HUMAN PREPUCE: STRUCTURE AND FUNCTION.
The prepuce, a cowl like fold of the skin, covering the glans penis, has received scant attention from the anatomists or surgeons.
Most of the male infants (96%) are born with a non-retractile prepuce but it becomes retractile subsequently, in most of the children, by the age of three, unless prevented by epithelial debris. (Gairdner, 1949).
In spite of the remarkable changes to which the glans penis is subjected to regarding its size and shape, and the prepuce being retracted frequently as the result of erection or manually, the prepuce covers the glans completely and snugly like a hosiered material and continues to do so through the entire span of life of the male.
The glans is bared of the prepuce spontaneously in erection and the latter is held obliquely against the engorged corona glandis, with the frenulum acting as a hitch or a check rein.
This structure has been ritually sacrificed by some communities while the ancient Romans went to the extent of infibulation - locking or muzzling of the prepuce (Rogers, 1973).
The surgeons have diametrically opposite views about its conservation.
Carcinoma is known to be completely prevented by an early circumcision but in view of its other advantages, its conservation by a plastic procedure has been recommended by others (Zaveleta, 1966; Parkash, 1972; Emmett, 1975).
[CIRP Note: Penile carcinoma in circumcised men has been reported by several researchers. The risk factors for penile carcinoma are now known to be the presence of the HPV virus, and tobacco use.]
The secretory function associated with this structure is a myth. (Parkash et al, 1973).
The morphometric study of tissue components has been reported by Elias and Pauly (1966) and this knowledge has not been fully utilised in histo-pathological studies.
The present study was undertaken to find an explanation as to what makes the prepuce fit the glans so closely and the qualitative and quantitative changes in its structure in relation to age.
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