THE EPITHELIUM OF THE PREPUCE
Among infants the foreskin normally sticks to the glans. This
epithelium or adhesive layer is natural, normal. It usually degenerates
freeing the foreskin in early infancy. Sometimes it does not release
in which case it is almost always recognised at the beginning
of puberty when during erection the adhesive layer between foreskin
and glans makes movement of the foreskin intensely painful.
Care must be taken with these epithelial adhesions. Not only
can an attempt to release them cause intense pain but if they
are broken and if the sticky skin surfaces are allowed to rest
in contact with each other again, they can fuse together causing
(Epithelium: tissue forming the outer layer of skin, lining
alimentary canal and other hollow areas).
The adhesive layer between the inner foreskin and the glans is
natural and normal in babies. This epithelium or layer will usually
release of its own accord, sometimes this happens before birth,
often within the first six months, and usually by the age of three
years old (4). The layer
releases last around the coronal ridge and in the area of the frenulum.
There are different degrees of adherence. Boys often release
the foreskin themselves during childhood or at the beginning of
puberty, the experience can be compared to the sensation of peeling
elastoplast from sensitive skin and can be a relatively interesting
exploration leading to the welcome discovery of the glans. Doctors
also perform this separation occasionally without anaesthetic which
is reported as an extremely painful experience.
After separation, sometimes a white film can form on the glans
which has the tendency to re-stick and needs re-releasing and regular
Occasionally the pain which a boy experiences when attempting
to release these infant adhesions can be so intense that it completely
hinders attempts with retraction and sometimes a full adherence
will continue through puberty and even until adulthood.
One man described the pain
during erection as intense or immanent. He requested circumcision
at 13 yrs. old and was advised to "wait and see what happens" by
his doctors. He limited his enjoyment and exploration to manipulating
the phallus by gently stroking or applying pressure to the area
round the glans, He was eventually circumcised after a renewed
request as soon as he was legally eligable at 18.
In "Symbolic Wounds" Bettelheim
reports a case where during masturbation "painful adhesions
interfered with full functioning of the penis" (6).
Bettelheim failed to recognise the degree of pain this causes,
even though the boy "wanted the operation very badly" obviously
a period of time elapsed before "Eventually we had to arrange for
Infant adhesions should be released at an early age. The inhibitive
influence of pain throughout childhood erections cannot be expected
to have a positive effect on the behavioural habits and psychological
attitudes of a child.
In addition from a practical perspective, a childs natural exploration
and manipulation is severly hindered by the immanence of pain.
He cannot explore and indulge in the natural early exercise which
he would otherwise enjoy. We could normally expect this early exercise
to encourage the development of a healthy and supple foreskin which
may subsequently be more resistant to stiffening processes.
Possibly because the sensation of pain is so obvious for the
young men with this condition, they actively desire to be circumcised,
therefore infant adhesions are usually treated during adolescence
or at latest as a young adult.
Adhesions and Early Learning discusses the effects of pain from this adhesive layer on psychological
Solutions offers a web
of files which discuss how to encourage the release of the adhesive