Date: Sat, 16 Nov 1996 13:13:48, -0500
From: Martin B Novoa
To: intact-L@cirp.org
Subject: Preputial sphincter and more

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-------- REPLY, Original message follows --------

> Date: Saturday, 16-Nov-96 10:53 AM
> From: John D Dalton
>
> Possibly out of order on this list, but has anyone shared my
> experience of the skin developing a new sphincter during
> restoration?
> -- 
> John D Dalton
> 
-------- REPLY, End of original message --------



John,

My friend Brian Levitt here in San Francisco has discovered this
phenomenon during his restoration and has mentioned it on several
occasions to me recently.  It has surprised him .  Frankly, I find his
claim hard to believe.  The sphincter (as the end point of the smooth
and striated muscle tissue that runs throughout the shaft skin --
inclduing foreskin -- of the penis) has been cut off, and there is no
good physiological reason I can think of that stretched skin would close
itself around the glans and form a new sphincter.  Perhaps Ken McGrath
or another can contradict this.

My suspicion about Brian's experience is that, lacking lifelong
experience with the real thing as some of us have, he is excited about
ordinary contouring.  I don't mean to discount his progress or his
excitement, but I can't encourage him too much about seeing a lot more
development.

We all know that some things are lost forever to circumcision:

1)  The preputial sphincter
2)  Important veins to help with tumescence, detumescence, and general
lower body circulation
3)  51% of the shaft skin of the penis (Taylor)
4)  Most, if not all, of the ridged band (frenar band)
5)  The specialized, concentrated nerve endings and Meissner's
corpuscles
6)  The neural pathways in the brain that correspond to the excised
tissue
7)  Often, much or all of the frenulum
8)  Often, the sensitive, sphincter-like meatal lips (through meatitis)

Of course, circumcision adds a few things to the penis:

1)  A ring cicatrice around the shaft, not always so neat
2)  On average a 10-fold increase (5 --> 50) in cell depth of tissue
covering the glans (keratinization)
3)  An substantial increase in cell depth of inverted, exposed preputial
mucosa on the shaft
4)  Often, pitting and scarring of the glans
5)  Often, scar tissue around the meatus (resulting in stenosis) from
repeated meatitis
6)  Often, pubic skin and hair pulled onto the penile shaft
7)  Hyperdevelopment of the capillary system of the penis to compensate
for the loss of the complex drainage system of veins
8)  Sometimes, an accumulation of lymphatic fluid in the penis, due to
this drainage deficiency, which hardens into a lump
9)  Sometimes, skin tags and skin bridges to the glans
10)  Sometimes, a curvature due to the nature of the surgery (such as
chordee)
11)  Sometimes, accumulation of trapped preputial debris via acquired
phimosis (circumcised phimosis)


Of these, it is my understanding that only the keratinization is addressed
by attempts at restoration (and even that is not a certainty).  I try to
be supportive of all of my friends who are restoring, but I think that
reviewing lists like this helps remind us of what we are trying to
educate parents about as they explore circumcision.

Relentlessly,

Martin