Histologic Characteristics of the Human Prepuce Pertaining to its Clinical Behavior as a Dual Graft

Tuncali, Dogan; Bingul, Ferruh; Talim, Beril; Sürücü, Hüseyin; Sahin, Firdevs; Aslan, Gürcan

doi:10.1097/01.sap.0000141939.42990.70

Cited by 13 publications

(15 citation statements)

References 26 publications

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“…[16] It is a simple fold of skin composed of an outer keratinized (skin) and inner (mucosal, lining a preputial sac) layers [Figure 1a] that are rich in nerves. [1718] The abundance of myelinated and nonmyelinated nerve fibers explains the high sensitivity of the human foreskin and its function as erogenous tissue. [1518]…”

Section: Introductionmentioning

confidence: 99%

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Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

Namavar¹,

Robati²

2011

Urol Ann

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Background and Aim:Premature ejaculation (PE) is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of foreskin remnants in adults on PE.Materials and Methods:The sensitive area of penile skin and the remaining parts of foreskin in adult men were recognized in 47 selective patients. Under local anesthesia, the remnant parts of foreskin were incised and removed. They were asked to fill the investigating questionnaire about the changes of intravaginal latency ejaculatory time (IVELT), patients and their sexual partners’ satisfaction with sexual life, control over ejaculation, and penile sensitivity, before and after treatment.Results:There were no signs of inflammation and no serious adverse reactions in all cases after operation. IVELT significantly increased from 64.25 before surgery to 731.49 sec after surgery (P<0.001). The percentage of postoperative satisfaction in both the patient and his partner significantly increased (P<0.001). After surgery, 95.7% of men had better control over their ejaculation. This surgery significantly decreased sensitivity of penis (P<0.001), but it did not change glans penis insensitivity.Conclusions:These results indicate that removal of foreskin remnants in adults is an effective modality in selective patients of PE.

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Section: Introductionmentioning

confidence: 99%

“…[1718] The abundance of myelinated and nonmyelinated nerve fibers explains the high sensitivity of the human foreskin and its function as erogenous tissue. [1518]…”

Section: Introductionmentioning

confidence: 99%

Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

Namavar¹,

Robati²

2011

Urol Ann

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“…The prepuce (foreskin) is richly innervated with sensory neurons, explaining the high sensitivity of the human foreskin (24). The precept behind circumcision to treat PE is that the surgical removal of the prepuce also ablates many of these sensory receptors, thus decreasing glans sensitivity.…”

Section: Surgical Therapy Overviewmentioning

confidence: 99%

Surgery is not indicated for the treatment of premature ejaculation

Anaissie

Yafi

2016

Transl. Androl. Urol.

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Premature ejaculation (PE) is considered the most common male sexual disorder, affecting up to 75% of men at some point in their lives. While medical management is the mainstay of therapy, surgical options such as dorsal nerve neurectomy (DNN), hyaluronic acid (HA) gel glans penis augmentation, and circumcision have been studied as alternative forms of treatment. Preliminary studies have suggested that DNN and HA gel glans penis augmentation are relatively safe and effective, but due to a lack of large, multicenter, randomized-control trials with long-term follow-up, the International Society of Sexual Medicine (ISSM) has been unable to endorse DNN or HA gel glans penis augmentation as options in the treatment of PE. Conflicting data regarding the efficacy and safety of circumcision has similarly led to its exclusion from ISSM recommendations for the treatment of PE. Ethical concerns, particularly the fundamental concept of non-maleficence, are also barriers to the implementation of surgery for PE.

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“…However, the foreskin is a richly innervated structure that protects the glans and plays an important role in the mechanical function of the penis during sexual acts. [16][17][18][19][20] Recent studies, several of which were not included in the AAP report (although they were published within the inclusion period of 1995-2010), suggest that circumcision desensitizes the penis 21,22 and may lead to sexual problems in circumcised men and their partners. [23][24][25][26][27][28][29] In light of these uncertainties, physicians should heed the precautionary principle and not recommend circumcision for preventive reasons.…”

Section: Complicationsmentioning

confidence: 99%

Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision

et al. 2013

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The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report’s conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non–US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

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Histologic Characteristics of the Human Prepuce Pertaining to its Clinical Behavior as a Dual Graft

Cited by 13 publications

References 26 publications

Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

Surgery is not indicated for the treatment of premature ejaculation

Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision

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