Changes

Contrary to some common misconceptions, the prepuce ([[foreskin]]) is not just a double fold of "[[skin]]" covering the glans penis. The foreskin is an organ of touch, an anatomically unique structure with its own complex vascular and neural systems and separate attachments to its parts and to the [[penis]]. [[Skin]] is for containment, attached to the tissue beneath and cannot move independently. The foreskin is the separate and distinct tissues fore (before) the [[shaft skin|skin of the penile shaft]]. The following description of the foreskin is that of the flaccid (non-erect) penis as the structural dynamics of the foreskin changes dramatically as the penis proceeds through tumescence to [[erection]].

The [[foreskin]] consists of the outer foreskin, an extension of the [[shaft skin]] from the back of the sulcus to the foreskin opening, not attached nor part of any other structure which makes the underside of the outer foreskin unique from any other [[skin]] found on the body, turns beneath itself at the mucocutaneous juncture where the [[preputial mucosa|inner foreskin]] begins. The inner foreskin [[mucosa]] begins at the mucocutaneous junction and is specialized and separate mucosal tissue which continues from this junction, traveling between the outer foreskin and the glans, attaching to the penis at the back of the sulcus beneath the end of the [[shaft skin]] and beginning of the outer foreskin at the top of the [[penis ]] (about 10mm to 25mm, 3/8 to 1 inch, behind the back of the glans). The inner foreskin continues toward the [[glans]] at the sides and transitions into the frenulum toward the bottom.<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref>

The [[frenulum]] is the structure traveling down the inner [[foreskin]] and connects the inner foreskin to the [[penis ]] between the hemispheres of the [[glans]] below the meatus (urethral opening) at the bottom of the glans and toward the sides and proceeding down the midline of the shaft. Many of the tactile nerve endings of the [[penis]] are found in the [[frenulum]]. This is similar to the glottal frenulum attaching the tongue to the bottom of the mouth. The [[ridged band]] (small corrugations of tissue, like mountain "ridges") are behind the mucocutaneous juncture and when the [[foreskin ]] is retracted appear behind the attachment at the sulcus. This area also contains many of the tactile nerve endings of the foreskin's neural system.

The foreskin's neural system contains hundreds of feet of nerves and thousands of tactile nerve endings, most of which are concentrated in the frenulum and ridged band. Tactile nerves are sensuous nerves sensitive to pleasant sensations and almost all present in the penis are found within the foreskin.<ref name="taylor1996" /> Comparatively, the nerve endings found in the glans are Free Nerve Endings, or nociceptive nerve endings, which are sensitive to cold, pain and unpleasant sensations. The foreskin's vascular system is also quite complex. The blood is supplied by the frenar artery and small and larger veins are present throughout the [[foreskin ]] and travel down the top of the penis. The abrupt ending of penile veins where they were crushed around the circumference of the penis just behind the area cut off can be seen on a [[circumcised ]] penis. The tissue and blood vessels over the [[glans ]] on the top must also be crushed prior to the dorsal cut to prevent hemorrhage and if a circumcision is to be allowed, special care must be taken to thoroughly crush the frenar artery as hemorrhage is very difficult to control.

At birth the [[Foreskin#Foreskin_in_infancy_and_childhood|infant boy's foreskin]] is almost always [[synechia| fused]] to his [[glans]] as his penis is not fully developed and one [[Immunological_and_protective_function_of_the_foreskin#The_protective_and_hygienic_function_of_the_foreskin| protective function of the foreskin]] is to keep feces and other foreign substances from the meatal opening and the urinary tract of the infant and toddler. That is why the only care for the [[intact ]] penis is to leave it alone, completely alone. No doctor, nurse, parent or any other care provider should ever investigate, probe or examine his [[foreskin]], especially any forced retraction which will tear foreskin from the [[glans]]. The undisturbed glans and inner foreskin [[preputial mucosa|mucosa]] is uncontaminated and any such trespasses may introduce that which the [[foreskin ]] is designed to keep out.<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> His [[foreskin ]] will naturally separate from his [[glans ]] and he should be the only one to touch or retract it. When it separates, he will know and he will be retracting his own [[foreskin]]. No other person should interfere with this natural process.<ref name="Wright1994">{{REFjournal