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→Washing: Revise text for clarity.
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 is outmoded and inaccurate 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 waterwithout soap, body wash, or shampoo.<ref>{{REFbook
|last=Bigelow
|first=Jim
}}</ref> It also is customary to wash before and after sex.
If the [[foreskin]] is non-retractable, then a [https://www.amazon.com/s?k=rubber%20bulb%20ear%20syringe rubber-bulb ear syringe] may be used to squirt warm water into the [[foreskin]] to flush it out for an occasional washing. Washing is recommended before and after sex and as desired needed to remove accumulated [[smegma]].
<b>Soap, body wash, and shampoo should not be used inside the preputial sac, because they remove the beneficial skin oil.</b>