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VIEWS AND REVIEWS: R S Kirby The Joy of Uncircumcising! Restore Your Birthright and Maximize Sexual Pleasure BMJ 1994; 309: 679a [Full text]

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Circumcision and uncircumcision

Jake H Waskett   (11 December 2003)

Foreskin Restoration

Rio Cruz   (16 December 2003)

Foreskin motion generates Meissner corpuscle stimulation

George Hill   (16 December 2003)

Circumcision and uncircumcision 11 December 2003
Jake H Waskett, Private researcher 9 Field Avenue, L21 9NG Send response to journal: Re: Circumcision and uncircumcision	In 1994, R S Kirby reviewed Bigelow's work, "The joy of uncircumcising!"[1]. In brief, Bigelow's book made the claim that following circumcision the glans penis keratinises causing a substantial decrease in sensitivity. Bigelow also asserted that by "restoring" the foreskin, this sensitivity can be regained. Kirby expressed doubt at these, and suggested that the newfound sensitivity reported by some of these men is effectively a placebo. Almost a decade later, it seems appropriate to examine the new evidence. Szabo and Short have raised doubts[2] about the keratinisation of the glans, finding that the epithelium of the glans was equally keratinised in circumcised and uncircumcised men. Bleustein et al. have studied the sensitivity of the glans penis[3], and have found no significant measurable difference in the sensitivity of the glans penis of circumcised and uncircumcised males. This confirms the earlier work of Masters and Johnson[4]. Perhaps in light of these findings, it is fair to conclude that Kirby was correct in thinking the effect on sensitivity described by "uncircumcising" men is indeed a placebo. J Waskett 1. Kirby RS. VIEWS AND REVIEWS: The Joy of Uncircumcising! Restore Your Birthright and Maximize Sexual Pleasure. BMJ 1994; 309:679a 2. Bleustein CB, Eckholdt H, Arezzo JC, Melman A. Effects of circumcision on male penile sensitivity. AUA 98th Annual Meeting: Abstract 1260. Apr 2003. 3. Szabo R, Short RV. How does male circumcision protect against HIV infection? BMJ, Jun 2000; 320:1592-1594. 4. Masters WH, Johnson VE. Human Sexual Response. Boston, MA: Little, Brown and Company; 1966:189-191 Competing interests: None declared
Foreskin Restoration 16 December 2003
Rio Cruz, Retired Santa Cruz, CA 95060 (USA) Send response to journal: Re: Foreskin Restoration	Jake Waskett concludes from his reading that the increased sensitivity reported by men who have "restored" their foreskin is due to placebo. I "restored" my own foreskin several years ago and I can assure Mr. Waskett that the increased sensitivity I now have is not due to placebo. But don't take my word, or the word of hundreds of other men who have experienced increased sensitivity through "restoration." Assuming Mr. Waskett is circumcised, he can find out for himself whether or not "restoration" helps simply by taping what might be left of his foreskin over the glans for several weeks and seeing what what happens.  In my own case, I was not prepared for positive results so rapidly. I thought it would take months or years to experience any change. So I was surprised and delighted to experience notable sensitivity gain within 2 to 3 weeks. Of course, achieving full coverage of the glans does often take several years of diligent effort and a "restored" foreskin is never going to be as good as the whole, natural organ nature endowed us with. Thousands of specialized nerves, the ridged band, and an entire tissue system is destroyed by amputating this most sexually important and sensitive part of penile anatomy. However, "restoration" does give a good cosmetic effect and a degree of increased sensitivity that made the effort well worth my time. Rio Cruz, PhD Competing interests: None declared
Foreskin motion generates Meissner corpuscle stimulation 16 December 2003
George Hill, Executive Secretary Doctors Opposing Circumcision, Suite 42, 2442 NW Market Street, Seattle, Washington 98107, USA Send response to journal: Re: Foreskin motion generates Meissner corpuscle stimulation	EDITOR—Waskett1 properly questions the increase in sensitivity after foreskin restoration claimed by Bigelow more than a decade ago.2 The decrease in penile sensitivity after circumcision is well documented both by extensive anecdotal and empirical evidence.3 The partial restoration of that sensitivity by foreskin restoration is also well documented by an abundance of anecdotal evidence from the thousands of men who have undertaken foreskin restoration by means of tissue expansion. The question is not whether penile sensitivity is lost by circumcision and regained by foreskin restoration, but how it occurs. There had been a paucity of research into this matter. When Bigelow prepared his work more than a decade ago,2 it was believed that the change in the sensitivity of the glans penis was the major contributor to the decrease in sensitivity after circumcision and its partial recovery by foreskin restoration. Blustein et al. held the foreskin back while statically testing the sensitivity of the glans penis.4 5 They did not test the sensitivity of the foreskin either statically or under dynamic movement, as occurs during sexual activity, so their work does not accurately measure the contribution to overall penile sensitivity of the foreskin Their work seems to establish that the glans penis is not the primary site of the increase in sensitivity, pleasure, and satisfaction in the male with a complete foreskin and, therefore, points to the foreskin as the probable location. Circumcision amputates the ridged band6 and tightens the penile skin, thereby destroying the gliding action that was first described by Lakshamanan6 and later by Warren & Bigelow.7 It now appears that the change in sensitivity observed by so many is caused by the loss of the gliding action6,7 and the loss of the highly innervated ridged band. Foreskin restoration restores the gliding action and allows better stimulation of the remaining nerves of the penile epithelium. It is not clear whether additional nerves are grown during the tissue expansion but the ridged band structure can never be replaced. Coitus is a dynamic activity. The gliding action of the foreskin allows it to move during coitus.7,8 It everts and un-everts in rapid succession during coitus. It appears more likely that this movement deforms and stimulates the Meissner nerve endings in the original or restored foreskin9 and causes the well documented contribution to pleasure, sensitivity, and satisfaction. More research is necessary to fully elucidate the exact method by which the foreskin provides erogenous sensitivity, pleasure, and satisfaction, while preventing premature ejaculation. George Hill Executive Secretary Doctors Opposing Circumcision Suite 42 2442 NW Market Street Seattle, Washington 98107 USA Web: http://www.doctorsopposingcircumcision.org References: Waskett JH. Circumcision and uncircumcision. BMJ 2003, Rapid response, 12 December 2003. Bigelow J. The Joy of Uncircumcising! Aptos, CA: Hourglass Book Publishing, 1992. Fink KS, Carson CC, DeVellis RF. Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction. J Urol 2002;167(5):2113-6. Bleustein CB, Eckholdt H, Arezzo JC, Melman A. Effects of circumcision on male penile sensitivity. AUA 98th Annual Meeting: Abstract 1260. Apr 2003. Bleustein CB, Eckholdt H, Arezzo JC, Melman A. Quantitative somatosensory testing of the penis: optimizing the clinical neurological examination. J Urol 2003;169(6):2266-9. Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol 1996;77:291-5. Lakshmanan S, Prakash S. Human prepuce: some aspects of structure and function. Indian J Surg 1980;44:134-7. Warren J, Bigelow J. The case against circumcision. Br J Sex Med 1994; Sept/Oct: 6-8. Taylor JR. Back and forth. Pediatrics News 2000;34(10):50. Competing interests: None declared