Phimosis and Circumcision: Concepts, History, and Evolution

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    • Phimosis and Circumcision: Concepts, History, and Evolution

      Bruno Pinheiro Falcão1*, Marcelo Marcondes Stegani2, Jorge Eduardo Fouto Matias2

      As described by Taylor et al,9 the inner layer of the
      foreskin is divided into 2 regions, “corrugated” and “smooth”
      (Figure 2). The first is a transversely corrugated mucosal
      zone with 10-15 mm in the prepuce which is not retracted.
      The “wavy” area is usually flat against the glans, and when
      retracted, it is always present in the body of the penis. The rest
      of the preputial tissue between the “wavy” area and the glans
      is smooth and relaxed. The “wavy” zone presents a marked
      increase in vascularization and the markings are deeper in
      younger individuals.
      The inner surface of the foreskin is covered by a keratinized
      squamous epithelium similar to that of the esophagus, with
      the presence of nerves, Schwann cells, lymphoid and capillary
      cells. The preputial mucosa does not have hair follicles, lanugo,
      sebaceous glands, or sweat glands. The presence of myelinated
      nerve fibers inside the papillae confirms the extremely
      sensitive nature of the “wavy” region of the foreskin.9
      It is classically postulated that the foreskin protects the glans,
      although it is equally likely that the glans forms and protects
      the foreskin. This exchange guarantees great sensitivity to the
      glans and penile body.
      ijmedrev.com/article_77035_678…70a643063f09531429671.pdf
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