Penis: Difference between revisions

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|accessdate=2024-09-25

}}</ref> and occurs after [[puberty]].

Protection of the penis in childhood is important, so nature provides two ways to prevent retraction. Cold & Taylor (1999) report:

The embryology of the penile prepuce has been controversial since the original account given by Schweigger-Seidel in 1866, who described a preputial fold that

progressively extended and fused with the epithelial covering of the glans. Glenister cited Retterer(1885–1915) as the first to show that the prepuce was formed by a combination of preputial folding and the ingrowth of a cellular lamella. This ingrowth creates the prepuce, glans, corona and coronal sulcus mucosa. This results in a common mucosal epithelium of the glans penis and the inner mucosal lining of the prepuce. The squamous mucosa of the glans penis, coronal sulcus and prepuce should be considered as one tissue compartment with a common cytokeratin polypeptide pattern.

The fused mucosa of the glans penis and the inner lining of the prepuce separates gradually over years, as a spontaneous biological process. Topical steroid

and nonsteroidal anti-inflammatory ointments are known to accelerate the glans-prepuce separation. In male rhesus monkeys exposed to intrauterine diethyl-stilbestrol, the normal separation of the glans/prepuce is delayed from a normal age of 2.5–3 years to 4.5–5.5 years. Despite this research, the hormones and/or growth factors responsible for this separation of the glans-prepuce are poorly understood. Gairdner found that 96% of newborn males have a fused mucosa; in

20% of boys aged 5–13 years, he reported that the prepuce could not be completely retracted. Oster confirmed in a large study that preputial non-separation (adhesions) is very common in children and teenagers. The separation of the prepuce/glans penis mucosa is usually complete by about age 17 years, as confirmed by later Chinese studies (Fig. 2). Recent work by Kayaba et al. verified that the preputial orifice may be tight in young boys, but resolves over time (Fig. 3) [22]. Without knowledge of the normal development of the penis, some physicians advocate childhood circumcision as a surgical treatment of normal anatomy [5]. One study stated that microscopic examination of the prepuce circumcised for phimosis showed normal histology in 46% of cases [23]. As the mean age in that study group was 8.7 years, almost half of these boys were circumcised for a normal stage of penile development; a tight preputial orifice with normal histology is not pathological in young boys, but should be considered a normal stage of penile development. Neonatal circumcision, before the prepuce has naturally separated, involves tearing the common prepuce/glans penis mucosa apart, with the concomitant risk of glanular excoriation and injury. Manipulation and retraction of the immature prepuce must be avoided to prevent scarring, bleeding, phimosis and psychological trauma.

</blockquote>

== Innervation ==

@@ Line 106: / Line 106: @@
   |accessdate=2024-09-25
 }}</ref> and occurs after [[puberty]].
+Protection of the penis in childhood is important, so nature provides two ways to prevent retraction. Cold & Taylor (1999) report:
+<blockquote>
+The embryology of the penile prepuce has been controversial since the original account given by Schweigger-Seidel in 1866, who described a preputial fold that
+progressively extended and fused with the epithelial covering of the glans. Glenister cited Retterer(1885–1915) as the first to show that the prepuce was formed by a combination of preputial folding and the ingrowth of a cellular lamella. This ingrowth creates the prepuce, glans, corona and coronal sulcus mucosa. This results in a common mucosal epithelium of the glans penis and the inner mucosal lining of the prepuce. The squamous mucosa of the glans penis, coronal sulcus and prepuce should be considered as one tissue compartment with a common cytokeratin polypeptide pattern.
+The fused mucosa of the glans penis and the inner lining of the prepuce separates gradually over years, as a spontaneous biological process. Topical steroid
+and nonsteroidal anti-inflammatory ointments are known to accelerate the glans-prepuce separation. In male rhesus monkeys exposed to intrauterine diethyl-stilbestrol, the normal separation of the glans/prepuce is delayed from a normal age of 2.5–3 years to 4.5–5.5 years. Despite this research, the hormones and/or growth factors responsible for this separation of the glans-prepuce are poorly understood. Gairdner found that 96% of newborn males have a fused mucosa; in
+% of boys aged 5–13 years, he reported that the prepuce could not be completely retracted. Oster confirmed in a large study that preputial non-separation (adhesions) is very common in children and teenagers. The separation of the prepuce/glans penis mucosa is usually complete by about age 17 years, as confirmed by later Chinese studies (Fig. 2). Recent work by Kayaba et al. verified that the preputial orifice may be tight in young boys, but resolves over time (Fig. 3) [22]. Without knowledge of the normal development of the penis, some physicians advocate childhood circumcision as a surgical treatment of normal anatomy [5]. One study stated that microscopic examination of the prepuce circumcised for phimosis showed normal histology in 46% of cases [23]. As the mean age in that study group was 8.7 years, almost half of these boys were circumcised for a normal stage of penile development; a tight preputial orifice with normal histology is not pathological in young boys, but should be considered a normal stage of penile development. Neonatal circumcision, before the prepuce has naturally separated, involves tearing the common prepuce/glans penis mucosa apart, with the concomitant risk of glanular excoriation and injury. Manipulation and retraction of the immature prepuce must be avoided to prevent scarring, bleeding, phimosis and psychological trauma.
+</blockquote>
 == Innervation ==