Difference between revisions of "Immunological and protective function of the foreskin"

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Although circumcision promoter [[Abraham L. Wolbarst]] (1914} once claimed that the human [[foreskin]] was filthy and harbored disease and [[infection]],<ref name="wolbarst1914">{{REFjournal
 +
|last=Wolbarst
 +
|first=Abraham L.
 +
|init=AL
 +
|author-link=Abraham L. Wolbarst
 +
|title=Universal Circumcision as a Sanitary Measure
 +
|journal=JAMA
 +
|date=1914-1-10
 +
|volume=62
 +
|issue=2
 +
|pages=92-97
 +
|url=https://jamanetwork.com/journals/jama/article-abstract/453164
 +
|accessdate=2022-08-11
 +
}}</ref> in reality the opposite is true.  The [[foreskin]] is designed by nature to be self-cleaning and to provide significant natural '''immunological and protective function''' against all types of [[infection]], including [[HIV]].
 +
 
 +
[[Connor Judson Garrett| Connor Garrett]] (2024) demolishes the myths falsely claiming health benefits of circumcision that have been promoted by the [[circumcision industry]] and cites the health, psychological, and sexual benefits of [[intactness]].<ref name="garrett2024-03-09">{{REFweb
 +
|url=https://intactamerica.org/intact-penis-care/
 +
|title=Intact Penis Care: Embracing Natural Well-being
 +
|last=Garrett
 +
|first=Connor
 +
|init=
 +
|author-link=Connor Judson Garrett
 +
|publisher=Intact America
 +
|date=2024-03-09
 +
|accessdate=2024-05-15
 +
}}</ref>
  
 
== The protective and hygienic function of the foreskin ==
 
== The protective and hygienic function of the foreskin ==
  
−
The [[foreskin]], like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the [[penis]] and puts the urethra at a distance form its environment, protecting it from foreign contaminants of all kinds while simultaneously shielding the penis from injury. It is a double fold of skin which offers two layers of protection.
+
The [[foreskin]], like the eyelid, also serves an important protective and hygienic function. The [[foreskin]] protects the delicate [[glans]] of the [[penis]] and puts the [[urethra]] at a distance from its environment, protecting it from foreign pathogens and contaminants of all kinds while simultaneously shielding the [[penis]] from injury. It is a double fold of [[skin]] which offers two layers of protection to prevent [[keratinization]] and maintain sensitivity.
 +
 
 +
At birth, the [[foreskin]] is usually attached to the [[glans]] (head) of the [[penis]] by a [[synechia]], akin to how a fingernail is attached to a finger.<ref>{{REFjournal
 +
|last=Deibert
 +
|init=GA
 +
|author-link=
 +
|title=The separation of the prepuce in the human penis
 +
|url=http://www.cirp.org/library/anatomy/deibert/
 +
|journal=Anatomical Record
 +
|date=1933-11
 +
|volume=57
 +
|issue=4
 +
|pages=387-9
 +
|accessdate=2019-10-20
 +
}}</ref> The [[preputial sac]] is sealed by the synechia so it cannot be infected.
 +
 
 +
In infancy, the foreskin's tubular neck (prepucial orifice) is often long and narrow while the [[Dartos]] sphincter muscle in the tip of the [[foreskin]] keeps its opening closed. This acts as an extension of the [[urethra]].<ref>{{REFjournal
 +
|last=Hunter
 +
|init=RH
 +
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1249280/pdf/janat00534-0090.pdf
 +
|title=Notes on the development of the prepuce
 +
|journal=Journal of Anatomy
 +
|date=1935-10
 +
|volume=70
 +
|issue=1
 +
|pages=6875
 +
|format=PDF
 +
|accessdate=2019-10-20
 +
}}</ref><ref>{{REFjournal
 +
|last=Glenister
 +
|init=TW
 +
|url=https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1956.tb04763.x
 +
|title=A consideration of their process involved in the development of the prepuce in man
 +
|journal=Br J Urol
 +
|date=1956-09
 +
|volume=28
 +
|issue=3
 +
|pages=243-249
 +
}}</ref>
 +
Together, these properties prevent the entry of pathogens and contaminants.<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> The [[foreskin]] protects the infant [[glans penis]] from ammonia in diapers (nappies) and prevents meatal ulcer and [[meatal stenosis]].<ref>{{GairdnerDM 1949}}</ref> <ref name="vanhowe2006">{{REFjournal
 +
|last=Van Howe
 +
|init=RS
 +
|author-link=
 +
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting
 +
|journal=Clin Pediatr (Phila)
 +
|volume=45
 +
|issue=1
 +
|pages=49-54
 +
|url=https://journals.sagepub.com/doi/10.1177/000992280604500108?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
 +
|quote=
 +
|pubmedID=16429216
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|pubmedCID=
 +
|DOI=10.1177/000992280604500108
 +
|date=2006-01
 +
|accessdate=2020-01-09
 +
|note=Jan-Feb 2006
 +
}}</ref> <ref>{{REFjournal
 +
|last=Upadhyay
 +
|init=V
 +
|author-link=
 +
|last2=Hammodat
 +
|init2=HM
 +
|author2-link=
 +
|last3=Pease
 +
|init3=PW
 +
|author3-link=
 +
|etal=no
 +
|title=Post circumcision meatal stenosis
 +
|trans-title=
 +
|language=
 +
|journal=N Z Med J
 +
|location=
 +
|date=1998-02-27
 +
|volume=111
 +
|issue=1060
 +
|pages=57-8
 +
|url=http://www.cirp.org/library/complications/upadhyay1/
 +
|quote=
 +
|pubmedID=9539919
 +
|pubmedCID=
 +
|DOI=
 +
|accessdate=2020-01-10
 +
}}</ref>
  
−
Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskins inner lining, these are not present in the glans.<ref name="hyman-brownstein1969">Hyman AB, Brownstein MH. Tyson's "glands": ectopic sebaceous glands and papillomatosis penis. ''Arch Dermatol'' 1969 Jan;99(1):31-6</ref>
+
Natural secretions of oil are achieved by sebaceous glands which are abound in the [[foreskin]]'s inner lining, these are not present in the [[glans penis]].<ref name="hyman-brownstein1969">{{REFjournal
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They are also present in the eye lid and perform the same function in both places. They secrete the oils necessary to keep the glans surface soft, moist, smooth, warm, sensitive, and with a healthy glistening red or purple colour. This moisturizer also maintains PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. Again, this function is analogous to the eye lid. The glans are meant to be an internal organ covered and protected from the outside world.
+
|last=Hyman
 +
|init=AB
 +
|last2=Brownstein
 +
|init2=MH
 +
|url=https://jamanetwork.com/journals/jamadermatology/article-abstract/530842
 +
|title=Tyson's "glands": ectopic sebaceous glands and papillomatosis penis
 +
|journal=Arch Dermatol
 +
|date=1969-01
 +
|volume=99
 +
|issue=1
 +
|pages=31-36
 +
|accessdate=2019-10-20
 +
}}</ref> They are also present in the eyelid and perform the same function in both places. They secrete the oils necessary to keep the [[glans]] surface soft, moist, smooth, warm, sensitive, and with a healthy glistening red or purple color. This moisturizer also maintains PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. Again, this function is analogous to the eye lid. The [[glans penis]] is meant to be an internal organ covered and protected from the outside world.
  
−
In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes. In healthy individuals, urine is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of urine as it rushes through the foreskin flushes it out effortlessly and naturally.<ref name="parkash-jeykumar1973">Parkash S, Jeykumar S, Subramanyan K, Chaudhuri S. Human Subpreputial collection: its nature and formation. ''J Urol'' 1973 Aug 110(2):211-2</ref>
+
In the genitally [[intact]] [[penis]] the [[urine]] stream flushes out the [[urethra]] and [[foreskin]] of foreign microbes. In healthy individuals, [[urine]] is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of [[urine]] as it rushes through the [[foreskin]] flushes it out effortlessly and naturally.<ref name="parkash-jeykumar1973">{{REFjournal
−
Though urine passes through the foreskin every day, the inner foreskin is remarkably free of urea — a by-product of liver metabolism that is secreted in urine. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of seminal vesicles, prostate, and urethral mucous glands, collectively or individually, keep the foreskin clear and clean as well.<ref>Parkash S. Penis: some facts and fancies. ''Journal of Physician's Association 0f Madras'' June 1982: pp.1-13</ref>
+
|last=Parkash
−
At birth, the foreskin is usually attached to the glans(head) of the penis, akin to how a fingernail is attached to a finger.<ref>Diebert GA. The separation of the prepuce in the human penis. ''Anatomical Record'' 1993 Nov;57(4):387-99.</ref>  
+
|init=S
−
At infancy the foreskins tubular neck(prepucial orifice) is often long and narrow while the sphincter muscle in the tip of the foreskin keeps its opening closed. This acts as an extension of the urethra.<ref>Hunter RH. Notes on the development of the prepuce. ''Journal of Anatomy'' 1935 Oct;70(1):6875.</ref> <ref>Glenister TW. A consideration of their process involved in the development of the prepuce in man. ''Br J Urol'' 1956 Sep;28(3):243-9</ref>
+
|last2=Jeykumar
−
Together, these properties prevent the entry of contaminants.
+
|init2=S
−
The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition. The intact penis is naturally clean and maintains a level of hygiene that is optimal when compared to a penis that has been altered by circumcision.
+
|last3=Subramanyan
 +
|init3=K
 +
|last4=Chaudhuri
 +
|init4=S
 +
|url=http://www.cirp.org/library/anatomy/parkash/
 +
|title=Human subpreputial collection: its nature and formation
 +
|journal=J Urol
 +
|date=1973-08
 +
|volume=110
 +
|issue=2
 +
|pages=211-212
 +
|accessdate=2019-10-20
 +
}}</ref>
  
−
Due to the open wounds and raw bleeding flesh, the circumcised penis needs much more care after circumcision. The surgically externalized glans is dirty rather then clean because of constant exposure to dirt, abrasion and contaminants.<ref name="vanhowe1997">Van Howe RS. Variability in penile appearance and penile findings: a prospective study. ''Br J Urol'' 1997; 80: 776-782.</ref>
+
Though [[urine]] passes through the [[foreskin]] every day, the inner foreskin is remarkably free of urea — a by-product of liver metabolism that is secreted in [[urine]]. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of [[seminal vesicles]], prostate, and [[urethra]]l mucous glands, collectively or individually, keep the foreskin clear and clean as well.<ref>{{REFjournal
−
Circumcised boys are also found to be more likely to develop balanitis, meatitis, coronal adhesions and meatal stenosis.<ref name="vanhowe1997" />
+
|last=Parkash
 +
|init=S
 +
|title=Penis: some facts and fancies
 +
|journal=Journal of Physician's Association of Madras
 +
|date=1982-06
 +
|pages=1-13
 +
}}</ref>
 +
 
 +
The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition. The [[intact]] [[penis]] is naturally clean and maintains a level of hygiene that is optimal when compared to a [[penis]] that has been altered by [[circumcision]].<ref name="fleiss-hodges-vanhowe1998" />
 +
 
 +
In comparison, due to the open wounds and raw [[bleeding]] flesh in a diaper, the [[circumcised]] [[penis]] needs much more care after [[circumcision]]. The surgically externalized [[glans]] is dirty rather then clean because of constant exposure to dirt, abrasion, pathogens, and contaminants.<ref name="vanhowe1997">{{REFjournal
 +
|last=Van Howe
 +
|init=RS
 +
|author-link=Robert Van Howe
 +
|url=https://bjui-journals.onlinelibrary.wiley.com/doi/pdf/10.1046/j.1464-410X.1997.00467.x
 +
|title=Variability in penile appearance and penile findings: a prospective study
 +
|journal=Br J Urol
 +
|date=1997
 +
|volume=80
 +
|pages=776-782
 +
|DOI=10.1046/j.1464-410X.1997.00467.x
 +
|accessdate=2019-10-20
 +
}}</ref> [[Circumcised]] boys are also found to be more likely to develop [[balanitis]], [[meatitis]], [[Skin bridge| coronal adhesions]], and [[meatal stenosis]].<ref name="vanhowe1997"/>
 +
 
 +
After retraction commences, excessive washing and the use of soap inside the [[foreskin]] should be avoided.<ref name="birley1993">{{REFjournal
 +
|last=Birley
 +
|init=HDL
 +
|author-link=
 +
|last2=Walker
 +
|init2=MM
 +
|author2-link=
 +
|last3=Luzzi
 +
|init3=GA
 +
|author3-link=
 +
|last4=Bell
 +
|init4=R
 +
|author4-link=
 +
|etal=yes
 +
|title=Clinical Features and management of recurrent balanitis; association with atopy and genital washing]
 +
|trans-title=
 +
|language=
 +
|journal=Genitourin Med
 +
|location=
 +
|date=1993-10
 +
|volume=69
 +
|issue=5
 +
|pages=400-3
 +
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195128/pdf/genitmed00029-0074.pdf
 +
|quote=
 +
|pubmedID=8244363
 +
|pubmedCID=1195128
 +
|DOI=10.1136/sti.69.5.400
 +
|accessdate=2021-03-20
 +
}}</ref>
  
 
== The immunological function of the foreskin ==
 
== The immunological function of the foreskin ==
  
−
The foreskin's inner fold and the glans of the penis are comprised of mucous membrane tissue. These are also present in your eyes, mouth, and all other bodily orifices including the female genitals. These are the first line of immunological defensive for the body's orifices. These mucous membranes perform many immunological and hygienic functions.  
+
The foreskin's inner fold and the [[glans]] of the [[penis]] are comprised of [[Preputial mucosa|mucous membrane]] tissue. These are also present in your eyes, mouth, and all other bodily orifices including the female genitals. These are the first line of immunological defense for the body's orifices. These mucous membranes perform many immunological and hygienic functions.  
−
Certain components such as Langerhans cells
 
−
<ref>Weiss GN, Sanders M, Westbrook KC. The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response? ''Isr J Med Sci'' 1993 Jan;29(1);42-3</ref>
 
−
plasma cells<ref>Flower PJ, Ladds PW, Thomas AD, Watson DL. An immunopathologic study on the bovine prepuce. ''Vet Pathol'' 1983 Mar;20(2):189-201.</ref>
 
−
apocrine glands,<ref> Ahmed A, Jones AW. Apocrine Cystadenoma: a report of two cases occurring on the prepuce. ''Br J Dermatol'' 1969 Dec; 81(12):899-901.</ref>
 
−
and sebaceous glands,<ref>Hyman AB, Brownstein MH. Tyson's "glands": ectopic sebaceous glands and papillomatosis penis. ''Arch Dermatol'' 1969 Jan;99(1):31-6</ref> <ref>Delbanco E. Über das gehäufte Aufreten von Talgdrusen an der Innerflähe des Präputium. ''Monatshefte für praktishe Dermatologie'' 1904; 38:536-8.</ref> <ref>Piccinno R, Carrel C-F, Menni S. ''et al''. sebacous glands mimicking molluscum contagiosum ''Acta Derm Venerol'' 1990;70:344-5.</ref> <ref>Krompecher St. Die Histologie der Absonderung fur Smegma Praeputi. ''Anatomischer Anzeiger'' 1932; 75:170-176.</ref>, collectively secrete emolliating lubricants.<ref>Parkash S, Jeykumar S, Subramanyan K, Chaudhuri S. Human Subpreputial collection: its nature and formation. ''J Urol'' 1973 Aug 110(2):211-2.</ref> Apocrine glans perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.<ref>Frohlich E Shamburg-Lever G, Klesses C. Immunelectron microscopic localization of cathepsin B in human apocrine glands. ''J Cutan Pathol'' 1993 Feb;20(1):54-60</ref>
 
−
There is also strong research to suggest that lysozyme can protect against HIV infection'
 
−
<ref>George Hill [http://www.cirp.org/library/disease/HIV/hill1/ Summary of evidence that the foreskin and lysozyme may protect against HIV infection]. 7 September 2003. </ref>
 
−
Apocrine glands also produce cytokine,<ref>Ahmed AA, Nordlind K, Schultzberd M, Liden S. Immunohisto chemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands Arch</ref>
 
−
which is a very important nonantibody protein that generates immune response when in contact with specific agents.
 
−
Plasma cells which increase in number in response to pathogens levels, secrete immunoglobulin.
 
−
<ref>Flower PJ, Ladds PW, Thomas AD, Watson DL. An immunopathologic study on the bovine prepuce. ''Vet Pathol'' 1983 Mar;20(2):189-201.</ref>
 
  
−
It is also very important to note that Langerhans cells that are present in the foreskin produce ''Langerin'', a substance that has been proven to kill the HI-virus on contact.<ref> de Witte L, Nabatov A, Pion M, ''et al''. [http://www.cirp.org/news/healthday2007-03-05/ Langerin is a natural barrier to HIV-1 transmission by Langerhans cells]. ''Nat Med'' 2007 Mar;13(3):367-71.</ref>
+
Certain components such as [[Langerhans cells]],<ref>{{REFjournal
−
All of these function to sequester and “digest” foreign pathogens. All these substances play an important role in protecting the penis from viral and bacterial pathogens. The immunological functions of the human prepuce have been extensively documented by respected researchers for quite some time.
+
|last=Weiss
−
<ref>P M Fleiss, F M Hodges, R S Van Howe. Immunological functions of the human prepuce. ''SEXUALLY TRANSMITTED INFECTIONS'' (London), Volume 74, Number 5, Pages 364-367, October 1998.http://www.cirp.org/library/disease/STD/fleiss3/</ref>
+
|init=GN
 +
|last2=Sanders
 +
|init2=M
 +
|last3=Westbrook
 +
|init3=KC
 +
|url=http://www.circumstitions.com/Langerhans.html
 +
|title=The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response?
 +
|journal=Isr J Med Sci
 +
|date=1993-01
 +
|volume=29
 +
|issue=1
 +
|pages=42-43
 +
|accessdate=2019-10-20
 +
}}</ref> plasma cells,<ref name="flower1983">{{REFjournal
 +
|last=Flower
 +
|init=PJ
 +
|last2=Ladds
 +
|init2=PW
 +
|last3=Thomas
 +
|init3=AD
 +
|last4=Watson
 +
|init4=DL
 +
|url=https://journals.sagepub.com/doi/abs/10.1177/030098588302000206
 +
|title=An immunopathologic study on the bovine prepuce
 +
|journal=Vet Pathol
 +
|date=1983-03
 +
|volume=20
 +
|issue=2
 +
|pages=189-201
 +
|accessdate=2019-10-20
 +
}}</ref> apocrine glands,<ref>{{REFjournal
 +
|last=Ahmed
 +
|init=A
 +
|last2=Jones
 +
|init2=AW
 +
|url=https://www.academia.edu/5687437/APOCRINE_CYSTADENOMA_A_REPORT_OF_TWO_CASES_OCCURRING_ON_THE_PREPUCE
 +
|title=Apocrine Cystadenoma: a report of two cases occurring on the prepuce
 +
|journal=Br J Dermatol
 +
|date=1969-12
 +
|volume=81
 +
|issue=12
 +
|pages=899-901
 +
|accessdate=2019-10-20
 +
}}</ref> and sebaceous glands,<ref>{{REFjournal
 +
|last=Hyman
 +
|init=AB
 +
|last2=Brownstein
 +
|init2=MH
 +
|title=Tyson's "glands": ectopic sebaceous glands and papillomatosis penis
 +
|journal=Arch Dermatol
 +
|date=1969-01
 +
|volume=99
 +
|issue=1
 +
|pages=31-36
 +
|accessdate=2019-10-20
 +
}}</ref><ref>{{REFjournal
 +
|last=Delbanco
 +
|init=E
 +
|title=Über das gehäufte Auftreten von freien Talgdrüsen an der Innenfläche des Präputiums
 +
|trans-title=About the increased occurrence of free sebaceous glands on the inner surface of the prepuce
 +
|language=German
 +
|journal=Monatshefte für praktische Dermatologie
 +
|date=1904
 +
|volume=38
 +
|pages=536-538
 +
|accessdate=2019-10-20
 +
}}</ref><ref>{{REFjournal
 +
|last=Piccinno
 +
|init=R
 +
|last2=Carrel
 +
|first2=Ch.-F.
 +
|init2=CF
 +
|last3=Menni
 +
|init3=S
 +
|etal=yes
 +
|title=sebacous glands mimicking molluscum contagiosum
 +
|journal=Acta Derm Venerol
 +
|date=1990
 +
|volume=70
 +
|pages=344-345
 +
}}</ref><ref>{{REFjournal
 +
|last=Krompecher
 +
|first=St.
 +
|init=S
 +
|title=Die Histologie der Absonderung des Smegma praeputii
 +
|trans-title=Histology of allocation of a smegma praeputii
 +
|language=German
 +
|journal=Anatomischer Anzeiger
 +
|date=1932
 +
|volume=75
 +
|pages=170-176
 +
}}</ref>, collectively secrete emollient lubricants.<ref name="parkash-jeykumar1973"/> Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.<ref>{{REFjournal
 +
|last=Frohlich
 +
|init=E
 +
|last2=Shamburg-Lever
 +
|init2=G
 +
|last3=Klesses
 +
|init3=C
 +
|title=Immunelectron microscopic localization of cathepsin B in human apocrine glands
 +
|journal=J Cutan Pathol
 +
|date=1993-02
 +
|volume=20
 +
|issue=1
 +
|pages=54-60
 +
}}</ref>  
  
−
In infancy, simple sugars in breast milk, like antibacterial oligosaccharides, are acquired from the mothers milk and excreted in urine.
+
There is also some research to suggest that lysozyme may protect against [[HIV]] infection.<ref>{{REFweb
−
University studies have shown that these substances cling to the mucosal lining of the inner foreskin and protect against urinary tract infections,
+
|first=George
−
<ref>Hanson LA, Karlsson B, Jalil F, ''et al''. Antiviral and antibacterial factors in human milk. In: Hanson LA, ed. ''Biology of Human Milk''. New York Raven Press; 1988. pp. 141-57</ref> as well as infections in other parts of the body.
+
|last=Hill
−
<ref>Coppa GV, Gabrielli O, Giorgi P, Catassi C, Montanari MP, Veraldo PE, Nichols BL. Preliminary study of breast feeding and bacterial adhesion to uroepithelial cells. ''Lancet'' 1990 Mar 10;335(8689):569-71.</ref>
+
|author-link=George Hill
−
Babies excrete in their urine about 300-500 milligrams of oligosaccharides each day. These compounds prevent virulent strains of Escherichia coli from adhering to the mucosal lining of the entire urinary tract, including the foreskin and glans.
+
|url=http://www.cirp.org/library/disease/HIV/hill1/
−
For these reasons breast-milk is highly efficacious at preventing UTI.
+
|title=Summary of evidence that the foreskin and lysozyme may protect against HIV infection
−
<ref>Gothefors L, Olling S, Winberg J. Breastfeeding and biological properties of faecal E. coli strains. ''Acta Paediatr Scand'' 1975 Nov;54(6):807-12.</ref>
+
|date=2003-09-07
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Rigorous study's have repeatedly demonstrated that breast feeding protects against urinary tract infections.<ref>Mårild S. Breastfeeding and Urinary Tract Infections. ''Lancet'' 1990;336:942. </ref>
+
|accessdate=2019-10-20
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<ref>Pisacane A, ''et al''. Breastfeeding and urinary tract infection. ''The Lancet'', July 7, 1990, p50 </ref>
+
}}</ref> <ref name="fleiss-hodges-vanhowe1998" />
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<ref>Pisacane A, Graziano L, Mazzarella G, ''et al''. Breast-feeding and urinary tract infection. ''J Pediatr'' 1992;120:87-89.</ref>
 
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Researchers have shown that premature foreskin retraction can expose the penis to hospital strains of Escherichia coli and can result in UTI.
 
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<ref>Winberg J ''et al''. The Prepuce: A Mistake of Nature? ''Lancet'' 1989, pp.598-99.</ref>
 
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Hence the protective function of the foreskin is in the child's best interest especially during chemically treated diaper wearing years where feces mixed with urine can not only contaminate the permanently exposed urinary meatus but also the amputation wound from the circumcision surgery itself.
 
  
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It is important to note that women have a higher risk of UTI. This is because the shorter urethra offers less protection via the immunological function of the urethra's mucosal lining. By the same observation we see that the tubular tip of the foreskin and its mucosal lining act as an extension of the urethra, hence providing more of that same protection via mucosa immunology and the adherence of antibacterial substances in breast milk. Understandably, removal of the foreskin destroys all this functionality.
+
Apocrine glands also produce cytokine,<ref>{{REFjournal
 +
|last=Ahmed
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|init=AA
 +
|last2=Nordlind
 +
|init2=K
 +
|last3=Schultzberd
 +
|init3=M
 +
|last4=Liden
 +
|init4=S
 +
|url=https://link.springer.com/article/10.1007%2FBF01105803
 +
|title=Immunohistochemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands
 +
|journal=Arch Dermatol Res
 +
|date=1995
 +
|volume=287
 +
|issue=8
 +
|pages=764-766
 +
|accessdate=2019-10-20
 +
}}</ref> which is a very important non-antibody protein that generates immune response when in contact with specific agents. Plasma cells which increase in number in response to pathogens levels, secrete immunoglobulin.<ref name="flower1983"/>
 +
It is also very important to note that [[Langerhans cells]] that are present in the [[foreskin]] produce ''Langerin'', a substance that has been proven to kill human immunodeficiency virus ([[HIV]]) on contact.<ref>{{DeWitte etal 2007}}</ref>
 +
 
 +
All of these function to sequester and “digest” foreign pathogens. All these substances play an important role in protecting the penis from viral and bacterial pathogens. The immunological functions of the human prepuce have been extensively documented by respected researchers for quite some time.<ref name="fleiss-hodges-vanhowe1998" />
 +
 
 +
[[Breastfeeding]] provides additional protection against [[urinary tract infection]].
 +
 
 +
{{SEEALSO}}
 +
* [[Breastfeeding]]
 +
* [[Care of intact, foreskinned boys]]
 +
* [[Circumcision and STDs]]
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* [[Circumcision and HIV]]
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* [[Development of retractable foreskin]]
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* [[Foreskin]]
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* [[Foreskin sensitivity]]
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* [[Immunological protection of breastfeeding]]
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* [[Keratinization]]
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* [[Penis]]
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* [[Pheromone]]
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* [[Preputial sac]]
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* [[Smegma]]
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* [[Transudation]]
 +
 
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{{LINKS}}
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* {{REFweb
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|url=http://www.intactaus.org/information/functionsoftheforeskin/
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|title=Functions of the Foreskin
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|last=Helard
 +
|first=Lou
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|author-link=Lou Helard
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|publisher=Intact Australia
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|website=http://www.intactaus.org
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|date=2014-08-01
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|accessdate=2020-06-05
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}}
  
 
{{REF}}
 
{{REF}}
  
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[[Category:Education]]
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[[Category:Foreskin anatomy]]
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[[Category:Immunology]]
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[[Category:Parental information]]
 
[[Category:Physiology]]
 
[[Category:Physiology]]
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[[Category:Immunology]]
 
  
 
[[Category:From Intactipedia]]
 
[[Category:From Intactipedia]]
 
[[Category:From IntactWiki]]
 
[[Category:From IntactWiki]]
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[[de:Immunologische und Schutzfunktion der Vorhaut]]

Latest revision as of 15:56, 11 June 2024

Although circumcision promoter Abraham L. Wolbarst (1914} once claimed that the human foreskin was filthy and harbored disease and infection,[1] in reality the opposite is true. The foreskin is designed by nature to be self-cleaning and to provide significant natural immunological and protective function against all types of infection, including HIV.

Connor Garrett (2024) demolishes the myths falsely claiming health benefits of circumcision that have been promoted by the circumcision industry and cites the health, psychological, and sexual benefits of intactness.[2]

The protective and hygienic function of the foreskin

The foreskin, like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the penis and puts the urethra at a distance from its environment, protecting it from foreign pathogens and contaminants of all kinds while simultaneously shielding the penis from injury. It is a double fold of skin which offers two layers of protection to prevent keratinization and maintain sensitivity.

At birth, the foreskin is usually attached to the glans (head) of the penis by a synechia, akin to how a fingernail is attached to a finger.[3] The preputial sac is sealed by the synechia so it cannot be infected.

In infancy, the foreskin's tubular neck (prepucial orifice) is often long and narrow while the Dartos sphincter muscle in the tip of the foreskin keeps its opening closed. This acts as an extension of the urethra.[4][5] Together, these properties prevent the entry of pathogens and contaminants.[6] The foreskin protects the infant glans penis from ammonia in diapers (nappies) and prevents meatal ulcer and meatal stenosis.[7] [8] [9]

Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskin's inner lining, these are not present in the glans penis.[10] They are also present in the eyelid and perform the same function in both places. They secrete the oils necessary to keep the glans surface soft, moist, smooth, warm, sensitive, and with a healthy glistening red or purple color. This moisturizer also maintains PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. Again, this function is analogous to the eye lid. The glans penis is meant to be an internal organ covered and protected from the outside world.

In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes. In healthy individuals, urine is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of urine as it rushes through the foreskin flushes it out effortlessly and naturally.[11]

Though urine passes through the foreskin every day, the inner foreskin is remarkably free of urea — a by-product of liver metabolism that is secreted in urine. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of seminal vesicles, prostate, and urethral mucous glands, collectively or individually, keep the foreskin clear and clean as well.[12]

The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition. The intact penis is naturally clean and maintains a level of hygiene that is optimal when compared to a penis that has been altered by circumcision.[6]

In comparison, due to the open wounds and raw bleeding flesh in a diaper, the circumcised penis needs much more care after circumcision. The surgically externalized glans is dirty rather then clean because of constant exposure to dirt, abrasion, pathogens, and contaminants.[13] Circumcised boys are also found to be more likely to develop balanitis, meatitis, coronal adhesions, and meatal stenosis.[13]

After retraction commences, excessive washing and the use of soap inside the foreskin should be avoided.[14]

The immunological function of the foreskin

The foreskin's inner fold and the glans of the penis are comprised of mucous membrane tissue. These are also present in your eyes, mouth, and all other bodily orifices including the female genitals. These are the first line of immunological defense for the body's orifices. These mucous membranes perform many immunological and hygienic functions.

Certain components such as Langerhans cells,[15] plasma cells,[16] apocrine glands,[17] and sebaceous glands,[18][19][20][21], collectively secrete emollient lubricants.[11] Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.[22]

There is also some research to suggest that lysozyme may protect against HIV infection.[23] [6]

Apocrine glands also produce cytokine,[24] which is a very important non-antibody protein that generates immune response when in contact with specific agents. Plasma cells which increase in number in response to pathogens levels, secrete immunoglobulin.[16] It is also very important to note that Langerhans cells that are present in the foreskin produce Langerin, a substance that has been proven to kill human immunodeficiency virus (HIV) on contact.[25]

All of these function to sequester and “digest” foreign pathogens. All these substances play an important role in protecting the penis from viral and bacterial pathogens. The immunological functions of the human prepuce have been extensively documented by respected researchers for quite some time.[6]

Breastfeeding provides additional protection against urinary tract infection.

See also

External links

References

  1. ↑ REFjournal Wolbarst AL. Universal Circumcision as a Sanitary Measure. JAMA. 10 January 1914; 62(2): 92-97. Retrieved 11 August 2022.
  2. ↑ REFweb Garrett, Connor (9 March 2024). Intact Penis Care: Embracing Natural Well-being, Intact America. Retrieved 15 May 2024.
  3. ↑ REFjournal Deibert GA. The separation of the prepuce in the human penis. Anatomical Record. November 1933; 57(4): 387-9. Retrieved 20 October 2019.
  4. ↑ REFjournal Hunter RH. Notes on the development of the prepuce PDF. Journal of Anatomy. October 1935; 70(1): 6875. Retrieved 20 October 2019.
  5. ↑ REFjournal Glenister TW. A consideration of their process involved in the development of the prepuce in man. Br J Urol. September 1956; 28(3): 243-249.
  6. ↑ a b c d REFjournal Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Infect. October 1998; 74(5): 364-67. PMID. PMC. DOI. Retrieved 14 January 2022.
  7. ↑ REFjournal Gairdner DMT. The fate of the foreskin: a study of circumcision. British Medical Journal. 1949; 2(4642): 1433-7. PMID. PMC. DOI. Retrieved 28 October 2019.
  8. ↑ REFjournal Van Howe RS. Incidence of meatal stenosis following neonatal circumcision in a primary care setting. Clin Pediatr (Phila). January 2006; 45(1): 49-54. PMID. DOI. Retrieved 9 January 2020.
  9. ↑ REFjournal Upadhyay V, Hammodat HM, Pease PW. Post circumcision meatal stenosis. N Z Med J. 27 February 1998; 111(1060): 57-8. PMID. Retrieved 10 January 2020.
  10. ↑ REFjournal Hyman AB, Brownstein MH. Tyson's "glands": ectopic sebaceous glands and papillomatosis penis. Arch Dermatol. January 1969; 99(1): 31-36. Retrieved 20 October 2019.
  11. ↑ a b REFjournal Parkash S, Jeykumar S, Subramanyan K, Chaudhuri S. Human subpreputial collection: its nature and formation. J Urol. August 1973; 110(2): 211-212. Retrieved 20 October 2019.
  12. ↑ REFjournal Parkash S. Penis: some facts and fancies. Journal of Physician's Association of Madras. June 1982; : 1-13.
  13. ↑ a b REFjournal Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Br J Urol. 1997; 80: 776-782. DOI. Retrieved 20 October 2019.
  14. ↑ REFjournal Birley HDL, Walker MM, Luzzi GA, Bell R, et al. Clinical Features and management of recurrent balanitis; association with atopy and genital washing]. Genitourin Med. October 1993; 69(5): 400-3. PMID. PMC. DOI. Retrieved 20 March 2021.
  15. ↑ REFjournal Weiss GN, Sanders M, Westbrook KC. The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response?. Isr J Med Sci. January 1993; 29(1): 42-43. Retrieved 20 October 2019.
  16. ↑ a b REFjournal Flower PJ, Ladds PW, Thomas AD, Watson DL. An immunopathologic study on the bovine prepuce. Vet Pathol. March 1983; 20(2): 189-201. Retrieved 20 October 2019.
  17. ↑ REFjournal Ahmed A, Jones AW. Apocrine Cystadenoma: a report of two cases occurring on the prepuce. Br J Dermatol. December 1969; 81(12): 899-901. Retrieved 20 October 2019.
  18. ↑ REFjournal Hyman AB, Brownstein MH. Tyson's "glands": ectopic sebaceous glands and papillomatosis penis. Arch Dermatol. January 1969; 99(1): 31-36. Retrieved 20 October 2019.
  19. ↑ REFjournal Delbanco E. Über das gehäufte Auftreten von freien Talgdrüsen an der Innenfläche des Präputiums [About the increased occurrence of free sebaceous glands on the inner surface of the prepuce] (German). Monatshefte für praktische Dermatologie. 1904; 38: 536-538. Retrieved 20 October 2019.
  20. ↑ REFjournal Piccinno R, Carrel CF, Menni S, et al. sebacous glands mimicking molluscum contagiosum. Acta Derm Venerol. 1990; 70: 344-345.
  21. ↑ REFjournal Krompecher S. Die Histologie der Absonderung des Smegma praeputii [Histology of allocation of a smegma praeputii] (German). Anatomischer Anzeiger. 1932; 75: 170-176.
  22. ↑ REFjournal Frohlich E, Shamburg-Lever G, Klesses C. Immunelectron microscopic localization of cathepsin B in human apocrine glands. J Cutan Pathol. February 1993; 20(1): 54-60.
  23. ↑ REFweb Hill, George (7 September 2003). Summary of evidence that the foreskin and lysozyme may protect against HIV infection. Retrieved 20 October 2019.
  24. ↑ REFjournal Ahmed AA, Nordlind K, Schultzberd M, Liden S. Immunohistochemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands. Arch Dermatol Res. 1995; 287(8): 764-766. Retrieved 20 October 2019.
  25. ↑ REFjournal de Witte L, Nabatov A, Pion M, Fluitsma D, de Jong MAWP, de Gruijl T, Piguet V, van Kooyk Y, Geijtenbeek TBH. Langerin is a natural barrier to HIV-1 transmission by Langerhans cells PDF. Nature Medicine. 4 March 2007; 13(3): 367-71. PMID. PMC. DOI. Retrieved 6 October 2022.
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