Dear Dr G,

I underwent circumcision when I was a teenager for hygiene purposes.

It was an unpleasant experience but the procedure itself was uneventful.

After the operation, however, the remaining skin felt overly tight, to the point of pain when I had an erection.

There is also a loss of sensation, as if the glans penis has been numbed.

I am now a grown man and although intercourse is not impossible, it is not enjoyable.

Is there any procedure that can be done to restore the foreskin? How is it done?

Is surgery necessary and is the process painful?

Regards

Restoring Raymond

The practice of foreskin restoration has been documented since the ancient Greek and Roman empires.

The exposure of the glans penis was considered inappropriate and improper in ancient Greek society and men with short foreskins that did not cover it would consider surgery or wearing a kynodesme (a leather strap) nude in a public place (in theatre or athletic situations).

During the reign of the Emperor Tiberius, a surgical method to lengthen the foreskin was widely practiced. During World War II, some European Jews sought foreskin restoration in order to avoid Nazi persecution!

Many circumcisions are done during infancy and there is some medical research that shows adult circumcision may cause sexual difficulties.

One study published in the Journal of Urology highlighted 32% of the participants reported a decrease in erectile function and loss of sensitivity. Another study demonstrated 48% of the circumcised adults expressed regret after the surgery. However, only a small number of participants were surveyed and no data on men regretting the operation after being circumcised during adolescence has been published.

Despite circumcision being the most common surgery performed in men, some regret the operation and desire to create the appearance of a more natural prepuce. Others may experience a decrease in penile sensation and request a reversal operation to restore it and enhance sexual stimulation.

The procedure, known as foreskin restoration involved the expansion of the residual penile skin to mimick the existence and function of the foreskin.

But overall, the main intention of those who choose to undergo foreskin restoration is to address body image issues and having to restore a sense of “wholeness” again.

Foreskin restoration is primarily accomplished by non-surgical methods of stretching. On the other hand, surgical intervention may also be an option for men who fail the first line intervention. The non-surgical foreskin restoration is commonly accomplished by a method called tissue expansion. This involves using a device to pull the residual penile skin on the shaft forward to cover the glans. Weights, elastic straps or some other mechanism is used to generate the varying tension – and of course all this pulling is associated with pain, discomfort or even injury. As the foreskin can only stretch at a slow rate, men are urged to have patience and dedication to undergo such a task.

A surgical foreskin restoration or reconstruction uses a skin graft on the deficient portion of the penile shaft – this is typically harvested from the scrotum. Of course, the outcome may again not be acceptable for some men, as the new skin will feel different sensation and may even have hairs!

There has been a movement to restore foreskins in modern times due to multiple reasons. The National Organization of Restoring Men (NORM) was founded in the United States as a non-profit support group for men who wished to undergo foreskin restorations.

Dr G wishes to point out that the reality operation may not live up to expectations and could even worsen aesthetics and decrease sensation. With that in mind, how much would you stretch your perseverance and the pain to restore the foreskin former glory?

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