EDITOR—Waskett1 properly questions the increase in sensitivity after foreskin restoration claimed by Bigelow more than a decade ago.2
The decrease in penile sensitivity after circumcision is well documented both by extensive anecdotal and empirical evidence.3 The partial restoration of that sensitivity by foreskin restoration is also well documented by an abundance of anecdotal evidence from the thousands of men who have undertaken foreskin restoration by means of tissue expansion. The question is not whether penile sensitivity is lost by circumcision and regained by foreskin restoration, but how it occurs.
There had been a paucity of research into this matter. When Bigelow prepared his work more than a decade ago,2 it was believed that the change in the sensitivity of the glans penis was the major contributor to the decrease in sensitivity after circumcision and its partial recovery by foreskin restoration.
Blustein et al. held the foreskin back while statically testing the sensitivity of the glans penis.45 They did not test the sensitivity of the foreskin either statically or under dynamic movement, as occurs during sexual activity, so their work does not accurately measure the contribution to overall penile sensitivity of the foreskin Their work seems to establish that the glans penis is not the primary site of the increase in sensitivity, pleasure, and satisfaction in the male with a complete foreskin and, therefore, points to the foreskin as the probable location.
Circumcision amputates the ridged band6 and tightens the penile skin, thereby destroying the gliding action that was first described by Lakshamanan6 and later by Warren & Bigelow.7 It now appears that the change in sensitivity observed by so many is caused by the loss of the gliding action6,7 and the loss of the highly innervated ridged band. Foreskin restoration restores the gliding action and allows better stimulation of the remaining nerves of the penile epithelium. It is not clear whether additional nerves are grown during the tissue expansion but the ridged band structure can never be replaced.
Coitus is a dynamic activity. The gliding action of the foreskin allows it to move during coitus.7,8 It everts and un-everts in rapid succession during coitus. It appears more likely that this movement deforms and stimulates the Meissner nerve endings in the original or restored foreskin9 and causes the well documented contribution to pleasure, sensitivity, and satisfaction.
More research is necessary to fully elucidate the exact method by which the foreskin provides erogenous sensitivity, pleasure, and satisfaction, while preventing premature ejaculation.
Rapid Response:
Foreskin motion generates Meissner corpuscle stimulation
Competing interests: No competing interests