Foreskin restoration is the process of restoring the foreskin (prepuce), usually in a man who has undergone circumcision or has sustained some injury to the genitals. Men undergoing this process choose it as an alternative to remaining circumcised.
Men attempt foreskin restoration for many reasons. Some restore the foreskin through tissue expansion techniques, possibly with the expectation of greater sexual sensitivity. Other men have cited a desire to appear "natural," to regain a sense of control over their own bodies, or because of views against circumcision.
Foreskin restoration is attempted mostly by circumcised adult men, although rarely some intact men with short foreskins have used these techniques. The process may or may not involve the assistance of support groups who share information and ideas. Many believe foreskin restoration should be delayed until sexual development is completed at around 18 years of age.
History
A form of foreskin restoration, historically known as epispasm, was practiced among some Jews in Hellenistic and Roman societies.[1] http://www.cirp.org/library/restoration/rubin/
European Jews, along with men circumcised for medical reasons, sought out underground foreskin restoration operations during World War II as a method to escape Nazi persecution.[2] http://www.cirp.org/library/restoration/tushmet1/
The practice was revived in the late twentieth century using modern materials and techniques.[3] http://www.cirp.org/library/restoration/bigelow1/ The development of the T-Tape in the 1990's has enabled the process to take place more rapidly.
Surgical techniques
Surgical methods of foreskin restoration, sometimes known as foreskin reconstruction, usually involve some method of grafting skin and/or mucous membrane taken from elsewhere on the body, typically the Censored page, onto the distal portion of the penis. Another method involves a four stage procedure in which the penile shaft is buried in the scrotum for a period of time(1) http://www.cirp.org/library/restoration/greer1/ . Such techniques have produced some satisfactory results, but many men have experienced serious complications.
Nonsurgical techniques
Nonsurgical methods of foreskin restoration are performed by means of stretching the skin, dartos muscle, and mucous membrane covering the shaft of the penis to stimulate new growth. The process may take several years to complete, and varying degrees of success have been reported.
The most common method of restoring the foreskin is to use tape to provide adhesion to the skin. The tape can be attached to an elastic strap to apply tension to the skin, directing the skin and remnant of inner mucosa over the glans. Specialized devices that grip the skin without tape are also commercially available. The tension level of any device should never cause pain or discomfort. This is often the limiting factor in tissue expansion, since there is a risk of damaging tissues by use of excessive tension.
The foreskin has three principal components, in addition to blood vessels, nerves and connective tissue: skin, which is exposed exteriorly; mucous membrane, which is the surface in contact with the Censored page when the Censored page is flaccid; and a band of muscle within the tip of the foreskin. Generally, the skin grows more readily in response to stretching than does the mucous membrane. The muscle is called the dartos, which normally holds the foreskin closed. This portion is removed in the majority of circumcisions and cannot be regrown with known non-surgical techniques, so the covering acheived usually looser than that of a natural foreskin. According to some observers, however, it is difficult to distinguish a restored foreskin from a natural foreskin because restoration produces a "nearly normal-appearing prepuce" [4] http://www.cirp.org/library/restoration/goodwin1/ .
Nonsurgical foreskin restoration does not restore the frenulum or the ridged band. Although not commonly performed, there are surgical "touch-up" techniques that can re-create some of the functionality of the frenulum and dartos muscle. Some of the techniques require tissue removal. Restoring men sometimes choose only the non-surgical options with the understanding that there is simply less risk involved, and that our natural regenerative processes could be more effective.
Physical Aspects
The process provides coverage of the glans. According to research, the foreskin comprises over half of the skin and mucosa of the human penis [5] http://www.cirp.org/library/anatomy/taylor/ . Tissue stretching has long been known to stimulate mitosis, and some research shows that regenerated human tissues have many of the attributes of the original tissue [6] http://www.utmb.edu/otoref/Grnds/tissue-expand.html .
In some men, foreskin restoration may alleviate reported problems, including prominent scarring (33%), insufficient penile skin for comfortable erection (27%), erectile curvature from uneven skin loss (16%), and pain and bleeding upon erection/manipulation (17%) (the figures are taken from a poll of men contacting anti-circumcision organisations, and may not be representative of the wider population. It is available at [7] http://www.noharmm.org/bju.htm ). Special consideration of these factors are important when deciding whether or not to restore, and what devices are appropriate.
Some men report a visually smoother glans, which they attribute to decreased levels of keratinization following restoration. However, a study that investigated the effect of glans coverage on levels of keratinisation reported no difference in keratin levels[8] http://www.circs.org/library/szabo/index.html within the group studied. Another study reported some difference in keratinization. [9] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9
446966&dopt=Abstract
Studies have also differed with respect to glans sensitivity [10] http://www.circs.org/library/bleustein/index.html . Some men have reported a qualitative improvement in sensitivity of the glans, and others have experience little or no change in the glans. Some have suggested psychological changes are present, with actual glans sensitivity itself being unaffected in a majority of men[11] http://www.circs.org/library/waskett/index.html . For some men undergoing this process, protecting the glans from dryness and abrasion with clothing can allow the glans texture to change to a quality similar to that of intact genitalia.
According to some men undergoing this process, protecting the glans from dryness and abrasion with clothing can allow the glans texture to change to a quality similar to that of intact genitalia.
Emotional and psychological aspects
Foreskin restoration has been reported as having beneficial emotional results in some men, and has been proposed as a treatment for negative feelings in some adult men about their circumcision (see Penn http://www.cirp.org/library/restoration/penn1/ , Greer http://www.cirp.org/library/restoration/greer1/ , Goodwin http://www.cirp.org/library/restoration/goodwin1/ , and Boyle et al. http://www.cirp.org/library/psych/boyle6 . These reports differ among medical professionals.
Negative feelings were discussed in the poll mentioned above. Respondents reported to suffer from: emotional distress, manifesting as intrusive thoughts about one’s circumcision, including feelings of mutilation (60%), low self-esteem/inferiority to intact men (50%), genital dysmorphia (55%), rage (52%), resentment/depression (59%), violation (46%), or parental betrayal (30%). Many respondents (41%) reported that their physical/emotional suffering impeded emotional intimacy with partner(s), resulting in sexual dysfunction. Almost a third of respondents (29%) reported dependence on substances or behaviors to relieve their suffering (tobacco, alcohol, drugs, food and/or sexual compulsivity).
In "Prepuce Restoration Seekers: Psychiatric Aspects," a 1981 study published in the Archives of Sexual Behavior, four case study subjects seeking surgical foreskin restoration were examined. The studies include reasons for foreskin restoration among some circumcised men (Mohl et al) http://www.circs.org/library/mohl/ .
See also
Books
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"Decircumcision: Foreskin Restoration, Methods and Circumcision Practices" by Gary M. Griffin , ISBN 1879967057.
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"The Joy of Uncircumcising!: Exploring Circumcision: History, Myths, Psychology, Restoration, Sexual Pleasure, and Human Rights" by Jim Bigelow and James L. Snyder , ASIN 093406122X
External links
- National Organization of Restoring Men http://www.norm.org
- Foreskin restoration for circumcised males http://www.cirp.org/pages/restore.html
- CELSUS'S DECIRCUMCISION OPERATION http://www.cirp.org/library/restoration/rubin/
- Surgical methods of restoring the prepuce: a critical review http://www.cirp.org/library/restoration/brandes1/
- Foreskin Restoration - Organizations http://www.eskimo.com/~gburlin/restore/jae/org.html
- Uncircumcising: undoing the effects of an ancient practice in a modern world http://www.cirp.org/library/restoration/bigelow1/ by Jim Bigelow
Last updated: 02-10-2005 07:18:24
Last updated: 04-25-2005 03:06:01