How to Identify Circumcision Damage in the Adult Male

How to Identify Circumcision Damage
in the Adult Male

http://www.noharmm.org/IDcirc.htm

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The risks of newborn circumcision are an underreported and ignored factor in this argument. Most often a poor surgical result isn't recognized until years after the event. The adverse long term consequences of infant circumcision on the sexual health of American men must be recognized by physicians, parents, and legislators.James L. Snyder, M.D., Past President, Virginia Urologic Society The Problem of Circumcision in America

Many circumcised men are unaware that they have been harmed by circumcision because they do not understand how the intact (non-circumcised) penis functions and/or they do not know how to identify their circumcision damage. Many circumcised men fail to recognize their own circumcision damage and assume that peculiar things about their penis are 'normal' or 'a birth defect.'

NOHARMM documents evidence of how males have been harmed by circumcision. After reading this page, we encourage you to complete a confidential  Harm Documentation Form and submit it to NOHARMM. Some individuals may be able to take legal action against their circumciser, especially those who initiate action within one year after first realizing their damage or, in the case of minors, within one year of turning age 18. We can refer you to an appropriate attorney.

This page illustrates some of the physical consequences of infant circumcision, as they appear in the adult male:

No skin mobility; scarring	Keratinization	Missing frenulum	Skin bridges
Pigmentation variations	Missing portions of glans	Other damage

For a discussion of circumcision's sexual and psychological consequences affecting men,
please read Long-Term Consequences of Neonatal Circumcision.

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No skin mobility; ScarringBelow: This photograph shows the lack of skin mobility during erection of a circumcised penis. Note the dark scar where the foreskin was amputated. This tightness and the unnatural dryness of the penile shaft and head causes some men (and their partners) pain, abrasion, and bleeding during sex. Breaks in the skin are an effective way to transmit and contract sexually transmitted diseases, including HIV.

Below: These five photographs show how the shaft skin of an intact (non-circumcised) penis moves during sexual activity.   Anonymous photo taken from usenet news. Range of skin movement marked by point A is several inches back and forth. Note how point B moves and the end of the foreskin widens to accommodate the head of the penis. Notice the smooth texture of the head of the penis. The moist mucosal surface of the foreskin and glans is similar to that of the female labia and vagina.  NOTE: Retraction is normally not possible or desirable in infants and young children.

Explore the severity of your circumcision or the amount of foreskin you have using the Coverage Index 

KeratinizationThe glans (penile head) is normally an internal organ protected by the moist mucosal tissue of the prepuce (foreskin). Without the foreskin, the glans is exposed to the outer environment (air, soap, clothing, sun, etc.). The glans dries out and develops several extra layers of skin (keratinization).1 Compare the dry, cracked appearance of the glans of a circumcised penis (upper right) with the moist mucosal end of the glans of an intact penis (lower right). The unnatural dryness of the circumcised penis can cause abrasion and bleeding during sex, whereas the moistness of the intact penis makes sex more comfortable, especially during penetration. For women with circumcised male partners, the problem of 'vaginal dryness' during sex may also be partly attributable to the unnatural dryness of the circumcised penis. Besides removing the densely nerve-laden foreskin, circumcision removes 50% of the penile shaft skin and associated nerve endings.2 The exposed glans then keratinizes, causing further loss of sensation. Many circumcised men in the Awakenings survey3 reported that desensitization caused them to abandon or bypass the subtler pleasures of genital foreplay in favor of immediate intercourse, which would offer them greater stimulation. They often hurried through intercourse, however — often needing extraordinary and sometimes violent thrusting — to obtain sufficient stimulation for both pleasure and orgasm. Other men reported frequent reliance on behaviors offering more stimulation than vaginal sex (e.g., oral sex, anal sex or masturbation) or compensating for diminished quality of sexual response with quantity (sexual compulsivity). Eventually, keratinization occurs even after adult circumcision. It can also occur in intact men with short foreskins or those who habitually wear their foreskin in the retracted position. Imagine how different female sexual response would be if the clitoral hood (female foreskin) and the labia were removed. Exposure of the clitoris to the constant effects of the outer environment would approximate the effects of male circumcision.

Circumcised penis(top view)

Intact penis(end view)

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NOTE: Non-surgical foreskin restoration methods (uncircumcision) have helped circumcised men
to regain skin mobility and to reverse some of the effects of keratinization.
These methods are explained in The Joy of Uncircumcising!.
Support group assistance is available from the National Organization of Restoring Men.

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Missing frenulumThe frenulum is a web of tissue connecting the foreskin to the underside of the glans (similar to the frenulum under the tongue or the upper lip). The penile frenulum is densely nerve-laden and is described as a male 'G-spot' — a very erogenous part of the penis.4 Circumcision often destroys the frenulum. Left: Circumcised penis with no frenulum. Right: Intact penis with retracted foreskin and an intact frenulum.

Image: Pro-Foreskin Site

Skin bridge(s)A skin bridge is tissue connecting the coronal ridge of the glans to the shaft of the penis. During erection and/or sexual activity, bridges can pull on the glans and be painful. A man can have one or several skin bridges of various lengths and widths. Some are flush with the penile surface, while others actually create a loop of skin through which one can insert a pencil. Skin bridges are a complication of infant circumcision and do not occur in adult circumcision, because infant circumcision requires the forced separation of the foreskin and glans. (Natural separation occurs between infancy and age 18.) Removing an infant's foreskin prior to its natural separation results in an exposed and raw glans, the coronal ridge of which can fuse with the raw skin edges of the penile shaft where the foreskin was cut. This fused tissue is what causes the bridge effect.

Pigmentation variationsThe pigmentation of the epidermal tissue of the penile shaft is often different from that of the mucosal tissue of the glans and inner foreskin. In the intact penis, only the epidermal tissue of the penile shaft and outer foreskin are visible. The pigmentation of this tissue is usually consistent. Only when the foreskin is retracted, and the glans is exposed, does any pigmentation difference become noticeable. In a circumcised penis, any difference in pigmentation (between the epidermal tissue and that of the mucosal tissue of the glans and remaining inner foreskin) is readily and permanently visible. Stark contrasts in skin tone can be a source of embarrassment and self-esteem issues for some circumcised males.

Gouges/missing portions of the glansSeparation of the foreskin from the glans occurs naturally between birth and age 18, which is why forcible separation is not required for adult circumcision. Infant circumcision involves the forced separation of these structures, which can tear portions of the glans that are tightly adhered to the foreskin. Also, some circumcision devices (e.g., Sheldon clamp) can sever all or part of the glans, or fail to shield the glans from the scalpel used to remove the foreskin.

Other circumcision-related damage may include:
  Meatal stenosis: The normal meatus (urinary opening) in an intact penis is a long slit. When the infant's penis is deprived of its protective foreskin, the meatus can become ulcerated (irritated) by urine, feces and abrasion from diapers. Ulceration can lead to stenosis (narrowing) of the meatus. If the stenosis is severe and impedes urination, a boy may need a meatotomy (surgical reopening of the meatus).
  Bowing/curvature of the penis: Uneven removal of tissue during circumcision can cause skin to be tighter on one side of the penis than the other. Bowing or curvature during erection can result. Curvatures can also be congenital (from birth) or the result of Peyronie's Disease.
  Skin tags: These are portions of the foreskin that remain after an uneven circumcision.
  Hemorrhage, infection, penile amputation, gender reassignment and death are other self-evident forms of damage.

For additional photos of dramatic, yet common, circumcision damage, visit: http://www.circumstitions.com/Botched1.html

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References

1  Bigelow J. The Joy of Uncircumcising! Aptos: Hourglass Publishing 1995:22-3.
2  Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. British Journal of Urology 1996;77:291-5.
3  Hammond T. Awakenings: A Preliminary Poll of Circumcised Men. San Francisco: NOHARMM 1994.
4  Per Judith Seifer, R.N., President, American Assn. of Sex Educators, Counselors and Therapists. In Ask Men’s Health. Men’s Health Magazine October 1994;133.

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