Throughout the world most doctors agree that the disadvantages of infant circumcision far exceed the advantages. This has lead to a decrease in the number of these operations performed each year worldwide. Outside the United States non-religious circumcision is uncommon but male genital mutilation in the United States remains as big a problem as female genital mutilation was elsewhere twenty years ago. But where does this leave men whose genitals were damaged by circumcision at birth and need reconstruction of the foreskin?
photographs courtesy Wiki-commons
There is no perfect method to reconstruct the prepuce. However for some men these methods are worth trying. For many a non-surgical, approach using tape and stretching the foreskin can be used. Other men prefer the quicker method of cosmetic foreskin reconstruction. Several methods are described. They have in common a release of the penile skin at the base of the penis. This skin is then stretched over the glans (head) of the penis. The bare area is reconstructed using a free skin graft or part of the scrotum. In all these cases the penis will have skin on its shaft that does not match the rest of the penis. In many cases the benefits are worth this problem.For men who do not want foreskin restoration but need to improve the appearance of the scars from circumcision, scar revision on the penis after circumcision is possible but often difficult. Unfortunately the shortage of skin created by removing the normal prepuce makes results unpredictable. Some men are already short of skin, especially when erect, and this can cause pain and discomfort. The only solution for them is the use of skin grafts or flaps.
Studies are planned for reconstructing the foreskin using modern methods of tissue regeneration, including fibroblasts from the patient's remaining penile skin. With any method the penis rarely looks the same as it would if it were not circumcised. So, as in all areas of medicine, prevention is better than cure.
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