Journal of Sexual Medicine, Volume 4, Issue 5, Page 1516. September 2007.
Winnipeg, Manitoba, Canada
Letters to the Editor
Circumcision does not diminish the sensitivity of the glans and penile shaft1. However, the prepuce is always front and center in the great circumcision debate and direct comparison of the glans with the prepuce, not shaft skin, is essential.
The glans is naturally insensitive to fine touch whether the penis is circumcised or not2, and study of the effect of circumcision on sexual function should therefore focus on the missing prepuce. Biologically, however, both glans and prepuce contribute to the single mucocutaneous junctional zone of the penis, and it is possible that these apparently dissimilar structures in fact share similar functions related more to sexual reflexes than to touch perception.
The ridged band of prepuce3,4 is tucked just inside the tip of the unretracted prepuce; it is a richly vascular mucosal tissue heavily innervated by movement-sensitive Meissner corpuscles. In addition to touch sensitivity2, the ridged band is uniquely ridged or corrugated, and not surprisingly, work in progress indicates that retraction and stretching of this accordion-like structure triggers reflex contraction of bulbocavernosus and bulbospongiosus. These bulb muscles
compress the root or bulb of the penis and among other things, including deep erogenous sensation, are responsible for ejaculation and clearing of residual urine from the posterior urethra following micturition.
Almost certainly, removal of the prepuce arnd its ridged band distorts penile reflexogenic functions, but exactly how and to what extent remain to be seen.
John R. Taylor
Winnipeg, Manitoba, Canada
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