Thirty-five of the 312 male members of the study-subject population were uncircumcised. Although approximately one-quarter of the male study subjects were beyond 40 years of age, more than half (19) of the uncircumcised males were found in this age grouping. The fact that only 16 out of a total of 231 male members of the study-subject population between the ages of 21 and 40 years were uncircumcised is representative of the medical trend toward urging routine circumcision of the newborn male infant. More than 95 percent of all deliveries in this country now are hospital deliveries, and circumcision is recommended as a routine neonatal procedure. The uncircumcised male, particularly one born in an urban area, indeed, is becoming a rarity in our society.
The phallic fallacy that the uncircumcised male can establish ejaculatory control more effectively than his circumcised counterpart was accepted almost universally as biologic fact by both circumcised and uncircumcised male study subjects. This concept was founded upon the widespread misconception that the circumcised penile glans is more sensitive to the exteroceptive stimuli of coition or masturbation than is the glans protected by a residual foreskin. Therefore, the circumcised male has been presumed to have more difficulty with ejaculatory control and (as many study subjects believed) a greater tendency toward impotence.
A limited number of the male study-subject population was exposed to a brief clinical experiment designed to disprove the false premise of excessive sensitivity of the circumcised glans. The 35 uncircumcised males were matched at random with circumcised study subjects of similar ages. Routine neurologic testing for both exteroceptive and light tactile discrimination were conducted on the ventral and dorsal surfaces of the penile body, with particular attention directed toward the glans. No clinically significant difference could be established between the circumcised and the uncircumcised glans during these examinations.
A clinical observation specifically relating to the uncircumcised penis may explain in part this lack of excessive sensitivity of the circumcised as opposed to the uncircumcised glans. Frequently during coition and occasionally during automanipulation the foreskin of the uncircumcised male retracts from the glans as the fully erect penis reacts to plateau-phase levels of sexual tensions. The foreskin retracts in direct relation to the degree of freedom of its movement over the subjacent glans with the penis in a flaccid state. When a minor to moderate degree of phimosis is present, foreskin retraction occurs only after long-continued coital connection. Only 6 of the 35 uncircumcised study subjects failed to demonstrate significant exposure of the glans during or immediately subsequent to active coition. Foreskin retraction usually does not develop as frequently, or progress as far, during automanipulation as during coition. This fact probably is related to the manipulative techniques employed. These will be discussed later in the chapter.
Since 29 of the 35 uncircumcised males developed a significant degree of foreskin retraction during active coition, obviously the uncircumcised glans frequently is exposed directly to exteroceptive stimuli resultant from intravaginal containment just as is the circumcised glans. Thus from a physiologic point of view, a retained foreskin probably contributes little if anything to the individual male's ejaculatory control.