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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.  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