The foreskin is the most special and precious “gift” given by God to human beings, and this “gift” has been preserved on the primate body for more than 100 million years without degradation or evolution, which shows that its function and structure have undergone thousands of refinements and are always indispensable. However, due to the lack of understanding of the foreskin and some distorted propaganda in the society, circumcision is a common phenomenon, causing a lot of unnecessary pain and a serious waste of medical resources.
Newborns are born within 1 year of age, 50% of the glans reveal themselves, 89% at the age of 3, 8% of the incidence of prepuce at the age of 6-7, and only 1% at the age of 16-18. The development of the penis body is often faster than the development of the foreskin, and the foreskin of the penis is often turned back on itself before puberty. As you can see, if the foreskin is removed too early, it is clear that a large portion is unnecessary. If the incorrect circumcision of the hidden penis, but also lead to foreskin too short, or even penile severance, so more should be eliminated. Therefore, it is especially important to popularize the knowledge about foreskin among all people and save it.
The foreskin is the most sensitive sexual sensory tissue on the male body, with a surface area of about 12 to 15 square inches, 10,000 to 20,000 nerve endings, a total length of 240 feet of innervated nerves, and a total length of 3 to 4 feet of distributed blood vessels. The foreskin has four special structures: the ligament, the ligament triangle, the ring of folds (ligament ring), and the meatus. The ridged band emanating from the penile tether is rich in sensory vesicles (pleasure vesicles), ensuring a high degree of sensitivity in the tethered area. The outer and inner plates of the foreskin are continuous, and there is a junction line between the outer and inner plates, which is commonly referred to as the circumcision ring. The part outside the foreskin ring is the outer plate, and the part inside the ring up to the coronal sulcus is the inner plate. In the weak state of the penis, most men’s foreskin is wrapped around the glans or part of it, but in the process of erection, the length of the penis changes and the position of the foreskin also changes, and as the length and thickness of the penis increases, the glans is gradually revealed.
The foreskin has a protective function, secreting substances such as lysozyme (a natural antibacterial substance), immunoglobulins (antibodies), Langham’s cells (one of the components of the body’s immune system), sebaceous glands and the sebum they secrete (similar to emollient creams that increase local skin moisture), which help prevent excessive keratinization of mucosal tissue and glans skin, and in early childhood, protect the urethra from urethral contamination, stricture of the external opening and urinary tract infections. The foreskin itself also has the following functions: protects the mucosal tissue and glans from injury; protects the sensitivity of the mucosal tissue and glans area; and protects the glans from sunburn, frostbite, and other environmental factors. In addition, the foreskin provides skin for reconstructive plastic surgery (e.g., hypospadias, eyelid burns). The foreskin contains a large number of specific fine sensory nerve endings that secrete natural lubricating fluid to maintain lubrication in the vagina; it wraps the penis without tension during erection, allowing it to stretch freely; it reduces the discomfort caused by excessive friction during sex; and it also serves to prevent painful intercourse and stimulation of the external genitalia of the spouse. Without enough foreskin, the penis is like a one-way piston, and its movement in the vagina is similar to piston movement. As the movement proceeds, the slippery fluid in the vagina is constantly taken out of the body, and the slippery fluid in the vagina becomes less and less, and the vagina becomes more and more dry, and the friction increases, so the movement becomes more and more difficult and uncomfortable. The older you get, the less synovial fluid you will secrete in the vagina and the more prominent the problems in this area will become. Due to the large loss of foreskin, the pleasure vesicles are drastically reduced, the patient’s sexual pleasure will be reduced, the waiting time for ejaculation and intercourse time is prolonged, increasing the chances of sexual organ damage, excessive physical expenditure, which also has a negative impact on patients with serious heart and brain organs and certain disabilities, and can even induce brain hemorrhage, angina, myocardial infarction and other diseases. Individual patients can also cause erectile dysfunction. The change of previous sexual habits and may increase the female partner’s worries about sexual life. Postoperative scar formation, unevenness at the surgical incision, postoperative penile adhesions, lymphedema, skin bridge formation, urethral fistula, hypospadias, and supraurethral fissure will undoubtedly affect the aesthetics. The experience of intense childhood pain can also cause severe psychological disorders that greatly hinder the patient’s ability to adjust to himself and perceive the world. There is also the possibility of inability to urinate, persistent bleeding, and infection after circumcision. More seriously, improper use of intraoperative monopolar electrocoagulation to stop bleeding or improper preparation of intraoperative local anesthetic solution may lead to penile necrosis and may even be life-threatening, which is not alarming.
We believe that secondary circumcision, primary circumcision with repeated glansitis of foreskin, urinary tract abnormalities combined with repeated infections, long foreskin after puberty, combined with repeated infections, adhesions or tight upward foreskin, tight circumcision ring, which affects sexual life, repeated foreskin inlay, these cases can also be circumcised. The incidence of penile cancer is very low, and it can be effectively prevented as long as good hygienic habits are usually practiced. The notion or behavior of asking or suggesting circumcision in order to prevent penile cancer is undoubtedly absurd. For those who have coagulation dysfunction, local acute infection, congenital abnormality of penis, hypospadias, occult penis, etc., circumcision cannot be performed even with the above conditions. Surgical treatment is not recommended in childhood if there is no specific medical reason. For primary circumcision, if there is no indication for surgery you can opt for conservative treatment (often suitable within 6 to 7 years of age). Adrenal glucocorticoid ointment or emulsion of 0.05% to 0.1% can be applied topically twice daily for 20 to 30 days. Topical hormones are not effective for foreskin adhesions and are not recommended. If there is more foreskin scale and recurrent infections, urinary retention, and repeated foreskin impaction, dorsal circumcision of the foreskin is most feasible. Prepubertal children, whether circumcised or circumcised, do not advocate surgery if there are no recurrent infections or adhesions; postpubertal males need surgery if they are circumcised; postpubertal males need surgery if their foreskin is too long, combined with recurrent infections, adhesions or tightly upturned foreskin. Circumcision should be strictly controlled by the indications for the operation, and should be performed in a regular hospital by a trained and skilled urologist or male surgeon, who will choose the surgical method according to the length of the penile foreskin, the degree and state of the prepuce, standardize the surgical steps, and do close follow-up work so that complications can be detected early and treated promptly.
This shows that circumcision is a very serious medical issue, if you have doubts about your foreskin, you must go to a regular hospital and choose a professional urologist or male surgeon to conduct an examination before you can determine whether to treat it or not. Treating your foreskin well and loving it will bring endless fun to your future life! Saving the foreskin is also the duty of every doctor with a conscience!