Circumcision: A Blessing or a Curse in the Light of Structural and Functional Analysis of Prepuce of Penis

Abstract Introduction: The prepuce is a double layer of skin and fascia covering the glans penis to a variable extent. The neuroanatomical details of the prepuce of the penis are inadequately described in literature and there are ubiquitous but confusing structural and functional details. The aim of the present study was to understand the functional significance of the prepuce of the penis by examining different types of cutaneous receptors, in particular the Meissner’s corpuscle (MC). Methodology: This prospective observational study used the skin of 18 boys and men (aged 3–72 years) from prepuce. Based on their age, the participants were split into three groups: <12 years ( n = 10), adults between the ages of 12 and 50 years ( n = 04), and more than 50 years ( n = 04). Stains for cytology, such as hematoxylin-eosin and Von Gieson’s stain, and neuronal tissue stains, such as silver impregnation, were applied to 5 mm thick sections. Sensory receptors like MCs were identified and counted and Meissner’s index (MI) was calculated for the three age groups. MCs were studied for structural details and compared with the MCs of other sites. Results: With cytological stains, the preputial skin consisted of usual layers of glabrous skin. With silver impregnation, the nerve plexus in the dermis was observed and some fibers went to innervate the dermal papillae to form globular structures resembling MCs of other sites. The MCs were simple in structure consisting of a core of nerve fibers surrounded by a capsule. The size of the MCs ranged from 2584 mm to 3680 mm. There was no significant difference in the size of the three age groups as revealed by analysis of variance (ANOVA). The MI ranged from 0.34 to 0.44 and ANOVA did not show any significant difference between the three age groups. Other sensory receptors such as Pacinian, genital corpuscles of Krause, and Ruffini corpuscles were scarce or absent in prepuce. Conclusion: Functionally, the prepuce may not be considered an important structure as it lacks most of the sensory receptors present in other parts of sensitive skin of the body. MCs are scanty in number and simple in structure. The prepuce has some protective role in maintaining moisture, preventing infections, and providing a barrier against irritants. However, the impact of circumcision on penile sensitivity and sexual arousal is likely minor.