Losses from CircumcisionDr Peter Ball MB,B ChirLast updated on 9th August 2003Many people think circumcision removes nothing more than a little extra skin. However, circumcision removes several critical components of male sexual anatomy. This list enumerates everything currently known to be physically lost after circumcision.Alongside these physical losses, it is important to remember that whenever a child is circumcised, by far the greatest loss is his choice to make decisions about his own body and his own sex life when he becomes an adult.The Foreskin which comprises up to 50% (sometimes more) of the mobile skin system of the penis. If unfolded and spread out flat the average adult foreskin would measure about 15 square inches( the size of a 3x5 inch index card). This highly specialised tissue normally covers the glans and protects it from abrasion, drying, callusing(keratinisation), and contaminants of all kinds.The effect of glans keratinisation has never been studied.[1. M. M. Lander, "The Human Prepuce," in G. C. Denniston and M. F. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 79-81. 2. M. Davenport, "Problems with the Penis and Prepuce: Natural History of the Foreskin," British Medical Journal 312 (1996): 299-301.]The Frenar Ridged Band,the primary erogenous zone of the male body. Loss of this delicate belt of densely innervated, sexually responsive tissue reduces the fullness and intensity of sexual response.[Taylor, J. R. et al., "The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision," British Journal of Urology 77 (1996): 291-295.]The Foreskin's 'Gliding Action'- the hallmark mechanical feature of the normal natural, intact penis. This non-abrasive gliding of the penis in and out of itself within the vagina facilitates smooth , comfortable, pleasurable intercourse for both partners. Without this gliding action, the corona of the circumcised penis can function as a oneway valve, scraping vaginal lubricants out into the drying air and making artificial lubricants essential for pleasurable intercourse.[P. M. Fleiss, MD, MPH, "The Case Against Circumcision," Mothering: The Magazine of Natural Family Living (Winter 1997): 36-45.]Nerve EndingsNerve Endings transmit Sensations to the Brain - Fewer Nerve Endings meansFewer Sensations.Circumcision removes the most important sensory component of the foreskin - thousands of coiled fine-touch receptors called Meissner's corpuscles. Also lost are branches of the dorsal nerve, and between 10,000 and 20,000 specialized erotogenic nerve endings of several types. Together these detect subtle changes in motion and temperature, as well as fine gradations in texture. [1. R. K. Winkelmann, "The Erogenous Zones: Their Nerve Supply and Its Significance," Proceedings of the Staff Meetings of the Mayo Clinic 34 (1959): 39-47. 2. R. K. Winkelmann, "The Cutaneous Innervation of Human Newborn Prepuce," Journal of Investigative Dermatology 26 (1956): 53-67.]The FrenulumThe highly erogenous V-shaped web-like tethering structure on the underside of the glans; frequently amputated along with the foreskin, or severed, either of which destroys its function and potential for pleasure.[1. Cold, C, Taylor, J, "The Prepuce," BJU International 83, Suppl. 1, (1999): 34-44. 2. Kaplan, G.W., "Complications of Circumcision," Urologic Clinics of North America 10, 1983.]Muscle SheathCircumcision removes approximately half of the temperature-sensitive smooth muscle sheath which lies between the outer layer of skin and the corpus cavernosa. This is called the dartos fascia.[Netter, F.H., "Atlas of Human Anatomy," Second Edition (Novartis, 1997): Plates 234, 329, 338, 354, 355.]The Immunological Defense Systemof the soft mucosa. This produces both plasma cells that secrete immunoglobulin antibodies and antibacterial and antiviral proteins such as the pathogen-killing enzyme lysozyme.[1. A. Ahmed and A. W. Jones, "Apocrine Cystadenoma: A Report of Two Cases Occurring on the Prepuce," British Journal of Dermatology 81 (1969): 899-901. 2. P. J. Flower et al., "An Immunopathologic Study of the Bovine Prepuce," Veterinary Pathology 20 (1983):189-202.]Lymphatic Vesselsthe loss of which reduces the lymph flow within that part of the body's immune system.[Netter, F.H., "Atlas of Human Anatomy," Second Edition (Novartis, 1997): plate 379.]Oestrogen Receptorsessential for sperm production in males, and have important physiological functions in the cardiovascular system, immune system, central nervous system, and in bone, where they support several diverse physiological processes such as cardiovascular protection, the humoral immune response, neuroprotection and bone remodelling.The Apocrine Glandsof the inner foreskin, which produce pheremones -nature's powerful, silent, invisible behavioural signals to potential sexual partners. The effect of their absence on human sexuality has never been studied.[A. Ahmed and A. W. Jones, "Apocrine Cystadenoma: A Report of Two Cases Occurring on the Prepuce," British Journal of Dermatology 81 (1969): 899-901.]Sebaceous Glandswhich lubricate and moisturise the foreskin and glans, normally a protected and internal organ-like the tongue or vagina. Not all men have sebaceous glands on their inner foreskin.[A. B. Hyman and M. H. Brownstein, "Tyson's Glands: Ectopic Sebaceous Glands and Papillomatosis Penis," Archives of Dermatology 99 (1969): 31-37.]Langerhans CellsSpecialised epithelial Langerhans cells, a first line component of the body's immune system in a whole penis.[G. N. Weiss et al., "The Distribution and Density of Langerhans Cells in the Human Prepuce: Site of a Diminished Immune Response?" Israel Journal of Medical Sciences 29 (1993): 42-43.]Penis Size Some of the penis length and circumference because its double-layered wrapping of loose and usually overhanging foreskin is now missing, making the circumcised penis truncated and thinner resulting in less girth than it would have been if left intact. An Australian survey in 1995 showed uncircumcised men to have erect penises an average of 8-20mm longer than those of men circumcised during childhood. There was no significant difference recorded for men circumsized during adulthood.[1. R. D. Talarico and J. E. Jasaitis, "Concealed Penis: A Complication of Neonatal Circumcision," Journal of Urology 110 (1973): 732-733. 2. Richters J, Gerofi J, Donovan B. Why do condoms break or slip off in use? An exploratory study. Int J STD AIDS. 1995; 6(1):11-8. ]Blood VesselsSeveral feet of blood vessels, including the frenular artery and branches of the dorsal artery are removed in circumcision. This loss of the rich vascularity interrupts normal flow to the shaft and glans of the penis, damaging the the natural function of the penis and altering its development. [1. H. C. Bazett et al., "Depth, Distribution and Probable Identification in the Prepuce of Sensory End-Organs Concerned in Sensations of Temperature and Touch; Thermometric Conductivity," Archives of Neurology and Psychiatry 27 (1932): 489-517. 2. Netter, F.H., "Atlas of Human Anatomy," Second Edition (Novartis, 1997): plates 238, 239.]Dorsal NervesThe terminal branch of the pudendal nerve connects to the skin of the penis, the prepuce, the corpora cavernosa, and the glans. Destruction of these nerves is a rare but devastating complication of circumcision. If cut during circumcision, the top two-thirds of the penis will be almost completely without sensation. [1. Agur, A.M.R. ed., "Grant's Atlas of Anatomy," Ninth Edition (Williams and Wilkins, 1991): 188-190. 2. Netter, F.H., "Atlas of Human Anatomy," Second Edition (Novartis, 1997): plate 380, 387.]Emotional BondingCircumcision performed during infancy disrupts the bonding process between child and mother. There are indications that the innate sense of trust in intimate human contact is inhibited or lost. It can also have significant adverse effects on neurological development. Additionally, an infant's self-confidence and hardiness is diminished by forcing the newborn victim into a defensive psychological state of "learned helplessness" or "acquired passivity" to cope with the excruciating pain which he can neither fight nor flee. The trauma of this early pain lowers a circumcised boy's pain threshold below that of intact boys and girls. [1. R. Goldman, Circumcision: The Hidden Trauma (Boston: Vanguard Publications, 1997), 139-175. 2. A. Taddio et al., "Effect of Neonatal Circumcision on Pain Responses during Vaccination in Boys," Lancet 345 (1995): 291-292.]Neurological Sexual CommunicationAlthough never studied scientifically, contemporary evidence suggests that a penis without its foreskin lacks the capacity for the subtle neurological "cross-communication" that occurs only during contact between mucous membranes and which contributes to the experience of sexual pleasure. Amputating an infant boy's multi-functional foreskin is a "low-grade neurological castration" [Immerman], which diminishes the intensity of the entire sexual experience for both the circumcised male and his partner.)