the foreskin is much more than a flap of skin

Message From: Babycenter Bulletin Board
Subject: Circumcision Debate Board
Posted on Date: 02/06/02
Posted by : mazza98

"First what the foreskin is not: The foreskin is not a flap of skin on the end of
the penis. This kind of terminology has been used to imply that the foreskin is
something redundant with no real function, that can easily be removed with no
consequence. This is not the case. 

The foreskin is special in that it is not directly attached as most skin is. It is
free to slide up and down the shaft of the penis with almost no friction. The
foreskin can be thought of as a continuation of the tube of skin that covers the
shaft of the penis, but much longer. This tube of skin is firmly attached only at
the base of the penis and at the head of the penis. In between the points of
attachment this tube of skin has the special property that easily slides on the
shaft of the penis rather than being firmly connected as most skin is. The
foreskin's length and the fact that it is unattached in the middle allows it to
slide up and down the shaft of the penis and roll in on itself over the head of the
penis (see diagram below). 

The foreskin is long enough so that it continues down the shaft of the penis and
rolls in on itself over the head of the penis. For those of you who are only
familiar with circumcised penises, that means that an intact penis has two to three
times as much skin that a circumcised penis. 

A foreskin is long. An intact penis has two to three times the length of skin that
a circumcised penis has. When flaccid, most of this length is taken up in the
double fold of skin covering the head of the penis. When erect the foreskin can
roll back to allow the penis to lengthen while still allowing the skin on the shaft
of the penis to remain loose. The foreskin is often long enough to cover the head
of the penis while erect. 

The foreskin is extremely sensitive. It is filled with nerve endings called stretch
receptors that fire when they are stretched, rolled, or massaged. 

The foreskin is filled with nerve endings called stretch receptors. These nerve
endings fire when they are stretched, rolled, or massaged. The only purpose of
these nerve endings is to make sex more enjoyable. The stretch receptors are unlike
the nerve endings in the head of the penis which are very sensitive to friction but
can be so sensitive that the sensation can be irritating or painful. The nerve
endings in the head of the penis tend to trigger orgasm much more than the nerve
endings in the foreskin. 

The head of the penis has no skin. This may be a surprise to those of you who are
familiar only with circumcised penises. The head of the penis is actually covered
by a very thin moist mucus membrane, very much like the inside of the lip or the
inside of the eyelid. The head of the penis is not meant to be exposed to the
elements such as friction against clothing, friction during sex, the sun's rays, or
soap (in infants urine or feces). The head of the penis is supposed to be protected
by the warm, moist coccoon that the foreskin creates. If the foreskin is remvoed,
the mucus membrane of the penis thickens in response to the lack of protection. It
may look like skin, but it is not. 

The foreskin is lined with smoothe muscle fibers which contract to make the
foreskin wrap snugly around the head of the penis. These muscle fibers can relax to
permit the foreskin to be retracted. 

The frenulum is a Y shaped web of skin that connects the foreskin to the underside
of the head of the penis. The frenulum is kind of like the web of skin under the
tongue. This is the most sensitive part of the penis, containing a huge number of
nerve endings. Circumcision usually removes all or most of the frenulum

Infant circumcision is made more acceptable by believing the notion that there is a
flap of skin at the end of the penis called the foreskin which hangs over the glans
and circumcision simply removes that flap. This is factually incorrect. By thinking
that the foreskin is separate or "extra" tissue it is easier to believe that its
removal does little to impact or change the rest of the skin of the penis. 

There is really no separate anatomical structure called the foreskin. Rather there
is one single continuous skin sheath of the penis which is called the skin system.
This single, uninterrupted skin sheath may, at any given time, fold to varying
degrees over the glans or retract to reveal it. The amount of the skin system that
is folded over can be referred to as the forefold of the skin system. Its extent
changes often to accommodate degrees of erection, and it is never a separate
structure from the skin of the shaft. 

What the operation called circumcision actually does then is to interrupt and
significantly reduce the skin system of the penis to a fraction of its normal
anatomical and functional extent. 


The skin system of the penis
The intact penis is covered by one single continuous skin sheath or skin system.
The skin sheath is partly folded at different times. This folded part of the skin
system is called the foreskin or prepuce. 

The fold of skin is often mistaken as a single layer, or a flap of skin. This is
wrong. Instead, it is a free, two-layer fold that forms when the skin coming down
the penis from the shaft folds underneath itself somewhere near the tip of the
penis then travels back to an attachment point behind the glans (see figures 6 and
4). The two sides of the fold do not adhere to each other even though they lie flat
against each other appearing to form a single flap of skin. 

Also, in the adult the skin system does not adhere to the glans so it can unfold
back off of the glans, leaving it fully exposed. When we speak of this skin sheath
we are not talking about the surface of the glans itself in the same way that we
talk about the surface of the shaft, because the glans has no real skin. When we
talk about the skin covering of the glans, this can only mean the foreskin. The
foreskin is its skin covering. 


The fictitious foreskin
 
A significant anatomical error has been made historically and continues today in
describing the penis by delineating the "foreskin" as a separate anatomical
structure from the shaft skin. People talk about the "foreskin" separately from the
shaft skin. This is a mistake. It is not correct. 

The foreskin is not a separate anatomical structure from the rest of the skin of
the penis. This is actually an artificial separation. When the word foreskin is
used, rather than referring to a separate part of the penis, it means the part of
the continuous skin system which happens to be folded over the glans at any given
time. So there is no real anatomical border to the "foreskin." Since the proportion
of the skin system that is folded over the glans increases and decreases by folding
and unfolding to various degrees all the time, we realize that "foreskin" is a poor
way of describing the anatomy of the penis. Instead, more accurate terminology
might be to describe that part of the skin system which covers the glans as the
"forefold of the skin system." 

Unlike the false border between "foreskin" and shaft skin, there is a real
anatomical border which exists in the skin system. It is between the mucosal, or
non-keratinized, part of the skin system (which consists of the inner lining of the
foreskin along with the surface of the glans) and the keratinized part (which is
the outer penile skin, including the outer foreskin). That border is at the most
distal part, or tip, of the skin system - it is the tip of the forefold (see
figures 6 and 7). 


The mobility of the skin system
The entire skin system moves freely. In the intact (uncircumcised) male, the penis
has a low friction gliding plane immediately beneath the surface of the skin which
is like no other body structure. This means that the skin of the penis does not
adhere to the underlying tissue the way that skin adheres to other parts of the
body. This unique quality allows the entire skin of the penis to move as a unit
back and forth longitudinally or around the shaft circumferentially making it the
most mobile skin in the intact male. 

The skin system covers the head of the penis to varying degrees depending on
moment-to-moment factors such as the state of erection and temperature. The free
fold of the skin system which we call "foreskin" unfolds and re-folds constantly to
varying degrees, adjusting to the current state of the penis. It is a very dynamic
system. The foreskin, among other functions, provides the penis with a reservoir of
skin which is needed during erection. The skin of the erect, intact penis is still
mobile and loose, allowing the mucosal inner foreskin to roll back and forth over
the glans (see figure 7). 

Thus, the dividing line between what we call the skin of the shaft and foreskin is
regularly crossed by the "shaft skin" or "foreskin." The delineated "foreskin" may
become entirely "shaft skin" when the penis becomes more erect because it is now
around the shaft. And if the penis shrinks momentarily beyond its usual flaccid
state, perhaps due to a cold swim at the beach, some of the "shaft skin" is now
"foreskin" because it covers the glans. The skin system is a dynamic, mobile and
flexible skin sheath that moves and adjusts to the momentary needs of the penis
(see figure 7). Such a system is not normally observed in the circumcised male. 

Another anatomical error is committed in describing the foreskin as a flap of skin
protruding from the shaft skin (figure 6a). This notion presumes that the foreskin
is a single layer of skin, like the skin of the shaft, which grows from the shaft
to cover the glans. In describing the foreskin this way it is easier to see it as
redundant or "extra skin" and it is more difficult to see how removing it might
impact the rest of the penis. This description of the foreskin is inaccurate. The
foreskin is not "extra" skin which protrudes from the shaft. There is no extra skin
on the body - this is a silly notion. Instead, it is a free, double-layered fold -
an integral part of the skin system. The foreskin extends from a point on the shaft
behind the glans to cover the glans then folds back underneath itself to the same
attachment point on the shaft, usually near the glans (see figure 6). The eyelid
works much the same way. The eye lid is not a single flap of skin, but rather two
freely moving layers of a fold of s kin, so that both the foreskin and the eyelid
have two layers. That's why it is more appropriate to refer to the "foreskin" as
the forefold of the skin system. 

In reality then, infant circumcision does not remove the "tip of the penis" or
"redundant skin" nor does it remove a separate structure called "the foreskin."
Rather, infant circumcision deletes a significant percentage of the skin system of
the penis, rendering the skin system relatively dysfunctional and rendering the
penis less dynamic. 


The "triple whammy"
The circumcised penis loses sensitivity in three ways: 
Loss of the foreskin nerves themselves. As has been demonstrated by studies such as
the one by Dr. Taylor and by the testimonials of the majority of intact men, the
inner foreskin possesses a greater density of nerve endings. It is thought to be
more erogenous than even the glans. The is no question that the foreskin is a
highly erogenous tissue. This tremendous amount of sensitivity is lost completely
when the forefold of the skin system is amputated. In addition to this, the most
sensitive part of the penis, the frenulum of the foreskin, is either partially or
totally removed in most infant circumcisions. The frenulum is the continuation of
the inner foreskin which attaches to the underside (ventral part) of the glans.
Thus, a significant percentage, if not the majority, of erogenous nerve supply to
the penis is removed in circumcision at birth. 

Damage to the glans. The erogenous sensitivity that remains after circumcision is
primarily in the glans. This is further reduced by removal of the protective
foreskin which leaves the glans permanently exposed. Unlike the shaft of the penis,
and most of the rest of the body, the head of the penis, does not posses its own
attached skin. This structure, like the eye ball and the gums of the mouth, is a
somewhat naked structure. Its surface is non-keratinized, like that of the gums,
the eye ball, and the clitoris in women. That means that it does not posses a
protective thick layer like the keratinized skin of the outer penile skin system.
Like the gums and the eye ball, the glans of the intact penis has a retractible
skin covering. The skin covering of the glans is the foreskin. The eyelid is very
similar in architecture to the foreskin. If the eyelid were removed and the eyeball
were to become keratinized, you'd have a much harder time seeing. The same is true
of the glans. It becomes artificially keratinized (dry, ha rdened, discolored, and
wrinkled) as a result of permanent exposure, and thus less sensitive. Because most
American men are circumcised and have a glans of this nature, it is harder to
notice the abnormality. But just compare the glans of an intact man with that of a
circumcised man next to each other and you'll notice a big difference. Thus, in
addition to removing lots of erogenous nerve endings in the inner foreskin and
frenulum, circumcision further desensitizes the remaining sensitivity of the glans
by leaving it exposed. 

Loss of skin mobility. The nerve endings in the glans are predominantly complex
touch receptors also known as mechanoreceptors. This is different from the light
touch receptors of the skin which detect surface friction. The mechanorecptors are
best stimulated by massage action rather than surface friction. Thus, the glans is
best stimulated to feel pleasure by a rolling massage action. With an ample and
highly mobile skin system that rolls over the glans with pressure from the opposing
surface, this optimal stimulation of the glans is achieved while avoiding direct
friction of the delicate glans surface. Direct friction tends to fire off pain
receptors causing irritation and also causes further keratinization of the glans.
With the skin system of the penis significantly reduced by circumcision, the
mobility is essentially gone and now the penis is a static mass with no dynamic
self stimulation mechanism. Now, it must be rubbed. Direct friction is now the
primary form of stimulation. So then circumcision further reduces erogenous s
ensitivity in the penis by reducing skin mobility and thus the ability to use the
foreskin to massage the glans. The combination of foreskin and glans in concert
results in an even higher level of stimulation which is unknown to the circumcised
male."

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