Changes

'''{{FULLPAGENAME}}''' is the term applied to the space on the [[foreskinned]] [[penis]] between the [[prepuce]] and the [[glans penis]].<ref>{{REFweb

}}</ref> The preputial sac may also be called the '''sub-preputial space''' or '''preputial cavity'''. [[Circumcised]] men do not have a preputial sac.

When boys are born, the preputial sac is sealed shut by a [[synechia]] called the ''balanopreputial lamina'',,<ref name="deibart1933">{{REFjournal

}}</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.===Penile health===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 preputial sac [[glans penis]] (head of the [[penis]]) is lined with covered and protected from friction, abrasion, [[trauma]], and [[mucosainfection]] as by the [[foreskin]] while it is appropriate for an internal organ where moisture is present.in the preputial sac,<ref name="cold-taylor1999fleiss1998">{{ColdCJ TaylorJR 1999FleissP HodgesF VanHoweRS 1998}}</ref> Urine so it does not accumulate [[keratin]], and other sources of moisture are not harmful maintains its [[Foreskin sensitivity| natural sensitivity]]. It is normal for the [[glans penis]] to itbe purple in color when the glans has been protected by the [[foreskin]].

}}</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]].

Wetness in 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>}}Fendereski et al. (2024) compared the penile health of [[circumcised]] boys without a preputial sac is associated to [[intact]] boys with having a preputial sac during the first five years of life. The authors reported that the [[circumcised]] boys had three times as many complaints when compared with [[intact]] boys.<ref name=fendereski2024">{{REFjournal |last=Fendereski |first= |init=K |author-link= |last2=Horns |first2= |init2=JJ |author2-link= |last3=Driggs |first3= |init3=N |author3-link= |last4=Lau |first4= |init4=G |author4-link= |last5=Shaeffer |first5= |init5=AJ |author5-link= |etal=no |title=Comparing Penile Problems in Circumcised vs. Uncircumcised Boys: Insights From a Large Commercial Claims Database With a Focus on Provider Type Performing Circumcision |trans-title= |language= |journal=J Pediatr Surg |date=2024-11 |volume=59 |issue=11 |article=161614 |url=https://www.sciencedirect.com/science/article/abs/pii/S002234682400407X |archived= |quote= |pubmedID=39084960 |pubmedCID=11486584 |DOI=10.1016/j.jpedsurg.2024.06.022 |accessdate=2025-12-03}}</ref>=== Sub-preputial moisture ===A longer [[foreskin| prepuce]]improves wetness in the preputial sac.<ref name="ofarrell2008">{{REFjournal

}}</ref> 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

}}</ref> Moistness also may be maintained by [[transudation]].<ref name="cold-taylor1999" /> The preputial sac may also receive [[pre-ejaculate]], which may be distinguished because it is more slippery. The sac may vary from very slightly moist to wet when one is aroused.

Nevertheless, some men report dryness in their preputial sac and with their [[glans penis]]. Some men recommend coconut oil and others recommend [[jojoba]] oil.<ref>{{REFweb |url=https://supremepenis.com/blog/best-natural-oils-for-penis-skin-care/ |title=Best Natural Oils for Penis Skin Care: Ultimate Guide to Healthy Skin |last=Anonymous |first= |init= |author-link= |publisher=Supreme Penis |date=2025-07-14 |accessdate=2025-08-21}}</ref> to moisturize the preputial sac. A longer prepuce helps few drops, applied once or twice a day, appears to be enough to keep out contaminants the sac moisturized, lubricated, and pathogenscomfortable. Lakshmanan & Parkash (1980) described the muscle fibers  === Foreskin fragrance ===The [[foreskin]] produces [[pheromone| pheromones]] that are likely to be present in the preputial sac.<ref name="fleiss1998" /> Many [[prepuceforeskinned]] (known as the men report a pleasant musky fragrance<ref name="vocabulary2024">{{REFweb |url=https://www.vocabulary.com/dictionary/musky |title=Musky |last= |first= |init= |publisher=vocabulary.com |date= |accessdate=2024-04-26}}</ref> <ref>{{REFweb |url=https://www.reddit.com/r/uncircumcised_talk/comments/1llu8bi/what_does_it_smell_like/ |title=What does it smell like? |last=Anonymous |first= |init= |author-link= |publisher=REDDIT |date=2025-06-27 |accessdate=2025-06-28}}</ref> from their [[dartospenis]]). Musk is also produced by deer to create sexual arousal.<ref name="vocabulary2024" /> The fragrance, which contract to keep the prepuce snugly close to when it occurs, is emitted from the preputial sac. The fragrance may contain stimulating [[glans penispheromone| pheromones]]and is variously characterized. A few find it offensive, but others find it attractive, pleasing, exciting, stimulating, or arousing.<ref name="vocabulary2024" /> <ref>{{REFjournalREFweb |url=https://www.reddit.com/r/uncircumcised_talk/comments/1juhht2/scent/ |title=Scent |last=LakshmananAnonymous

|init=S

|last2publisher=ParkashREDDIT |first2date= |init2=S |author2-link= |etal=no |titleaccessdate=Human prepuce: some aspects of structure and function |trans2025-title= |language= |journal=Indian J Surg |location= |date=1980 |volume=44 |issue= |article= |page= |pages=13404-7 |url=http://www.cirp.org/library/anatomy/lakshmanan/09 |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.<ref name="fleiss1998">{{FleissP HodgesF VanHoweRS 1998}}</ref>

Cold & Taylor (1999) described a healthy microbiome Some believe that lives within the preputial sac.<ref name="cold-taylor1999" /> They also reported that Langerhans cells are found use of soap in the mucosa of the preputial sac. harms the natural [[Langerhans cellsmicrobiome]] are part and increases the strength of the immunological defenses fragrance. The musky foreskin fragrance may be contained by avoiding retraction of the [[penisforeskin]]. 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 HIVSeveral manufacturers offer musk-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 functionscented cologne for men. |Author= |Source= |ref=<ref>{{DeWitte etal 2007}}</ref>}}

Birley et al. (1993) studied 43 men with recurrent or persistent [[balanitis]] at an outpatient genitourinary disease clinic in London, [[United Kingdom| UK]] where most men are [[intact]]. Of the study group only 33 percent were [[circumcised]]. Birley and colleagues discovered that the men in that group washed frequently with soap or shower gel.  The men were instructed to wash less frequently, to stop using soap, and to treat with emollients. The soap and shower gel apparently removed the natural skin oil, which appears to be essential for health of the [[mucosa]] of the preputial sac.<ref name="birley1993">{{REFjournal

The presence of the healthy [[microbiome]], the [[Langerhans cells]], and the lytics in the sub-preputial moisture give the preputial sac strong immunological functions. [[Circumcision]] destroys the preputial sac and its protective immunological functions and makes the patient more vulnerable to [[infection]] throughout life.<ref name="fleiss1998" /> One frequently hears the advice to wash the preputial sac at least daily to prevent [[infection]]. This advice does not reflect the [[Immunological and protective function of the foreskin| immunological functions]] of the [[foreskin]] and the need to maintain skin oil to avoid [[balanitis]].<ref name="birley1993" /> <ref name="fleiss1998" /> It is not consistent with medical science, and is outmoded and inaccurate. Washing may introduce pathogens into the preputial cavity.<ref name="fleiss1998" /> It also removes the skin oil and protective lytic substances described above. It is better to rinse only as necessary, using only clear warm water without soap, body wash, or shampoo.<ref>{{REFbook |last=Bigelow |first=Jim |author-link=Jim Bigelow |year=1994 |title=The Joy of Uncircumcising!: Exploring Circumcision: History, Myths, Psychology, Restoration, Sexual Pleasure, and Human Rights |url=https://www.amazon.com/Joy-Uncircumcising-Circumcision-Psychology-Restoration/dp/093406122X |editor= |edition=2 |volume= |chapter=The Reputation of the Foreskin in America |pages=74 |location= |publisher=Hourglass Book Pub |isbn=978-0934061223}}</ref> One or twice a week is sufficient.<ref name="damon2010">{{REFweb |title=Intact Care of Elderly Men in Nursing Homes |url=http://www.drmomma.org/2010/05/intact-care-of-elderly-men-in-nursing.html |archived= |trans-title= |language= |last=Damon |first= |init=KL |author-link= |publisher=Peaceful Parenting |website=www.drmomma.org |date=2010 |accessdate=2023-12-12 |format= |quote=It is true that nursing programs (and medical school programs) in the [[United States]] have a long way to go in teaching proper [[intact]] care and development.}}</ref> It also is customary to wash before and after sex.

One frequently hears If the advice to wash the preputial sac at least daily to prevent [[infectionforeskin]]is non-retractable, then a [https://www. This advice is outmodedamazon.<ref name="fleiss1998" com/> <ref names?k="birley1993" /> Washing rubber%20bulb%20ear%20syringe rubber-bulb ear syringe] may introduce pathogens be used to squirt warm water into the preputial cavity[[foreskin]] to flush it out for an occasional washing.<ref name="fleiss1998" /> It also removes the skin oil Washing is recommended before and after sex and protective lytic substances described above. It is better as needed to wash only as necessary, using only warm waterremove accumulated [[smegma]].

If the [[foreskin]] is non-retractable<b>Soap, body wash, then a rubber-bulb ear syringe may and shampoo should not be used to squirt warm water into inside the [[foreskin]] to flush it out for an occasional washing. Washing is recommended before and after sex and as desired to remove accumulated [[smegma]].== Urination==[[Intact]] men sometimes askpreputial sac, "do I have to retract my foreskin when I pee?" They may have been heard myths that it is unhealthy to have [[urine]] inside the foreskin. There is no factual basis for that claim. Urine is normally sterile when it leaves the urethra. Boys by necessity pee through their [[foreskin]] because it does not retract. Men with [[phimosis]] also pee through their foreskin because they remove the foreskin does not retract. It is not necessary to pull back when you peebeneficial skin oil.</b>

Everything in the preputial sac is covered with [[Mucosa| mucosal membrane]] (similar to the inside of your mouth), which likes to be wet, so no damage or threat to health is caused == Urination by having urine inside the foreskin. The sphincter action of the preputial orifice functions like a one way valve, blocking the entry of contaminants while allowing the passage of urine.<ref nameforeskinned men=="fleiss1998" /> The urine will help to flush contaminants and pathogens out of the foreskin. Some individuals may experience [[ballooning of the foreskin]], which is harmless.

The [[foreskin]] overhang or [[acroposthion]] may be used as a hose nozzle to control and direct the stream. It may help to stretch one's foreskin out from one's body. One man said, "When I need to pee, I open my fly, pull my foreskin out and give it a tug to get any wrinkles out, then I hold my foreskin with the thumb and forefinger of both hands and use the overhang text of my foreskin this section has been relocated to direct my streamits own article. When I finish, I milk it a bit to get any residual pee out of my Please see [[urethraUrination by foreskinned men]]."

[[Category:TermPhysiology]] [[de:Präputialsack]]