New Data Support Long-Term Health Benefits of the Intact Foreskin

New Data Support Long-Term Health Benefits of the Intact Foreskin

The Foreskin Is Necessary
By Paul M. Fleiss, MD, MPH

Paul M. Fleiss, MD, MPH, is assistant clinical professor of pediatrics at the University of Southern California Medical Center. He is the author of numerous scientific articles published in leading national and international medical journals.

Published in Mothering: The Magazine of Natural Family Living, Winter 1997, pp. 36--45.
http://www.mothersagainstcirc.org/fleiss.html

What Is the Foreskin?

The foreskin is a uniquely specialized, sensitive, functional organ of touch. No other part of the body serves the same purpose. As a modified extension of the penile shaft skin, the foreskin covers and usually extends beyond the glans before folding under itself and finding its circumferential point of attachment just behind the corona (the rim of the glans). The foreskin is, therefore, a double-layered organ. Its true length is twice the length of its external fold and comprises as much as 80 percent or more of the penile skin covering.6,7

The foreskin contains a rich concentration of blood vessels and nerve endings. It is lined with the peripenic muscle sheet, a smooth muscle layer with longitudinal fibers. These muscle fibers are whirled, forming a kind of sphincter that ensures optimum protection of the urinary tract from contaminants of all kinds.

Like the undersurface of the eyelids or the inside of the cheek, the undersurface of the foreskin consists of mucous membrane. It is divided into two distinct zones: the soft mucosa and the ridged mucosa. The soft mucosa lies against the glans penis and contains ectopic sebaceous glands that secrete emollients, lubricants, and protective antibodies. Similar glands are found in the eyelids and mouth.

Adjacent to the soft mucosa and just behind the lips of the foreskin is the ridged mucosa. This exquisitely sensitive structure consists of tightly pleated concentric bands, like the elastic bands at the top of a sock. These expandable pleats allow the foreskin lips to open and roll back, exposing the glans. The ridged mucosa gives the foreskin its characteristic taper.

On the underside of the glans, the foreskin's point of attachment is advanced toward the meatus (urethral opening) and forms a bandlike ligament called the frenulum. It is identical to the frenulum that secures the tongue to the floor of the mouth. The foreskin's frenulum holds it in place over the glans, and, in conjunction with the smooth muscle fibers, helps return the retracted foreskin to its usual forward position over the glans.

Retraction of the Foreskin

At birth, the foreskin is usually attached to the glans, very much as a fingernail is attached to a finger. By puberty, the penis will usually have completed its development, and the foreskin will have separated from the glans.8 This separation occurs in its own time; there is no set age by which the foreskin and glans must be separated. One wise doctor described the process thus, 'The foreskin therefore can be likened to a rosebud which remains closed and muzzled. Like a rosebud, it will only blossom when the time is right. No one opens a rosebud to make it blossom.'9

Even if the glans and foreskin separate naturally in infancy, the foreskin lips can normally dilate only enough to allow the passage of urine. This ideal feature protects the glans from premature exposure to the external environment.

The penis develops naturally throughout childhood. Eventually, the child will, on his own, make the wondrous discovery that his foreskin will retract. There is no reason for parents, physicians, or other caregivers to manipulate a child's penis. The only person to retract a child's foreskin should be the child himself, when he has discovered that his foreskin is ready to retract.

Parents should be wary of anyone who tries to retract their child's foreskin, and especially wary of anyone who wants to cut it off. Human foreskins are in great demand for any number of commercial enterprises, and the marketing of purloined baby foreskins is a multimillion-dollar- a-year industry. Pharmaceutical and cosmetic companies use human foreskins as research material. Corporations such as Advanced Tissue Sciences, Organogenesis, and BioSurface Technology use human foreskins as the raw materials for a type of breathable bandage.10

What Are the Foreskin's Functions?

The foreskin has numerous protective, sensory, and sexual functions.

• Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands-glands that produce the sebum, or oil, that moisturizes our skin.11 The foreskin produces the sebum that maintains proper health of the surface of the glans.

• Immunological Defense: The mucous membranes that line all body orifices are the body's first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme.12 Lysozyme is also found in tears and mother's milk. Specialized epithelial Langerhans cells, an immune system component, abound in the foreskin's outer surface.13 Plasma cells in the foreskin's mucosal lining secrete immunoglobulins, antibodies that defend against infection.14

• Erogenous Sensitivity: The foreskin is as sensitive as the fingertips or the lips of the mouth. It contains a richer variety and greater concentration of specialized nerve receptors than any other part of the penis.15 These specialized nerve endings can discern motion, subtle changes in temperature, and fine gradations of texture.16, 17, 18, 19, 20, 21, 22, 23

• Coverage During Erection: As it becomes erect, the penile shaft becomes thicker and longer. The double-layered foreskin provides the skin necessary to accommodate the expanded organ and to allow the penile skin to glide freely, smoothly, and pleasurably over the shaft and glans.

• Self-Stimulating Sexual Functions: The foreskin's double-layered sheath enables the penile shaft skin to glide back and forth over the penile shaft. The foreskin can normally be slipped all the way, or almost all the way, back to the base of the penis, and also slipped forward beyond the glans. This wide range of motion is the mechanism by which the penis and the orgasmic triggers in the foreskin, frenulum, and glans are stimulated.

• Sexual Functions in Intercourse: One of the foreskin's functions is to facilitate smooth, gentle movement between the mucosal surfaces of the two partners during intercourse. The foreskin enables the penis to slip in and out of the vagina nonabrasively inside its own slick sheath of self-lubricating, movable skin. The female is thus stimulated by moving pressure rather than by friction only, as when the male's foreskin is missing.

• The foreskin fosters intimacy between the two partners by enveloping the glans and maintaining it as an internal organ. The sexual experience is enhanced when the foreskin slips back to allow the male's internal organ, the glans, to meet the female's internal organ, the cervix-a moment of supreme intimacy and beauty.

The foreskin may have functions not yet recognized or understood. Scientists in Europe recently detected estrogen receptors in its basal epidermal cells.24 Researchers at the University of Manchester found that the human foreskin has apocrine glands.25 These specialized glands produce pheromones, nature's chemical messengers. Further studies are needed to fully understand these features of the foreskin and the role they play.
Care of the Foreskin

The natural penis requires no special care. A child's foreskin, like his eyelids, is self-cleansing. For the same reason it is inadvisable to lift the eyelids and wash the eyeballs, it is inadvisable to retract a child's foreskin and wash the glans. Immersion in plain water during the bath is all that is needed to keep the intact penis clean.26

The white emollient under the child's foreskin is called smegma. Smegma is probably the most misunderstood, most unjustifiably maligned substance in nature. Smegma is clean, not dirty, and is beneficial and necessary. It moisturizes the glans and keeps it smooth, soft, and supple. Its antibacterial and antiviral properties keep the penis clean and healthy. All mammals produce smegma. Thomas J. Ritter, MD, underscored its importance when he commented, 'The animal kingdom would probably cease to exist without smegma.'27

Studies suggest that it is best not to use soap on the glans or foreskin's inner fold.28 Forcibly retracting and washing a baby's foreskin destroys the beneficial bacterial flora that protect the penis from harmful germs and can lead to irritation and infection. The best way to care for a child's intact penis is to leave it alone. After puberty, males can gently rinse their glans and foreskin with warm water, according to their own self-determined needs.

- Paul M. Fleiss, MD, MPH, is assistant clinical professor of pediatrics at the University of Southern California Medical Center. He is the author of numerous scientific articles published in leading national and international medical journals.

Published in Mothering: The Magazine of Natural Family Living, Winter 1997, pp. 36--45.

http://www.mothersagainstcirc.org/fleiss.html

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Related Links: (In English)
___________________________________________________________________

> Intact America: (USA) <
> http://www.intactamerica.org <

> Mothers Opposing Circumcision (International and Worldwide) <
> http://www.mothersagainstcirc.org <

> Doctors Opposing Circumcision (International and Worldwide) <
> http://www.doctorsagainstcircumcision.com <

> Nurses Opposing Circumcision (International and Worldwide) <
> http://www.Nurses.cirp.org <

> International Coalition for Genital Integrity (International and Worldwide) <
> http://www.icgi.org <

> Jews Opposing Circumcision: (Israel, UK, International and Worldwide) <
> http://www.jewsagainstcircumcision.org <

> Catholics Opposing Circumcision (International and Worldwide) <
> http://www.catholicsagainstcircumcision.org <

> Muslims Opposing Circumcision (International and Worldwide) <
> To Mutilate in the Name of Jehovah or Allah by Sami A. Aldeeb Abu-Sahlieh <
> http://www.cirp.org/library/cultural/aldeeb1/ <

> The History of Circumcision (International and Worldwide) <
> http://www.HISTORYOFCIRCUMCISION.NET <

> Ending Circumcision In The Jewish Community By Moshe Rothenberg, CSW. (International and Worldwide) <
> http://www.nocirc.org/symposia/second/rothenberg.html <

> An Orthodox Rabbi Speaks Out Opposing Circumcision, 2007 (Israel, UK, CA, International and Worldwide) <
> http://www.rabbinathan.com/writings/circum.shtml <

> Brit Shalom - A Covenant of Wholeness Text (Israel, UK, International and Worldwide) <
> http://www.nocirc.org/religion/Naming_ceremony.php <

> Bris B'lee Milah & Bris Shalom Ceremony Text (International) <
> http://www.noharmm.org/nontrad.htm <

> Brit B'lee Milah & Bris Shalom Ceremony Text (Israel, UK, USA, International and Worldwide) <
> http://www.cirp.org/pages/cultural/bris_shalom.html <

> List of Brit B'lee Milah & Bris Shalom Rabbis by Dr. Mark D. Reiss, M.D. (International and Worldwide) <
> http://www.circumstitions.com/Jewish-shalom.html <
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A Rabbi Speaks Out Against Circumcision Surgery

'I believe circumcision is a major mistake...The code of the Jewish law is called 'halacha' (the way). Within the Code, there is a provision that if a mother looses a son because of circumcision, she is NOT obligated to circumcise her next son. I extrapolate from this, the inter-connection of my human family, that enough deaths and maiming have occured because of circumcision. Therefore - circumcision is no longer a requisite! Just as we no longer practice the animal sacrifices in the traditional temple, so let us not sacrifice an important piece of our mammal in the temple of tradition.'

- Rabbi Natan Segal, 2007
Rabbi Natan Segal, Rabbi of Shabbos Shul, the Shul of Marin County, Marin County, California, U.S.A.

Ordination: 1977 Rabbi Zalman Schachter-Shalomi Yeshiva B'nai Or Philadelphia, Pa.

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Jewish Doctors Opposing Circumcision Surgery

'I am a 72 year old retired physician, a Jew who is an active member of a Conservative synagogue, and a grandfather. Three years ago, as I was about to become a grandfather for the first time, my interest in the subject became more focused. I learned that more and more physicians now realize that any potential benefits of circumcision are far outweighed by its risks and drawbacks. Whether done by a physician in the hospital, or a mohel in a ritual brit milah, the procedure has significant complication rates of infection, hemorrhage and even death. Mortality may actually be higher than thought since some of these deaths have not been attributed to circumcision, but listed only under their secondary causes, such as hemorrhage or infection. I’ve learned of the very important role the foreskin has in the protection of the head of the penis in the infant, and in sexual functioning in adulthood.
Growing numbers of American Jews are now leaving their sons intact as they view circumcision as a part of Jewish law that they can no longer accept. Alternative brit b’li milah or brit shalom ceremonies (ritual naming ceremony without cutting) are being performed by some rabbis. Increasing numbers of intact boys are going to religious school, having bar mitzvahs, and taking their place as young adults in the Jewish community.
As a Jewish grandfather, I want to assure young couples about to bring a child into the world, that there are other members of the Jewish “older” generation, including other Jewish physicians, and even some rabbis, who feel as I do. If your heart and instincts tell you to leave your son intact, listen!'

- Dr. Mark D. Reiss, M.D.
http://www.doctorsopposingcircumcision.org
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Physicians have a duty to refuse to perform circumcision. They also must educate parents who, out of ignorance or misguidance, request this surgery for their sons. The healthcare professional's obligation is to protect the interests of the child. It is unethical in the extreme to force upon a child an amputation he almost certainly would never have chosen for himself.
- Paul M. Fleiss, MD, MPH. Assistant clinical professor of pediatrics at the University of Southern California Medical Center. He is the author of numerous scientific articles published in leading national and international medical journals.

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RELATED LINKS: (IN HEBREW)
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> Israeli Association Against Genital Mutilation (Israel, in Hebrew) <
> http://www.britmila.org.il <

> Gonen Al Hayeled / Protect the Child (Israel, in Hebrew) <
> http://www.gonen.us <

> Kahal / Intact Israelis' Parents' Rights Group (Israel, in Hebrew) <
> http://www.kahal.org <

___________________________________________________________________
Related Links: (In English)
___________________________________________________________________

> Jews Opposing Circumcision (Israel, UK, United States) <
> http://www.jewsagainstcircumcision.org <

> By Moshe Rothenberg, MSW. Ending Circumcision In The Jewish Community (Israel, UK, USA) <
> http://www.nocirc.org/symposia/second/rothenberg.html <

> *Brit B'lee Milah & Bris Shalom: Alternative Non-Circumcision Rituals (Israel, UK, USA) <
> http://www.circumstitions.com/Jewish-shalom.html <

> One Rabbi Speaks Out Against Circumcision, 2007 (Israel, UK, CA) <
> http://www.rabbinathan.com/writings/circum.shtml <

> Paul M. Fleiss, MD., The Case Against Circumcision (UK) <
> http://www.mothersagainstcirc.org/fleiss.html