British Journal of Sexual Medicine, Sep/Oct 1997.
The nerve supply
The causes of adolescent phimosis
In the course of practicing preventive medicine over the past 15 years, I have carried out many routine examinations of students in the first year of higher education. Among males aged 18-22, I have discovered around 300 cases of phimosis.
The condition occurs in approximately 10% of the population and is recognized to be present when the diameter of the preputial orifice is smaller than the diameter of the erect glans.
The classic treatment for phimosis is surgical - either circumcision or a simple plastic surgical procedure that retains the foreskin but widens its excessively tight orifice.
In view of the fact that this treatment is essentially bloody and traumatic (and sometimes mutilating), it seemed appropriate to study the aetiology of the condition to find out why these males retain a an infantile foreskin and to determine whether some alternative simpler and less traumatic treatment could be devised.
Unusual masturbatory practices
Masturbatory methods used by boys with phimosis are of several types and I have classified them as follows.
The method is similar to the kinesitherapy of soft tissues and is remarkably simple. It is surprising that it has not been described before.
However, I have known some patients who have used their common sense and have themselves modified their practice of masturbation during adolescence. Furthermore, broaching the topic of masturbation helps to remove the guilt associated with a sexual practice that is widespread but often carried out shamefully because of the taboo attached to it, particularly in Western society.
Preserving sexual sensation
The nerve supply of the foreskin and its role in sexual sensation are preserved and, more importantly, the mobility of the penile sheath that is necessary to prevent irritation of the partner's vaginal mucosa is preserved.
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