared with circumcision it was relatively easy to perform, did not risk damage to 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 ...

, and before the invention of

antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and preventio ...

was less likely to become infected. However, the literature often indicates that despite being "a simple operation" it was "not liked by some", or refers to the "untidy apron-like appearance" it could produce. Dorsal slit is now rare in Western countries as a treatment for phimosis. Standard guidelines suggest conservative approaches first and, should those fail, either circumcision or preputioplasty to both retain the foreskin and relieve the phimosis.

Paraphimosis and other conditions

In some cases the foreskin may become swollen as a result of

(foreskin trapped behind the glans) or other conditions such as severe balanitis. Should reduction of the swelling by conservative methods be unsuccessful, a dorsal slit is a common intervention of choice since circumcision is almost always excluded in such cases. While it was formerly recommended that circumcision be subsequently performed once the originating condition has subsided, this appears to be no longer the case.

Dorsal genital slits in some African tribes

A variety of "dorsal slit" circumcision was once predominant amongst the Maasai tribe of

Kenya ) , national_anthem = " Ee Mungu Nguvu Yetu"() , image_map = , map_caption = , image_map2 = , capital = Nairobi , coordinates = , largest_city = Nairobi , ...

and

Tanzania Tanzania (; ), officially the United Republic of Tanzania ( sw, Jamhuri ya Muungano wa Tanzania), is a country in East Africa within the African Great Lakes region. It borders Uganda to the north; Kenya to the northeast; Comoro Islands ...

, and is still practised and found in many of the more remote regions of the very large area known as "Maasailand" generally. However, the Maasai operation is different in this: rather than a dorsal slit from the opening of the prepuce to the corona, a heart shaped "oval" is excised from the dorsum of the prepuce and the glans is pushed through this hole. Later the edges of the cut prepuce will heal. The prepuce is first cut off, leaving only a small part where the main veins are located, which is pulled down and the small hole through which the glans in pushed through is created. The remaining part is left hanging down, but the glans exposed. Formerly tribes that copied the Maasai like the numerous

Kikuyu Kikuyu or Gikuyu (Gĩkũyũ) mostly refers to an ethnic group in Kenya or its associated language. It may also refer to: *Kikuyu people, a majority ethnic group in Kenya *Kikuyu language, the language of Kikuyu people *Kikuyu, Kenya, a town in Centr ...

of Kenya also practised the same form of circumcision. Photos of the operation and result are numerously found in specialized African books, such as Carol Beckwith and Tepelit Ole Saitoti's ''Maasai''. There are words for the resultant "preputial flap" in the Maa and Gikuyu languages, and possibly in other African tongues. In Gikuyu the word, now archaic, is likely to be ''ngwati''.

Dorsal slit reversal

According to Goodwin, the dorsal slit operation may be reversed by suturing the cut ends together, which restores the tissue to its normal position and recreates the foreskin.

References

{{reflist Circumcision Male genital modification