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Cold & Taylor (1999) described a healthy [[microbiome]] that lives within the preputial sac.<ref name="cold-taylor1999" /> They also reported that Langerhans cells are found in the mucosa of the preputial sac. [[Langerhans cells]] are part of the immunological defenses of the [[penis]].
De Witte et al. (2007) reported that Langerhans cells produce a substance named ''langerin''. The langerin offers protection against HIV infection:
{{Citation
|Title=Langerin is a natural barrier to HIV-1 transmission by Langerhans cells
|Text=Langerin prevents HIV-1 transmission by LCs. HIV-1 captured by Langerin was internalized into Birbeck granules and degraded. Langerin inhibited LC infection and this mechanism kept LCs refractory to HIV-1 transmission; inhibition of Langerin allowed LC infection and subsequent HIV-1 transmission. Notably, LCs also inhibited T-cell infection by viral clearance through Langerin. Thus Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function.
|Author=
|Source=
|ref=<ref>{{DeWitte etal 2007}}</ref>
}}
→Urination by foreskinned men: Add external link.
|DOI=https://doi.org/10.1002/ar.1090570409
|accessdate=2023-05-23
}}</ref> so it cannot be [[Infection| infected]]. The preputial sac will remain closed for a variable number of years. Thorvaldsen & Meyhoff (2005) conducted a survey of 4000 young men in [[Denmark]]. They reported that the mean age of first foreskin retraction is 10.4 years in [[Denmark]].<ref name="Thorvaldsen">{{REFjournal |last=Thorvaldsen |init=MA |last2=Meyhoff |init2=H |title=Patologisk eller fysiologisk fimose? |trans-title=Pathological or physiological phimosis? |language=Danish |journal=Ugeskr Læger |volume=167 |issue=17 |pages=1858-1862 |url=http://www.cirp.org/library/normal/thorvaldsen1/ |quote= |pubmedID= |pubmedCID= |DOI= |date=2005 |accessdate=2025-03-06}}</ref> Non-retractile foreskin is the more common condition until about 10-11 years of age.
The preputial sac is lined with [[mucosa]] as is appropriate for an internal organ where moisture is present.<ref name="cold-taylor1999">{{ColdCJ TaylorJR 1999}}</ref> [[Urine]] and other sources of moisture are not harmful to it.
The [[glans penis]] (head of the [[penis]]) is covered and protected from friction, abrasion, [[trauma]], and [[infection]] by the [[foreskin]] while it is in the preputial sac, <ref name="fleiss1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> so it does not accumulate [[keratin]], and maintains its [[Foreskin sensitivity| natural sensitivity]]. It is normal for the [[glans penis]] to be purple in color when the glans has been protected by the [[foreskin]].
Parkash et al. (1973) reported that epithelial debris [exfoliated skin or mucosa] accumulates in the preputial sac and forms [[smegma]].<ref name="parkash1873">{{REFjournal
}}</ref>, a natural, normal, benign, healthy, and beneficial product of the body, which will collect harmlessly in the preputial sac.
A longer [[prepuce]] helps to keep out contaminants and pathogens.<ref name="fleiss1998" /> Lakshmanan & Parkash (1980) described the muscle fibers in the [[prepuce]] (known as the [[dartos]]), which contract to keep the prepuce snugly close to the [[glans penis]].<ref>{{REFjournal
|last=Lakshmanan
|first=
|init=S
|author-link=
|last2=Parkash
|first2=
|init2=S
|author2-link=
|etal=no
|title=Human prepuce: some aspects of structure and function
|trans-title=
|language=
|journal=Indian J Surg
|location=
|date=1980
|volume=44
|issue=
|article=
|page=
|pages=134-7
|url=http://www.cirp.org/library/anatomy/lakshmanan/
|archived=
|quote=
|pubmedID=
|pubmedCID=
|DOI=
|accessdate=
}}</ref> The muscle fibers form a whorl at the tip to keep the tip of the [[foreskin]] and keep the preputial sac closed against the outside world and contamination with pathogens.<ref name="fleiss1998" />
Cold & Taylor (1999) described a healthy [[microbiome]] that lives within the preputial sac.<ref name="cold-taylor1999" /> They also reported that Langerhans cells are found in the mucosa of the preputial sac. [[Langerhans cells]] are part of the immunological defenses of the [[penis]].
De Witte et al. (2007) reported that Langerhans cells produce a substance named ''langerin''. The langerin offers protection against HIV infection:
{{Citation
|Title=Langerin is a natural barrier to HIV-1 transmission by Langerhans cells
|Text=Langerin prevents HIV-1 transmission by LCs. HIV-1 captured by Langerin was internalized into Birbeck granules and degraded. Langerin inhibited LC infection and this mechanism kept LCs refractory to HIV-1 transmission; inhibition of Langerin allowed LC infection and subsequent HIV-1 transmission. Notably, LCs also inhibited T-cell infection by viral clearance through Langerin. Thus Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function.
|Author=
|Source=
|ref=<ref>{{DeWitte etal 2007}}</ref>
}}
=== Sub-preputial moisture ===
A longer [[foreskin]] improves wetness in the preputial sac.<ref name="ofarrell2008">{{REFjournal
|last=O'Farrell
|volume=16
|issue=3
|pages=109-12
|url=http://www.cirp.org/library/anatomy/prakash/
|DOI=
|accessdate=2022-10-07
}}</ref> The preputial sac may also receive [[pre-ejaculate]]. The authors further reported that the wetness is rich in lytic material.<ref name="parkash1982" /> Lytic material causes lysis or a breakdown of pathogen cell walls.<ref>{{REFweb
|url=https://medical-dictionary.thefreedictionary.com/lytic
|title=Lytic
|date=2012
|accessdate=2022-10-07
}}</ref> Moistness also may be maintained by [[transudation]].<ref name="cold-taylor1999" /> The preputial sac may vary from very slightly moist to wet. A longer also receive [[prepuce]] helps to keep out contaminants and pathogens.<ref name="fleiss1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> Lakshmanan & Parkash (1980) described the muscle fibers in the [[prepuce]] (known as the [[dartospre-ejaculate]]), which contract to keep the prepuce snugly close to the [[glans penis]].<ref>{{REFjournal |last=Lakshmanan |first= |init=S |author-link= |last2=Parkash |first2= |init2=S |author2-link= |etal=no |title=Human prepuce: some aspects of structure and function |trans-title= |language= |journal=Indian J Surg |location= |date=1980 |volume=44 |issue= |article= |page= |pages=134-7 |url=http://www.cirpmay be distinguished because it is more slippery.org/library/anatomy/lakshmanan/ |archived= |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=}}</ref> The muscle fibers form a whorl at the tip sac may vary from very slightly moist to keep the tip of the [[foreskin]] and keep the preputial sac closed against the outside world and contaminationwet when one is aroused.<ref name="fleiss1998" />
=== Foreskin fragrance ===
The [[foreskin]] produces [[pheromone| pheromones]] that are likely to be present in the preputial sac.<ref name="fleiss1998" /> Many [[foreskinned]] men report a pleasant musky fragrance<ref name="vocabulary2024">{{REFweb
}}</ref> from their [[penis]]. Musk is also produced by deer to create sexual arousal.<ref name="vocabulary2024" /> The fragrance, when it occurs, is emitted from the preputial sac.
The fragrance may contain stimulating pheromones and is variously characterized. A few find it offensive, but others find it attractive, pleasing, exciting, stimulating, or arousing.<ref name="vocabulary2024" /> <ref>{{REFweb |url=https://www.reddit.com/r/uncircumcised_talk/comments/1juhht2/scent/ |title=Scent |last=Anonymous |first= |init= |author-link= |publisher=Reddit |date= |accessdate=2025-04-09}}</ref>
Some believe that the use of soap in the preputial sac harms the natural [[microbiome]] and increases the strength of the fragrance. The musky foreskin fragrance may be contained by avoiding retraction of the [[foreskin]].
== Urination by foreskinned men==
[[Foreskinned]] men sometimes ask, "do I have to retract my [[foreskin]] for [[urination]]?"<ref>Some men with abundant overhanging foreskin find it awkward and difficult to retract and keep retracted their [[foreskin]] because the foreskin is constantly pushing to glide forward to return to its normal position of covering and protecting the [[glans penis]].</ref> They may have been heard myths that it is unhealthy to have [[urine]] inside the [[foreskin]], however there is no factual basis for that claim. Urine has a healthy microbiome<ref name="cold-taylor1999" /> when it leaves the urethra and is helpful for flushing out the [[foreskin]] and keeping it clean. The presence of urine in the preputial sac is ''not'' unsanitary and does not do harm. Nature has planned for this condition. Boys by necessity pee through their [[foreskin]] because it the juvenile foreskin does not retract and men with [[phimosis]] also pee through their [[foreskin]] because the foreskin does not retract. It does no harm so it is not necessary to pull back when you pee.
The epithelium of all tissue in the preputial sac is [[Mucosa| mucosal membrane]] (similar to the inside of your mouth), which likes to be wet, so no damage or threat to health or well-being is caused by having [[urine]] inside the [[foreskin]]. The sphincter action of the preputial orifice functions as a one way valve, blocking the entry of contaminants and pathogens while allowing the passage of urine.<ref name="fleiss1998" /> The [[urine]] will serve to flush contaminants and pathogens out of the [[foreskin]]. A few individuals may experience [[ballooning of the foreskin]], which is harmless.
[[Foreskinned]] men may enjoy feeling a slight tickling sensation as the [[urine]] flows out through their [[acroposthion]].
One may retract or not retract for [[urination]]. The human [[foreskin]] is highly flexible and stretchable. It may be stretched as desired laterally and/or lengthwise to cause [[mitosis]] and [[tissue expansion]] to resolve issues. What works best depends to some extent on individual anatomy. Either way is okay.
===Video===
A NSFW video image of a [[foreskinned]] man urinating through his [[acroposthion]].
https://www.reddit.com/r/4skinoverhang/comments/15xxkyc1jhcx5j/overhang_soft_peeemptying_the_hose/?chainedPosts=t3_15xxkyc
{{SEEALSO}}
* [[Hygiene]]
* [[Immunological and protective function of the foreskin]]
* [[Living with a foreskin in circumcised America]]
* [[Meatus]]
* [[Microbiome]]
* [[Transudation]]
* [[Urinary tract infection]]
{{LINKS}}
* {{REFweb
|url=https://www.cirp.org/library/hygiene/
|title=Penile hygiene in the intact non-circumcised male
|first=
|init=
|author-link=
|publisher=Circumcision Reference Library
|date=2013
|accessdate=20232025-1003-3103
}}
* {{REFweb
|first=Connor
|init=
|authorlink=Connor Justin Garrett
|publisher=Intact America
|date=2024-03-09
|accessdate=2024-05-10
}}
* {{REFweb
|url=https://www.reddit.com/user/C4Charkey/comments/1jumg8s/the_accidental_intactivist_manifesto_iii_the/
|title=Section III. The Hygienic Hoax: Soap, Water, and the Ghosts of Victorian Anxiety
|last=C4Charkey
|first=
|init=
|author-link=C4Charkey
|publisher=REDDIT
|date=2025-04-08
|accessdate=2025-04-12
}}
{{REF}}
[[Category:Education]]
[[Category:Penile anatomy]]
[[Category:Physiology]]
[[de:Präputialsack]]