Does the glans become keratinized?
The uncircumcised penis consists of the penile shaft, glans, urethral meatus, inner and outer surface of the foreskin, and the frenulum, the thin band connecting the inner foreskin to the ventral aspect of the glans. A keratinised, stratified squamous epithelium covers the penile shaft and outer surface of the foreskin. This provides a protective barrier against HIV infection. In contrast, the inner mucosal surface of the foreskin is not keratinised15 and is rich in Langerhans' cells,10 making it particularly susceptible to the virus. There is controversy about whether the epithelium of the glans in uncircumcised men is keratinised; some authors claim that it is not,15 but we have examined the glans of seven circumcised and six uncircumcised men, and found the epithelia to be equally keratinised. I
The above excerpt is from the British Journal of Medicine. Full text available at:
http://www.bmj.com/cgi/content/full/320/7249/1592
Circumcision Doesn't Reduce Sexual Satisfaction And Performance, Says Study Of 4,500 Men
ScienceDaily (Jan. 8, 2008) — More than 98 per cent of men who are circumcised can enjoy the same levels of sexual satisfaction and performance as men who are not, according to a study of nearly 4,500 males published in the January issue of the UK-based urology journal BJU International.
The randomised trial, carried out by researchers from Uganda and the USA, was undertaken because previous studies showed that the procedure -- which is now recommended as an efficient way to reduce HIV transmission - showed conflicting results. "Previous studies have been problematic and shown contradictory results" points out co-author Professor Ronald H Gray from the Bloomberg School of Health at Johns Hopkins University, Baltimore, USA.
"Studies focusing on men circumcised in adulthood were highly selective, because there were medical indications for surgery, circumcised infants can't provide before and after comparisons and in most studies sample sizes were small and follow-up was short. "This study, carried out as part of an HIV prevention initiative, enabled us to compare two groups of men with the same demographic profiles and levels of sexual satisfaction and performance at the start of the study."
The research team looked at 4,456 sexually experienced Ugandan men aged from 15 to 49 who did not have the HIV virus. 2,210 were randomised to receive circumcision and 2,246 had their circumcision delayed for 24 months. They followed up both sets of men at six, 12 and 24 months and then compared the information on sexual desire, satisfaction and sexual performance for the circumcised men and the control group.
Their research showed that:
98.6 per cent of the circumcised men reported no problems in penetration, compared with 99.4 per cent of the control group. 99.4 per cent of the circumcised men reported no pain on intercourse, compared with 98.8 per cent of the control group.
Sexual satisfaction was more or less constant in the circumcision group -- 98.5 per cent on enrolment and 98.4 per cent after two years -- but rose slightly from 98 per cent to 99.9 per cent in the control group. This difference was not felt to be clinically significant.
At the six-month visit there was a small, but statistically significant, difference in problems with penetration and pain among the circumcised group, but this was temporary and was not reported at subsequent follow-up visits.
There was considerable consistency between the men in each group when it came to age, religion, marital status, education and number of sexual partners in the last year. The majority of the men were Catholic, married, had one sexual partner and were educated to primary school level.
"Our study clearly shows that being circumcised did not have an adverse effect on the men who underwent the procedure when we compared them with the men who had not yet received surgery" concludes Professor Gray. "Other studies have already shown that being able to reassure men that the procedure won't affect sexual satisfaction or performance makes them much more likely to be circumcised." "BJU International was very keen to publish this large-scale study as there has been a lot of conflicting evidence about the effects of circumcision" says the journal's Editor, Professor John Fitzpatrick from University College Dublin, Ireland. "We believe that these findings are very important as they can be used to support public health messages that promote circumcision as an effective way of reducing HIV transmission."
The effect of male circumcision on sexual satisfaction and function, results from a randomized trial of male circumcision for human immunodeficiency virus prevention. Rakai, Uganda. Kigozi et al. BJU International. Volume 101, pp 65-70. January 2008.
http://www.sciencedaily.com/releases/2008/01/080107101013.htm
I was circumcised at 35 and have not noticed any loss of sensitivity. As other guys have pointed out, sex feels different after circumcision, but I haven't noticed any postings from guys cut as adults who say their dicks are now numb and dull. Lawrence Wade is right when he says that the scar is very sensitive since it has a concentration of nerves, and the same with the inner foreskin, since this is now exposed with all of those nerves under the skin! He even had his frenulum removed and he says the feelings are better.
Paul (USA)
Post-circumcision keratinisation is indeed a myth. The only study to have investigated it was Szabo and Short. They found that the glans was equally keratinised in circumcised and uncircumcised males. (See above) The other studies investigated sensitivity, again finding no differences. These indirectly tested keratinisation, which was the (hypothetical) mechanism for the (equally hypothetical) loss of sensitivity.
http://circs.org/library/masters/index.html
http://circs.org/library/bleustein/index.html
There is little doubt that the skin of the glans peels in many cases, and becomes drier. But let's not perpetuate the myth of keratinisation.
Jake (USA)
As part of the healing process the glans will likely peel, unless you have routinely kept for your foreskin pulled back prior to the circumcision. If not, you can expect a sort of "dry skin" to form over the glans (between 2-4 weeks post circ typically) which will peel off. This is not the same as keratinisation and is quite normal. It will almost seem like your glans had a sunburn and then peels. This is not a problem and is perfectly normal for the newly exposed and now drying glans. This will not make your penis less sensitive as some anti-circ activists claim. To the contrary, I found my penis had a new, velvety smooth texture and touch on the glans and inner lining was more pleasurable than before my circumcision.
Justin (Oregon, USA)
Q. I told my friend I was getting circumcised and he said I would be less sensitive because he read that my penis would become tough and keratinized. Is that true?
A. The epidermis, which includes the glans of your penis, is divided into several layers where cells are formed through mitosis at the innermost layers. They move up the strata changing shape and composition as they differentiate and become filled with keratin. They eventually reach the top layer called stratum corneum and become sloughed off, or desquamated. This process is called keratinization and takes place within weeks all over the body, including the glans of the uncircumcised male. Why do you think uncircumcised men have smegma (cock cheese). They secrete an oily substance called sebum that is made of fat (lipids) and the debris of the sloughed off keratinized cells, that all mix to become smegma. If the glans of the uncircumcised man was not keratinized his smegma would be quite different. So don't worry about keratinization. It is a scare tactic. Your glans will dry out and become very smooth to the touch rather than sticky the way it likely is now. But your sensitivity will be exquisite and you will enjoy sex as much or more than before you were circumcised. .
Dr. Bob (New York, USA)
I was circumcised at 13. I lived in California where 95% of boys my age were cut. I have never regretted it. The tight skin on the shaft gives much more feeling when rubbed then the lose skin when uncut. Most people against circumcision state that the nerves in the foreskin are eliminated, leading to less feeling. This I found was false. The nerves in the foreskin run down the entire length of the penis. When circumcised, the nerve endings are now exposed where the scar is which makes this an extremely sensitive area. Much more then with the foreskin. The feeling at ejaculation is much stronger than before being cut. Also the smegma and it's odor are gone. I have no regrets and we had our son circumcised and I've never met a woman who wished I had a foreskin.
RM (USA)
I think that people who have not enjoyed both uncut and cut states find it difficult to understand the matter of "sensitivity", compounded no doubt by the fact that every person has a different experience. Having been cut some 25 or more years ago, as an adult, I can affirm that the sensitivity is very different now. Before, I could masturbate quite quickly to climax my simply moving the shaft skin up and down quite firmly, but that climax was not especially strong. Now it takes much longer if I concentrate on rubbing just the head, normally using a lube to minimize the amount of movement of the little remaining shaft skin. However the sensation is quite mind-blowing, far, far stronger than I ever experienced uncut. So, even though its a little more effort, I vastly prefer my current cut state, and would never want to go back. Penetrative sex and oral are similarly much improved, as is the feeling when my wife gives me manual stimulation. Those cut as babies can be assured that they really aren't missing much without a foreskin, though I do appreciate that some people do enjoy the versatility of a foreskin, esp. many gays. However, on balance, the many advantages of circumcision greatly outweigh the few disadvantages.
Cliff (UK) cliffordha@aol.com
I was circumcised four months ago and my knob (glans) has definitely NOT lost any sensitivity. In fact, it has become much more sensitive and become a problem as rubs against my boxers and it makes me hard (and once to the point of orgasm), embarrassing when doing sport! I used to wear boxer-briefs, but moved to boxers after the cut and so now I am forced to wear tight under shorts or swim shorts to hold it in position - however boxer-briefs still cause the same problem. If you wanna be circed - try 'dick skin pull-backs' and leave you foreskin back a few weeks. If you've got a tight skin - DON'T let doctors stretch it - VERY PAINFUL and embarrassing.
Ben, aged 15 (UK)
My survey asked women who had experienced both sorts which were more sensitive and got
pretty much an even vote. This seems to me to show
that there isn't much difference. I didn't lose any sensitivity when I got cut.
I that what there are two factors in so-called loss of sensitivity:
1. A glans which is normally foreskin covered most of the time (which is not necessarily
the case in an uncircumcised man) will be damp. This means if will drag on clothes
etc. when exposed, creating uncomfortable sensations. This ceases once it dries out - but
of course is still there as soon as it is moist again. If you are circumcised, try wetting
your glans thoroughly with saliva then do up your trousers again - you'll see what I mean
(and that you haven't lost this sort of non-sexual sensitivity).
2. If someone has had (because of phimosis) a glans which cannot ever (or only with
difficulty) see the light of day he wil have no experience of regular contact of anything
with the glans. The brain has no experience of blocking out these sensations when they are
not required. The situation is made worse because of the dampness factor (above). The
brain soon learns to adapt to this - the sensitivity hasn't just changed, you have just
learned to ignore it. In a man with a normal foreskin this will not occur since he will
have been used to an exposed glans (regular teenage erections, sex-play, masturbation
etc). So his brain has already
learned how to handle an exposed knob.
It does follow from this that the experience of circumcision will be much more dramatic
when it is done to rectify phimosis than when the foreskin was more normal in terms of
length and looseness. But it doesn't follow that any sensitivity (of a sexual sort) is
lost.
J. Badger
I was circumcised 2 years ago, at the age of 22. I didn't lose any sensitivity at all based on my circumcision, removal of the frenelum or taping back of my foreskin that I was doing. And no studies have ever conclusively proven that any sensitivity is lost as a result of circumcision. It's important to note, too, that the nerves that served the foreskin (which I have never found erogenous) do not shrivel up and die when you're circumcised: they remain at the circumcision scar- and THAT can be highly erogenous.
It IS true that the sensation of sex changes quite significantly as a result of circumcision, but I don't think sensitivity is changed at all, one way or another. I greatly prefer my circumcised state.
Lawrence (Toronto, Canada)
I was circumcised at age 27 and recirced at 41, and that was 12 years ago, so I would say that the long term results are in. I notice that sensitivity is a major issue and rightly should be, for after all, who wants to give up that. My experience is that there is very little loss of sensitivity, if any, following the operation. Most of my inner foreskin was removed with the first circ and yet I felt that intercourse was so much better, or at least a lot different. The main thing uncircumcised, was that the skin covered the head on the back stroke, so the inner lining was facing the wrong way anyhow. I suffered from premature ejaculation for about 6 months following the first circ and my urologist had told me that I would be "quick on the trigger". Today I would say that sex would be hard to improve on.
Loren (USA)
Before being circumcised at the age of 19 - a move that satisfied both my then partner and myself - i found all sorts of techniques to keep my foreskin retracted (elastic bands, pushing the inner skin inside the outer skin, and so on) but there was really no way of having the sensitivity that being circumcised gives during sex.
Those of us who have been cut as young adults know that the "exquisite sensitivity" of foreskins is pure hogwash. The foreskin is a sleeve of skin whose sole advantage, if any, may be to enable a selfish male to jerk off inside himself while having sex with a partner. This is, to say the least, a doubtful advantage. Being circumcised increases aural penile sentivity, the sensitivity of the scar is fabulous, having no frenulum means you can thrust without the fear it will be torn, and with experience comes a greater ability to not only feel your partner better (which is particularly important when you have vaginal sex), but also respond and control yourself better. As to the "choice" question, I've never encountered a male circumcised as an adult who didn't wish he had been done as an infant!
Henri
I was circumcised in 1985 at the age of 40 (a birthday present from a girlfriend). A few months earlier I read a article about penis sensitivity in a man's magazine. It talked about the gentle rubbing of the bare glans on underwear. I immediately skinned back and it felt wonderful. At first the sensations soon became almost unbearable and I just had to masturbate to an explosive orgasm. The skin slipped forwards as my penis softened and it would not stay back. So every day I skinned back for a little longer. I began go out for a long walk on rough ground and enjoy the pleasant sensations. During one such walk I met a girl (now my wife). We met every day and we soon started sharing a bed. We often talked about circumcision which always led to great sex. She woke me early on the morning of my birthday and she told me about her surprise birthday present. There was just time for one last long sex session with a foreskin! The operation was done freehand with local anesthetic. It healed fast.
That was 20 years ago. Reading Ter's post reminded me of those great sensations (which I still get) but I had never freeballed before so straight off with the underpants and on with the denims: it feels great! I shave my balls regularly and keep the rest of the hair very short so the whole area gets great stimulation.
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