A review on the history of and treatment options for foreskin reconstruction after circumcision (2024)

Abstract

Circumcision is arguably one of the most performed procedures in the world and transcends cultures, nationalities, and religions. New insights into the motivations of men seeking circumcision reversal was the incentive to further investigate known reconstructive therapies. Therefore, the purpose of this study is to present an overview of the historical context and treatment options known for foreskin reconstruction. This review was written after a comprehensive literature search on PubMed, EMBASE, Web of Science, MEDLINE, SCHOLAR databases, and additional Google searches. The practice of foreskin manipulation and the undoing of penile circumcision has a long and turbulent history going back to antiquity. Nowadays, the available data on treatment options remains sparse, focusing primarily on surgical techniques and is generally poorly documented. Nonsurgical methods of reconstruction are rarely mentioned in literature. Nonetheless, nonsurgical methods, such as manual stretching and device-assisted tissue expansion, are commonplace among those who pursue foreskin reconstruction. Although the nonsurgical methods have yielded good results with minimal adverse effects, no proper medical research has been performed to quantify these outcomes. Future studies should also be performed to assess the impact that foreskin reconstruction has on quality of life in this population.

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A review on the historyof and treatment options for foreskin reconstruction after circumcision (1)
A review on the historyof and treatment options for foreskin reconstruction after circumcision (2)
A review on the historyof and treatment options for foreskin reconstruction after circumcision (3)
A review on the historyof and treatment options for foreskin reconstruction after circumcision (4)
A review on the historyof and treatment options for foreskin reconstruction after circumcision (5)
A review on the historyof and treatment options for foreskin reconstruction after circumcision (6)

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Data availability

Pubmed Search: ((“Foreskin”[Mesh] OR foreskin*[tiab] OR prepuce*[tiab] OR praeputium[tiab] OR preputium[tiab] OR praeputial[tiab] OR preputial[tiab]) AND (“Reconstructive Surgical Procedures”[Mesh] OR reconstruct*[tiab] OR restor*[tiab] OR rehab*[tiab] OR repair*[tiab])) AND (“Circumcision, Male”[Mesh] OR circumcis*[tiab] OR uncircumcis*[tiab] OR post-circumcision[tiab]OR decircumcision[tiab] OR uncircumcision[tiab]). Embase/Medline Search: Circumcision AND Decircumcision OR Foreskin OR Foreskin Restoration OR Reconstruction OR Restoration AND Uncircumcision.

References

  1. UNAIDS. Male circumcision: global trends and determinants of prevalence, safety and acceptability. UNAIDS; WHO; 2019. p. 42.

  2. Raveenthiran V. The evolutionary saga of circumcision from a religious perspective. J Pediatr Surg. 2018;53:1440–3.

    Article Google Scholar

  3. Cox G, Krieger JN, Morris BJ. Histological correlates of penile sexual sensation: does circumcision make a difference? Sex Med. 2015;3:76–85.

    Article Google Scholar

  4. Nayyar C, Chander R, Gupta P, Sherwal B. Co-infection of human immunodeficiency virus and sexually transmitted infections in circumcised and uncircumcised cases in India. Indian J Sexually Transmitted Dis. 2014;35:114–7.

    Article Google Scholar

  5. Gebremedhin S. Assessment of the protective effect of male circumcision from HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in Sub-Saharan Africa. East Afr J public health. 2010;7:295–9.

    PubMed Google Scholar

  6. Morris BJ, Moreton S, Krieger JN. Critical evaluation of arguments opposing male circumcision: a systematic review. J Evid Based Med. 2019;12:263–90.

    Article Google Scholar

  7. Ozer M, Timmermans F. An insight into circumcised men seeking foreskin reconstruction: a prospective cohort study. Int J Impot Res. 2020;32:641.

  8. Moher DLA, Tetzlaff J, Altman DG,The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097

    Article Google Scholar

  9. Hodges F. The ideal prepuce in ancient Greece and Rome: male genital aesthetics and their relation to lipodermos, circumcision, foreskin restoration, and the kynodesme. Bull Hist Med. 2001;75:375–405.

    Article CAS Google Scholar

  10. Isaacs D. Circumcision. J Paediatrics Child Health. 2011;47:1–2.

    Article Google Scholar

  11. Tushnet L. Uncircumcisio. Med. Times. 1965;93:588–93.

    CAS PubMed Google Scholar

  12. Schultheiss D, Truss M, Stief C, Jonas U. Uncircumcision: a historical review of preputial restoration. Plast Reconstr Surg. 1998;101:1990–8.

  13. Brandes S, McAninch J. Surgical methods of restoring the prepuce: a critical review. BJU Int. 1999;1999:109–113.

    Google Scholar

  14. Futaba K, Bowley D. The foreskin: problems and pathology. Surgery (Oxford). 2010;28:387–90.

    Article Google Scholar

  15. Lascaratos J, Kostakopoulos A, Liapi E, Lascaratos G. Unknown methods of uncircumcision according to Oribasius (4th century AD). Urology. 2003;2003:62.

    Google Scholar

  16. Werblowsky R. The Oxford dictionary of the Jewish religion. Oxford: Oxford University Press; 1997.

  17. Rubin J. Celsus’ decircumcision operation: medical and historical implications. Urology. 1980;16:121–4.

    Article CAS Google Scholar

  18. Gilman S. Decircumcision: the first aesthetic surgery. Mod Jud. 1997;17:201–10.

    Article Google Scholar

  19. Feriz H. A simple method of plastic surgery of the prepuce after radical (ritual) circumcision. Munch Med Wochenschr. 1962;104:1406–7.

    CAS PubMed Google Scholar

  20. Penn J. Penile reform. Br J Plast Surg. 1963;16:287–8.

    Article CAS Google Scholar

  21. Greer D. Technique for foreskin reconstruction and some preliminary results. J Sex Res. 1982;18:324–30.

    Article Google Scholar

  22. Goodwin W. Uncircumcision: a technique for plastic reconstruction of a prepuce after circumcision. J Urol. 1990;144:1203–5.

    Article CAS Google Scholar

  23. Lynch M, Pryor J. Uncircumcision: a one-stage procedure. Br J Urol. 1993;72:257–8.

    Article CAS Google Scholar

  24. Haseebuddin M, Brandes S. The prepuce: preservation and reconstruction. Curr Opin Urol. 2008;18:575–82.

    Article Google Scholar

  25. McAninch J. Reconstruction of extensive urethral strictures: circular fasciocutaneous penile flap. J Urol. 1993;149:488–91.

    Article CAS Google Scholar

  26. Foregen. Foregen: promoting genital integrity through regenerative medicine. 2017.

  27. Purpura V, Bondioli E, Cunningham EJ, de Luca G, Capirossi DEN. The development of a decellularized extracellular matrix-based biomaterial scaffold derived from human foreskin for the purpose of foreskin reconstruction in circumcised males. J Tissue Eng. 2018;9:1–11.

  28. MOHARMM. NOHARMM—National Organization to halt the abuse and route mutilation of males. 2020.

  29. Griffiths. Restoration devices. NORM. 2017.

  30. Bigelow J. The joy of uncircumcising! Hourglass Book Pub; 1994.

  31. Foreskin Restoration. A recourse for techniques, advice and information about non-surgical foreskin restoration. In: Restoration. FgbF; 2020.

  32. Restoring with T-Tape—a graphic guide. 2020. RestoringForeskin.org.

  33. Foreskinrestorationinfo. 2020. Foreskinrestoration.info.PUD.

  34. How To Tug. 2020. TLCTugger.com.

  35. The DILE Insert Foreskin Restoration System. 2020. Dileinsert.com.

  36. DTR. 2020. Foreskinrestore.com.

  37. Foreskin Restoration—CAT II Q Device—regrow penile foreskin for better male sexual health. 2020. Catstretcher.com.

  38. TLCTugger.com. Images of TCL-tugger: by courtesy of Ron Low to use these images for non-commercial purposes. 2017.

  39. Wallace W. An undeniable need for recognition: What do you call a man who has undergone foreskin restoration? “Uncircumcised”? “Restored”? How about just BRAVE? A response to Hill. Clin Anat. 2015;28:962–3.

    Article Google Scholar

  40. McLeod D, Alpert S. Double-V scrotoplasty for repair of congenital penoscrotal webbing: a hidden scar technique. J Pediatr Urol. 2014;10:810–4.

    Article Google Scholar

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Author information

Authors and Affiliations

  1. Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Location VUMC, Amsterdam, The Netherlands

    Floyd Wilhelmus Timmermans,Sterre Elisabeth Mokken,Sahaand Cris Zoë Poor Toulabi,Mark-Bram Bouman&Müjde Özer

  2. Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Location VUMC, Amsterdam, The Netherlands

    Floyd Wilhelmus Timmermans,Sterre Elisabeth Mokken,Mark-Bram Bouman&Müjde Özer

  3. Amsterdam Movement Sciences Research Institute, Amsterdam University Medical Center, Location VUMC, Amsterdam, The Netherlands

    Floyd Wilhelmus Timmermans

  4. Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Location VUMC, Amsterdam, The Netherlands

    Sterre Elisabeth Mokken,Mark-Bram Bouman&Müjde Özer

Authors

  1. Floyd Wilhelmus Timmermans

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  2. Sterre Elisabeth Mokken

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  3. Sahaand Cris Zoë Poor Toulabi

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  4. Mark-Bram Bouman

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  5. Müjde Özer

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Contributions

FWT: methodology, investigation, writing—original draft; SEM: writing—review and editing, visualization; SCZPT: writing—review and editing, visualization; M-BB: writing—review and editing; MÖ: conceptualization, investigation, supervision, and project administration.

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Correspondence to Müjde Özer.

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A review on the historyof and treatment options for foreskin reconstruction after circumcision (10)

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Timmermans, F.W., Mokken, S.E., Poor Toulabi, S.C.Z. et al. A review on the historyof and treatment options for foreskin reconstruction after circumcision. Int J Impot Res 34, 424–433 (2022). https://doi.org/10.1038/s41443-021-00438-3

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  • DOI: https://doi.org/10.1038/s41443-021-00438-3

A review on the history of and treatment options for foreskin reconstruction after circumcision (2024)

FAQs

What do hospitals do with foreskin after circumcision? ›

Their versatility means that they can be used to cultivate skin cells. Because of this, they're not tossed out with the rest of the medical waste after a birth. Instead, hospitals sell them to companies and institutions for a wide variety of uses. Companies will pay thousands of dollars for a single foreskin.

How do they replace the foreskin after circumcision? ›

You won't get your old foreskin back. But you can stretch penile skin over time to create a new foreskin or surgically attach skin from another area of your body to your penis. Risks depend on the approach, but may include dissatisfaction with how your new foreskin looks.

Is foreskin restoration worth it? ›

A person may experience potential benefits from foreskin restoration and having a layer of skin around the glans. Some of these benefits may include : increased sensitivity of the glans, which may result in an improvement in their sex life. protection of the plans from mechanical stress.

What are the results of restored foreskin? ›

Restoration techniques may result in: increased penile sensation during sex. less chafing during sex or from clothing. natural lubrication to make sex more comfortable and preserve penile nerves.

What do they do with the extra foreskin after circumcision? ›

In some boys and men, this extra foreskin can sometimes lead to health problems if it can't be fully drawn back from the head of the penis. In this case, the foreskin may need to be surgically removed.

Who eats foreskin after circumcision? ›

In some Antambahoaka communities, during the Sambatra ceremony the grandparents will eat the foreskin of their newly circumcised grandchild.

What is the new way of circumcision? ›

An appropriately-sized plastic ring is inserted underneath the foreskin. The foreskin is stretched over the plastic ring, and it's secured by tying on a sterile suture thread to stop blood flow to the foreskin. The plastic ring remains on the penis until the foreskin falls off naturally in seven to 10 days.

What is human foreskin used for after circumcision? ›

In this context, preputial skin removed after surgery has been shown to be a good autologous skin graft (e.g. repair of hypospadias, reconstruction of the eyelid, repair of syndactyly and urethroplasty).

What happened to the foreskin after circumcision? ›

A hood of skin, called the foreskin, covers the head (or glans) of the penis. In circumcision, the foreskin is surgically removed, exposing the end of the penis.

Can I leave my foreskin back forever? ›

If you are not circumcised, you can still avoid paraphimosis by: Always pulling the foreskin back down to its natural position. This could be after having sex, going to the bathroom, or cleaning yourself. Never leaving the foreskin behind the head of your penis for any longer than you need to.

Does circumcision reduce pleasure? ›

Two large studies of a random sample of men in Africa found no difference in sexual pleasure after circumcision between those who'd had been snipped and those who hadn't, Michael Brady, chairman of the pediatrics department at Nationwide Children's Hospital in Ohio, who worked on those trials, wrote in an email.

What are the cons of foreskin? ›

With that said, having a foreskin may increase your risk of certain infections if cleanliness is not maintained. This is because the skin under the foreskin is warm and moist, providing the ideal environment for bacteria or fungus (particularly if smegm* is allowed to accumulate).

Will foreskin regeneration be possible? ›

Foreskin restoration is something that you can do if you were circumcised as a child. It is a method or practice to regrow your foreskin. There are a few different options for foreskin restoration including surgery and skin stretching tools.

Can uncircumcised guys pull back foreskin? ›

When the foreskin separates from the glans of the penis it can be pulled back (retracted) to expose the glans. Foreskin retraction may happen immediately after birth, or it may take several years. Some boys can retract their foreskin as early as age 5, but some may not be able to do this until their teenage years.

What is the motivation for foreskin restoration? ›

Adverse physical, sexual, emotional/psychological and self-esteem impacts attributed to circumcision had motivated participants to seek foreskin restoration. Most sought no professional help due to hopelessness, fear, or mistrust. Those who sought help encountered trivialization, dismissal, or ridicule.

How do hospitals dispose of foreskin? ›

The usual procedure for managing the extracted foreskin is to dispose of it in the biological waste, but some studies have revealed the huge potential of foreskin cells as an important resource for medical research.

Do you keep foreskin after circumcision? ›

Usually, after the circumcision has healed, the penis requires no additional care. Occasionally a small piece of the foreskin remains. You should pull back this skin gently each time the child is bathed. Examine the groove around the head of the penis and make sure it's clean.

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