Article by C.J. Cold, MD, and J.R. Taylor published in British Journal of Urology (now BJI International), Vol. 83, Supp. 1, pp. 34-44, 1983. DOI: 10.1046/j.1464-410x.1999.0830s1034.x  The authors describe the prepuce as a common anatomical structure of both male and female genitalia. The authors discuss the embryology, anatomy, and function of the prepuce.  Based on the complex anatomy and the function of the prepuce, or foreskin, the authors advise against neonatal (infant) circumcision. The state that the removal of normal genital anatomy in children and infants should be deferred until the individual can make their own informed choice.

The prepuce is an integral, normal part of the external genitalia that forms the anatomical covering of the glans penis and clitoris. The outer epithelium has the protective function of internalising the glans (clitoris and penis), urethral meatus (in the male) and the inner preputial epithelium, thus decreasing external irritation or contamination. The prepuce is a specialized, junctional mucocutaneous tissue which marks the boundary between mucosa and skin; it is similar to the eyelids, labia minora, anus and lips. The male prepuce also provides adequate mucosa and skin to cover the entire penis during erection. The unique innervation of the prepuce establishes its function as an erogenous tissue.

 

The prepuce is a specialized, specific erogenous tissue in both males and females. Therefore, surgical excision should be restricted to lesions that are unresponsive to medical therapy, such as lichen sclerosis of the penis (balanitis xerotica obliterans) or vulva, which is unresponsive to other therapies (e.g. topical clobetasol, intralesional corticosteroids, topical testosterone propionate ointment, etretinate, and carbon dioxide or laser vaporization). Preputial plasty [100] should be considered in place of circumcision whenever possible, so as to preserve the corpuscular sensory receptors, dartos muscle, penile mucosa and complete function of the penis, while avoiding abnormal exposure and keratinization of the glans penis. Although some cultures celebrate the abnormal anatomy caused by circumcision, many women and men have reported this abnormal penile/clitoral exposure to be uncomfortable. The male prepuce contains the vast majority of the penile dartos muscle that cannot be regenerated after circumcision.

The complete text of the article is available in the CIRP Library.