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In mammals, the foreskin or prepuce is the retractable double-layered fold of skin and mucous membrane that covers the head of the penis, (the glans penis). It serves as a sheath to protect the glans penis from injury.

The human foreskin

In humans, the foreskin, a part of the penis, is a double-folded tube of highly innervated and vascularized skin and mucous membrane [1] (similar to the inside of the mouth) which attaches at the crested end of the glans at the sulcus, and to the body above the pubic bone and scrotum. Unlike the skin on the rest of the body, which is attached to the underlying tissue, the foreskin and shaft skin are free to glide along the shaft of the penis. Smooth muscle fibres keep the foreskin close to the glans penis but make it highly elastic.[2]

The inner surface of the foreskin is fused with the glans penis at birth.[3] The fusion gradually breaks down over a period of 3 to 17 years, releasing the foreskin and allowing it to become retractable.[4] 44 percent of boys have fully retractable foreskins by age ten, 90 percent by age 16, and 99 percent by age 18.

The coverage of the glans by the foreskin in adults is a highly variable characteristic. Some men have abundant overhang when flaccid, while others do not have complete glans coverage. Schoeberlein, in a German study, found that around 50% of uncircumcised young men had full coverage of the glans while 42% had partial coverage while the remaining 8% were both glans and sulcus free. After adjusting for circumcision he established that in 4% of the young men the foreskin atrophied (shrank) spontaneously.


One of the purposes of the foreskin is to protect the glans of the penis from damage; it serves a similar function to that of the eyelids protecting the eyes. Only the outside of the foreskin should be washed during infancy and childhood. As stated above, it is entirely normal for the foreskin to be fused with the glans in babies and not to fully retract in young boys. Forcible retraction of the foreskin should be avoided and the child himself should be the first person to retract the foreskin.[5] Premature retraction, which is painful, can cause infection and may in exceptional cases cause permanent damage to the glans penis. The fusion breaks down over a period of years.

Periodic washing under the foreskin becomes more important after a male becomes sexually active. If the man does not wash under the foreskin for a few days, the accumulation of secretions, sloughed skin cells and bacteria produce a white creamy paste between the prepuce and glans penis called smegma. In developing countries where infant circumcision is not routinely practised and genital hygiene is poor, penile cancer may comprise 10 to 20% of all malignancies, although it is rare in Western countries. Squamous cell carcinoma of the penis


Phimosis is a condition in which the foreskin cannot be retracted fully or at all. Phimosis is treated through the use of topical steroid ointments, stretching, or circumcision. In some cases, a dorsal slit is made in the foreskin to correct a medical problem. See phimosis for more information on treatment of phimosis. Non-retractile foreskin is a normal condition prior to puberty.[6]

Where the foreskin is partially retractable, a condition called paraphimosis may occur where the foreskin becomes trapped behind the glans. This is a serious condition which must be treated as a medical emergency.

Surgical modification

In addition to its use as a treatment for phimosis, circumcision is also practiced, primarily on infants, for religious or aesthetic reasons or alleged health benefits. See medical analysis of circumcision for a detailed discussion on the positive and negative health effects of circumcision.

Preputioplasty is now the preferred surgical treatment for non-retractile foreskin.[7] [8]

Some circumcised men engage in foreskin restoration by tensioning the remaining skin to encourage skin expansion.

Cultural views

In ancient Greece, men competed naked in athletic contests but an exposed glans was considered obscene. Often a thong (kynodesme) was worn to hold the foreskin closed. The Greeks regarded circumcision as a mutilation and this led to clashes with Jewish people as can be seen in Maccabees 1 and 2.

Among many tropical South American Indians, it was considered shameful for a man's glans penis to be seen in public, but completely acceptable for a man to be naked. In some tribes, such as in the Mato Grosso, the foreskin would be held shut by a clamping device made from a palm fronds. This could well have been introduced to prevent parasites from entering under the foreskin.[dubious ]In other tribes, such as the Yanomami, the foreskin would be clamped into a string-like belt worn around the waist. In this case, the foreskin would tend to continue to grow as a result of the sustained tension, resulting in foreskins that had an overhang of possibly two inches or more.

Among the Maori of New Zealand (unlike many other Polynesian peoples, who superincised) an exposed glans (tehe) was considered obscene, and a string hanging down from a waistband was tied around the foreskin to prevent it.

The purported foreskin of Jesus Christ has been venerated as a Christian relic in various places at various times. It is known as the Holy Prepuce.

In a survey, WOMEN'S PREFERENCES FOR PENILE CIRCUMCISION IN SEXUAL PARTNERS, Williamson & Williamson found that among a predominantly white Midwestern female population,"[71-83% of] women state a preference for circumcised penises particularly for sexual activities like fellatio, but also for intercourse, manual stimulation, and visual appeal." Of the women who took part in the survey 78% had no sexual experience with uncircumcised men. Of the 24 women who had experience with both circumcised and uncircumcised partners, two-thirds favored circumcision exclusively and a significantly greater proportion preferred circumcised partners for all the sexual activities listed above. This would indicate that in this sample of a modern society the exposed glans is seen as "sexier" rather than obscene by a significant majority.

A recent survey [9] found that women "were significantly more likely to have experienced vaginal dryness during intercourse with circumcised than with genitally intact men". The survey's authors concluded that the foreskin reduces the loss of lubricating fluid during sexual intercourse. However, due to the size of the survey (35), the unknown methodology of recruitment and the known anti-circumcision activism of the survey organisers the results are viewed with some scepticism.

Judaism and Islam

Both Jews and Moslems practice ritual circumcision whereby the foreskin of a young boy is cut away permanently. In Judaism, an expert circumcisor known as a mohel performs the ritual, known as brit milah on an eight day old baby boy. It is considered to be religiously mandated by the Torah as the mark of the Covenant between God and Abraham, the forefather of both the ancient Hebrews, and the sons of Ishmael. In this religion, the foreskin is considered to be the embodiment of "spiritual impurity" symbolizing the physical lusts and sexual drives which need to be tamed for the betterment of mankind.

See also

External links

  • Fleiss P, Hodges F, Van Howe RS. Sex. Trans. Inf. 74(5): 364-367 (1998). Immunological functions of the human prepuce Note: the authors hold a strong anti-circumcision point of view.
  • C.J. Cold and J.R. Taylor. British Journal of Urology 83, Suppl. 1: 34-44 (1999) The Prepuce Note: the authors hold a strong anti-circumcision point of view.