Canadian Family Physician, Volume 49: Page 1592, December 2003.
In assessing the link between male circumcision and cervical cancer in female partners, Dr Rivet1 ignores the fact that, morphologically, the prepuce is highly specialized tissue2 and might be worthy of preservation in itself.
The "ridged band" is a ring of uniquely corrugated mucosa just inside the tip of the prepuce: it is highly vascular, and its individual ridges are tipped with Meissner corpuscles known to be sensitive to movement, such as that incurred by sexual intercourse. Work in progress shows that stretching the prepuce and its ridged band triggers reflex contraction of muscles of the bulb of penis known to be associated with ejaculation and, not insignificantly, erogenous sensation. Further information on the ridged band can be found at http://research.cirp.org.
As if excision of the prepuce and its specialized tissue were not enough, my colleagues and I2 found that routine neonatal circumcision regularly removes a large portion of the true skin of the penile shaft. It follows that the usual parade of "cosmetic" side effects of routine neonatal circumcision woefully underestimates its true cost.
Sexual function is only rarely included in circumcision discussions and, without it, parents seeking advice for properly informed consent, as well as their baby boys, are poorly served.
Dr Rivet would be well advised to stick with her original and much sounder advice to parents. And, of course, to include an update on preputial structure and its relationship to adult sexual function.
—John R. Taylor, MB, FRCPC, MRCPEG
The original of this document is located at: http://www.cfpc.ca/cfp/2003/Dec/vol49-dec-letters-4.asp.
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