Basic Anatomy

The penis is structured around a series of long tubular tissue structures known as erectile tissue. This spongy tissue is able to hold a large volume of blood to produce an erection necessary for sexual intercourse. The glans penis (or just glans for brevity) is actually an extension of this spongy material, covered with mucous membrane much like the lining of the mouth and the vagina.

This tissue is protectively covered by a tube of skin which, in it's natural state, extends from the body to cover the glans. This external covering is actually in two parts. At the preputial sphincter, also known as the frenar band, the external skin, which is basically the same type of skin which covers the rest of the body, connects to a different type of skin which is slightly mucousal in nature and which is rich in stretch receptor nerves. This skin 'rolls' under the outer skin and ends just behind the corona of the glans at the sulcus. This skin is very thin, sensitive and has elastic qualities. It is long enough to cover most of the penis when it is retracted (pulled back) and because of it's thin structure and elasticity, is capable of 'telescoping', or folding, over itself as it is moved back and forth, especially during sexual activity. The folding action is made possible by the texture of the inner foreskin which has a series of ridges or natural folding points in concentric circles, which hug the shaft and glans. This series of folds is called the ridged band and has the same characteristics of action as the inner and outer eyelids.

The nature of the inner foreskin is also such that it secretes sebum, natural oilsand emollients which serve to keep the glans moist and soft. After circumcision, the glans is no longer kept moist and soft and the skin becomes keratinized (dry and hard). This causes a decrease in the sensitivity of the nerves in the glans, since the transmission of pressure is more resistive. It is also now understood, that the frenar band, which is completely lost to circumcision, helps to keep the foreskin over the glans during nocturnal erections, to prevent the glans from becoming dry while exposed.

Underlying Anatomy

When the foreskin is retracted, it is possible to see the true nature of the inner foreskin. It is a moist mucous membrane of very thin skin and served by a rich blood supply. Look closely and you can see the veinous nature here. It is now known that this skin is also richly innervated (contains a lot of nerves) which are sensitive to the stretching motion of the skin as it passes over the spherical shape of the glans, especially at the corona. This is particularly significant since these nerves play an important roll in sexual stimulation.




This photo illustrates, approximately the amount of skin which would be left after a typical circumcision. However, there is still about 3 times as much skin still 'rolled' up beneath the outer shaft skin. You can see, about another thumbs width above this man's thumb, there is a slight change in the texture and quality of the skin. I've called this the 'transition point'. If he were to continue pulling back, the inner skin would pull out and almost completely cover his penis shaft. This demonstrates just how much skin is lost to circumcision. The distance from the transition point to the frenar band represents about 30% of the overall penile skin. Allow that amount again for the inner skin still folded beneath it and about 20% for stretch for a total of 80%, the approximate amount of skin removed by circumcision. The crush-point, the point where the actual cut is made and which becomes the scar, is formed when the transition point is stretched to the current position of the frenar band and the surgery performed. This stretching also pulls pubic skin down onto the shaft. This skin contains pubic hair follicles, so in circumcised men, pubic hair often grows on the shaft, which is not normal.

The Two 'Frens'

This close-up of the foreskin partially retracted clearly shows the definition of the frenar band. It is noticeably tighter than the skin behind it, yet it is also very elastic. The cells in this band are a muscle-type tissue known as smooth muscle, different from the more familiar muscles since they are not attached to any bone and do not need to be to carry out their action. The moist nature of the glans is also clearly evident. The sulcus or groove curves upward here to dissect the glans into 'hemispheres'. This is where the frenulum is attached to the glans. In this photo it is seen on the underside of the penis and just above the frenar band.





From the underside with the foreskin retracted, the frenulum can be seen as an expanding web coming down from the glans and widening out under the sulcus. This frenulum, like the one under your tongue, is intended to maintain a maximum distention of it's members. It keeps the foreskin from being retracted too far and it is now believed to be the center point of the massive nerve network contained in the inner foreskin. All nerves 'report' to this point and from here the information is sent directly to the brain. In many circumcisions, the frenulum, and it's nerve network, are completely lost.

Circulation

The penis has been described by Desmond Morris (The Naked Ape, The Human Animal) as "a marvel of fluid mechanics". To be sure the penis has adequate plumbing to provide and subside erection, the skin, including the skin of the prepuce, is embedded with a vast array of veins. Blood to the penis is provided by an artery protected within the inner structure of the penis itself. A network of veins allows blood to exit. This exit of blood is restricted during arousal so that the erection can be maintained.

As you see in the photo to the left, this network of veins branches throughout the foreskin. Even when soft (above) the veins are very noticeable and seem to carry a high volume of blood most of the time.Circumcision seriously damages this veinous network. One has to wonder what affect this has on erection and performance not to mention the overall nutrition of the cells in the various tissues affected by this massive destruction of the circulatory system. There are no known detailed studies of this to date, however Dr. Paul Fleiss, MD mentions that this causes a circulatory condition called backflow, in his article, "Where is my Foreskin?".

Notice that even during erection, with pressure on the base of the penis, the frenar band keeps the skin forward. This exemplifies the previous note that it keeps the foreskin over the penis during nocturnal erection to protect the glans and keep it moist.

Not Just a Flap of Skin!

The foreskin is more than just a flap of skin. It is an integral part of the male reproductive system. It protects the penis, which is actually an INTERNAL organ housed in an external sheath of skin.



It distributes moisturizing agents and emollients to keep the glans soft. These secretions are also part of the 'self-cleansing' nature of the penis. As our eyes tear to remove contaminants, the emollients of the foreskin serve to protect the penis from foreign bodies and dirt. It is highly innervated and erogenous, bearing tens of thousands of stretch receptor nerves which participate in the overall enjoyment of sexuality. It has also been learned that the foreskin enhances the sex act for female partners; since the penis moves within it's own sheath, friction and irritation to the vagina are reduced. It carries blood away from the penis back to the return side of the circulatory system.

After birth, the foreskin protects the still developing glans from contamination by urine and feces. During infancy, the foreskin and glans are bonded together by tissue called synechia. Until a boy is 3-5, the foreskin cannot be retracted due to the existence of the synechia. As this tissue starts to break down, the penis becomes itchy and young boys are often seen to pull at themselves. This is not masturbation. The itch prompts them to tug gently and help break down the synechia and eventually the boy will be able to retract the skin. This process, leading to full retractability can last well into the teen years. It is important that parents are aware of this. No one but the boy himself should ever retract the foreskin for the first time. The prepuce is a natural part of the male anatomy and serves a variety of functions from protection to stimulation. Leave it there...it is NOT just a flap of skin!

Educational Foreskin Links

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Additional Relevant Links

Regular Guy Researches Circumcision for His Son:
http://viewofcircumcision.blogspot.com/

An expectant mother researches circumcision for her blog:
http://crunchydomesticgoddess.blogspot.com/2006/11/circumcision-post_06.html

Why Americans Started Circumcising in Physicians Own Words:
http://www.noharmm.org/docswords.htm/

Where do Cut-Off Foreskins Go?:
http://www.alternet.org/envirohealth/47421/

Care for the Intact Child:
http://www.parentingweb.com/misc/intact_care.htm

Safeguarding Your Intact Boy:
http://www.mothersnature.com/toddlers/info/safeguard.html


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The above links were culled from the Categorized Circumcision Link Collection: http://sites.google.com/site/completebaby/links