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පෙරහම

විකිපීඩියා වෙතින්
(අක්හම වෙතින් යළි-යොමු කරන ලදි)
පෙරසම
තොරතුරු
ලතින්prepucium, præputium
පූර්වජGenital tubercle, Urogenital folds
ධමනිය
Dorsal artery of the penis
ශිරාව
Superficial dorsal vein of the penis
ස්නායුව
Dorsal nerve of the penis
හඳුන්වනයන්
ග්‍රේ ගේp.1250
MeSHA05.360.444.492.362
Dorlands
/Elsevier		Preupuce
TAA09.4.01.011
FMA19639
ව්‍යූහ විද්‍යාත්මක ශබ්දමාලාව

In male human anatomy, the foreskin or prepuce (a technically broader term that also includes the clitoral hood, the homologous structure in women) is a retractable double-layered fold of skin and mucous membrane that covers the glans penis and protects the urinary meatus (උසුරුවනුයේ /miːˈeɪtəs/) when the penis is not erect.

හැඳින්වීම

[සංස්කරණය]
Foreskin (more anatomy visible)

The outside of the foreskin is like the skin on the shaft of the penis, but the inner foreskin is a mucous membrane like the inside of the eyelid or the mouth. Like the eyelid, the foreskin is free to move after it separates from the glans, usually by puberty. Smooth muscle fibres keep it close to the glans but make it highly elastic.[1] The foreskin is attached to the glans with a frenulum, which helps retract the foreskin over the glans. At the end of foreskin, there is a band of tissue called the ridged band, which, according to one study, is rich in nerve endings called Meissner's corpuscles.[2] According to a study by Sorrells et al., the five most sensitive areas of the penis are on the foreskin.[3]

In children, the foreskin covers the glans completely, but, in adults, this need not be so. Schöberlein [4] found that about 50% of young men had full coverage of the glans, 42% had partial coverage, and, in the remaining 8%, the glans was uncovered. After adjusting for circumcision, he stated that, in 4% of the young men, the foreskin had spontaneously atrophied (shrunk).

විකසනය

[සංස්කරණය]

Eight weeks after fertilization, the foreskin begins to grow over the head of the penis, covering it completely by 16 weeks. At this stage, the foreskin and glans share an epithelium (mucous layer) that fuses the two together. It remains this way until the foreskin separates from the glans.[5]

At birth, the foreskin is usually still fused with the glans.[5] As childhood progresses the foreskin and the glans gradually separate, a process that may not be complete until late puberty.[6] Thorvaldsen and Meyhoff reported that average age of first foreskin retraction in Denmark is 10.4 years.[7] Wright argues that forcible retraction of the foreskin should be avoided and that the child himself should be the first one to retract his own foreskin.[8] Premature retraction may be painful, and may result in infection.

කාර්යය

[සංස්කරණය]

The World Health Organization state that there is "debate about the role of the foreskin, with possible functions including keeping the glans moist, protecting the developing penis in utero, or to enhance sexual pleasure due to the presence of nerve receptors".[9]

ලිංගික

[සංස්කරණය]

සැකිල්ල:Detail

Taylor et al described the foreskin in detail, documenting a ridged band of mucosal tissue. They stated "This ridged band contains more Meissner's corpuscles than does the smooth mucosa and exhibits features of specialized sensory mucosa."[10] In 1999, Cold and Taylor stated "The prepuce is primary, erogenous tissue necessary for normal sexual function."[2] Boyle et al, state that "The complex innervation of the foreskin and frenulum has been well-documented, and the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision, with an inevitable reduction in sexual sensation experienced by circumcised males."[11] The AAP noted that the work of Taylor et al "suggests that there may be a concentration of specialized sensory cells in specific ridged areas of the foreskin."[12]

Moses and Bailey (1998), describe the evidence of sensory function as "indirect," and state that, "aside from anecdotal reports, it has not been demonstrated that this is associated with increased male sexual pleasure."[13] The World Health Organisation states that there is little evidence for diminished sexual function, adding that studies have been inconsistent.[14] Fink et al. reported "[a]lthough many have speculated about the effect of a foreskin on sexual function, the current state of knowledge is based on anecdote rather than scientific evidence."[15] Masood et al. state that "[c]urrently no consensus exists about the role of the foreskin or the effect circumcision has on penile sensitivity and overall sexual satisfaction."[16] Schoen states that "[a]necdotally, some have claimed that the foreskin is important for normal sexual activity and improves sexual sensitivity. Objective published studies over the past decade have shown no substantial difference in sexual function between circumcised and uncircumcised men."[17]

Foreskin in motion (gliding action).

The term 'gliding action' is used in some papers to describe the way the foreskin moves during sexual intercourse. This mechanism was described by Lakshamanan & Prakash in 1980, stating that "[t]he outer layer of the prepuce in common with the skin of the shaft of the penis glides freely in a to and fro fashion..."[18] Several opponents of circumcision have argued that the gliding movement of the foreskin is important during sexual intercourse.[19] Warren & Bigelow claim that gliding action would help to reduce vaginal dryness and that restoration of the gliding action is an important advantage of foreskin restoration.[20] O'Hara describes the gliding action, stating that it reduces friction during ලිංගික සංසර්ගය, and suggesting that it adds "immeasurably to the comfort and pleasure of both parties".[21] Taylor suggests that the gliding action, where it occurs, may stimulate the nerves of the ridged band[22], and speculates that the stretching of the frenulum by the rearward gliding action during penetration triggers ejaculation.[23]

Taves used a single subject to test the actual force required to penetrate a measuring apparatus. When the foreskin was retracted a more than tenfold, increase in force was needed.[24] He argued that this confirms the belief of Morgan (1967) that the foreskin makes sexual penetration easier during sexual intercourse.[25] Whiddon (1953) and Foley (1966) also believed that the presence of the foreskin made sexual penetration easier.[26][27]

වෙනත්

[සංස්කරණය]

Gairdner (1949) states that the foreskin protects the glans[5] but some studies show that inflammation of the glans is more common when the foreskin is present.[28]

The fold of the prepuce maintains sub-preputial wetness, which mixes with exfoliated skin to form smegma. Some authors believe that smegma contains antibacterial enzymes,[29] though their theory has been challenged.[30] The American Academy of Pediatrics state that "No controlled scientific data are available regarding differing immune function in a penis with or without a foreskin."[31] Inferior hygiene has been associated with balanitis,[32] though excessive washing can cause non-specific dermatitis.[33]

ගැටළු

[සංස්කරණය]

Frenulum breve is where the frenulum is insufficiently long to allow the foreskin to fully retract, which may lead to discomfort during intercourse. The frenulum may also tear during intercourse. Phimosis is a condition when the foreskin of an adult cannot be retracted properly. (Before adulthood, the foreskin may still be separating from the glans.[34]) Phimosis can be treated by gently stretching the foreskin, by changing masturbation habits,[35] using topical steroid ointments, preputioplasty, or by circumcision.

Non-retractable foreskin is not always indicative of a clinical condition. The first time the foreskin retracts (say during masturbation or sex) can be a slightly painful experience, as the glans penis is not used to friction and air contact. However the problem resolves itself after a few days of acclimatization, which may include consciously retracting the foreskin and exposing it to air, water, or friction. A condition called paraphimosis may occur if a tight foreskin becomes trapped behind the glans and swells as a restrictive ring. This can cut off the blood supply, resulting in ischaemia of the glans penis.

Korean doctors claim that South Korean men have a gene that causes “abundant foreskin,” believing that at least 90% of Korean men have “too much” foreskin. [36] Although there is no scientific evidence of this alleged genotype and it was found that most Korean physicians could not define phimosis, almost all of South Korean physicians recommend universal circumcision because they believe it eliminates tight foreskins and brings many benefits. [37][38] Aposthia is a rare condition in which the foreskin is not present at birth.

Surgical and other modifications of the foreskin

[සංස්කරණය]
High and tight circumcised penis.

Circumcision is the removal of the foreskin, either partially or completely. It may be done for religious, aesthetic, health, or hygiene reasons, or to treat disease.

Preputioplasty is a procedure to relieve a tight foreskin without resorting to circumcision.

Other practices include genital piercings involving the foreskin and slitting the foreskin.[39]

ලැංගහෑන් සෛල

[සංස්කරණය]

Langerhans cells are immature dendritic cells that are found in all areas of the penile epithelium,[40] but are most superficial in the inner surface of the foreskin.[40] The recent Szabo and Short (2000) study targets Langerhans cells as receptors of HIV, and states that these cells "must be regarded as the most probable sites for viral entry in primary HIV infection in men."[41] Langerhans cells are also known to express the c-type lectin langerin, which may play a role in transmission of HIV to nearby lymph nodes.[40]However, de Witte et al. (2007) reported that langerin, produced by Langerhans cells, blocks the transmission of HIV to T cells.[42]

Additional images

[සංස්කරණය]
  • Caravaggio's Amor Victorious with the Roman Cupid Amor showing his penis with its foreskin
    Caravaggio's Amor Victorious with the Roman Cupid Amor showing his penis with its foreskin
  • A penis and pubic hair
    A penis and pubic hair
  • Erect human penis
    Erect human penis
  • A penis and foreskin flaccid (left) and semi-erect (right)
    A penis and foreskin flaccid (left) and semi-erect (right)
  • ‍ෙ‍පරසම සහිත ශිෂ්නයක්
    ‍ෙ‍පරසම සහිත ශිෂ්නයක්
  • A short foreskin that doesn't cover the complete glans
    A short foreskin that doesn't cover the complete glans
  • Naturally short foreskin - most of the glans is uncovered even in flaccid state
    Naturally short foreskin - most of the glans is uncovered even in flaccid state
  • Acroposthion of the foreskin
    Acroposthion of the foreskin
  • Taping the foreskin back
    Taping the foreskin back
  • Circumcised penis
    Circumcised penis

වෙනත් සතුන්ගේ පෙරසම

[සංස්කරණය]

In koalas, the foreskin contains naturally-occurring bacteria that play an important role in fertilization.[43] Almost all mammals have foreskins, although in these non-human cases the foreskin is usually a sheath into which the whole penis is retracted. Only monotremes (the platypus and the echidna) lack foreskins.[44]

පෙරසම යොදාගන්නා වෛද්‍ය සහ පාරිභෝගික නිශ්පාදන

[සංස්කරණය]

Foreskins obtained from circumcision procedures are frequently used by biochemical and micro-anatomical researchers to study the structure and proteins of human skin. In particular, foreskins obtained from newborns have been found to be useful in the manufacturing of more human skin.[45]

Foreskins from circumcised babies are used to make a commercial anti-wrinkle skin cream. A six-week supply costs US$130.[46]

Foreskins of babies are also used for skin graft tissue,[47][48][49] and for β-interferon-based drugs.[50]

Foreskin fibroblasts have been used in biomedical research.[51]

ආශ්‍රිත ලිපි

[සංස්කරණය]

References

[සංස්කරණය]
  1. ^ Lakshmanan, S (1980). "Human prepuce - structure & function". Indian J Surg. 44: 134–7. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  2. ^ a b Cold, CJ. "The prepuce". BJU Int. 83 Supp 1: 34–44. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  3. ^ Sorrels, Morris (2007). "Fine-touch pressure thresholds in the adult penis" (PDF). Bjuinternational. 99: 864–869. 2009-10-07 දින මුල් පිටපත (PDF) වෙතින් සංරක්ෂණය කරන ලදී. සම්ප්‍රවේශය 2009-03-01. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  4. ^ Schöberlein circumcision taboos. Phimosis frenulum and foreskin conditions, phimosis and male initiation
  5. ^ a b c Gairdner, D (1949). "The Fate of The Foreskin: a study of circumcision". BMJ. 2: 1433–7.
  6. ^ Øster, J (1968). "Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys". Arch Dis Child. 43: 200–3.
  7. ^ Phimosis: Pathological or Physiological?
  8. ^ Wright JE (1994). "Further to "the further fate of the foreskin". Update on the natural history of the foreskin". Med. J. Aust. 160 (3): 134–5. PMID 8295581. {{cite journal}}: Unknown parameter |month= ignored (help)
  9. ^ "Male circumcision: Global trends and determinants of prevalence, safety and acceptability" (PDF). World Health Organization. p. 18.
  10. ^ Taylor, JR (1996). "The prepuce: specialized mucosa of the penis and its loss to circumcision". Br J Urol. 77: 291–5. doi:10.1046/j.1464-410X.1996.85023.x. ISSN 0007-1331. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  11. ^ Boyle, G; Goldman, R; Svoboda, J; Fernandez E (2002). "Male Circumcision: Pain, Trauma and Psychosexual Sequelae". Journal of Health Psychology. 7: 329–343. doi:10.1177/1359105302007003225.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  12. ^ "American Academy of Pediatrics: Circumcision Policy Statement". Pediatrics. 103: 686–693. 1999. doi:10.1542/peds.103.3.686. PMID 10049981. 2007-01-22 දින මුල් පිටපත වෙතින් සංරක්ෂණය කරන ලදී. සම්ප්‍රවේශය 2009-03-01. {{cite journal}}: Unknown parameter |month= ignored (help)
  13. ^ Moses S (1998). "Male circumcision: assessment of health benefits and risks". Sexually Transmitted Infections. Vol 74 (Issue 5): 368–373. 2006-11-30 දින මුල් පිටපත වෙතින් සංරක්ෂණය කරන ලදී. සම්ප්‍රවේශය 2007-04-28. There is indirect evidence suggesting that the foreskin may have an important sensory function, although aside from anecdotal reports, it has not been demonstrated that this is associated with increased male sexual pleasure. {{cite journal}}: |issue= has extra text (help); |volume= has extra text (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  14. ^ "Male circumcision: Global trends and determinants of prevalence, safety and acceptability" (PDF). World Health Organization. p. 22. Although it has been argued that sexual function may diminish following circumcision due to the removal of the nerve endings in the foreskin and subsequent thickening of the epithelia of the glans, there is little evidence for this and studies are inconsistent.
  15. ^ Fink KS, Carson CC, DeVellis RF (2002). "Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction". J. Urol. 167 (5): 2113–6. PMID 11956453. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  16. ^ Masood S, Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK (2005). "Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?". Urol. Int. 75 (1): 62–6. doi:10.1159/000085930. PMID 16037710.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  17. ^ Schoen EJ (2007). "Should newborns be circumcised? Yes". Can Fam Physician. 53 (12): 2096–8, 2100–2. PMID 18077736. {{cite journal}}: Unknown parameter |month= ignored (help)
  18. ^ Lakshmanan S; Prakash S (1980). "Human prepuce: some aspects of structure and function". Indian Journal of Surgery. 44: 134–137. The outer layer of the prepuce in common with the skin of the shaft of the penis glides freely in a to and fro fashion and has to be delicate and thin, as was observed in this study. [...] The inner lining of the projecting tubular part has the structure of the outer layer and adds to the thin gliding skin when retracted.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  19. ^ Kigozi G, Watya S, Polis CB; et al. (2008). "The effect of male circumcision on sexual satisfaction and function, results from a randomized trial of male circumcision for human immunodeficiency virus prevention, Rakai, Uganda". BJU Int. 101 (1): 65–70. doi:10.1111/j.1464-410X.2007.07369.x. PMID 18086100. Opponents of circumcision, using results from selected observational studies, have argued that the procedure impairs sexual function, and reduces sexual pleasure and satisfaction through keratinization of the glans, removal of the most sensitive preputial tissues, and loss of the 'gliding' mechanism provided by the foreskin {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |doi_brokendate= ignored (|doi-broken-date= suggested) (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  20. ^ Warren, J; Bigelow J (September/October 1994). "The case against circumcision". Br J Sex Med: 6–8. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link)
  21. ^ O'Hara K (2002). Sex as Nature Intended It: The Most Important Thing You Need to Know about Making Love, but No One Could Tell You Until Now. Turning Point Publications. p. 72. During intercourse, the natural penis shaft actually glides within its own shaft skin covering. This minimizes friction to the vaginal walls and opening, and to the shaft skin itself, adding immeasurably to the comfort and pleasure of both parties.
    Friction is not entirely eliminated during natural intercourse but it is largely eliminated. Friction can take place in the lower vagina, but only if the man uses a stroke that exceeds the (forward and backward) gliding range of the shaft's extra skin. And in such a case, there will be friction only to the extent that the shaft exceeded its extra skin, which is uncommon since the natural penis has a propensity for short strokes. Primarily, it is the penis head that makes frictional contact with the vaginal walls, usually in the upper vagina where there is ample lubrication. [...] The gliding principle of natural intercourse is a two-way street—the vagina glides on the shaft skin while the shaft skin massages the penis shaft as it glides over it.
  22. ^ Taylor, J (2000). "Back and Forth". Pediatrics News. 34 (10): 50.
  23. ^ Taylor JR (2003). "Evidence sketchy on circumcision and cervical cancer link". Can Fam Physician. 49: 1592. PMID 14708921. {{cite journal}}: Unknown parameter |month= ignored (help)
  24. ^ Taves D (2002). "The intromission function of the foreskin". Med. Hypotheses. 59 (2): 180–2. PMID 12208206. {{cite journal}}: Unknown parameter |month= ignored (help)
  25. ^ Morgan WK (1967). ""Penile plunder"". Med. J. Aust. 1 (21): 1102–3. PMID 4226264. {{cite journal}}: Unknown parameter |month= ignored (help)
  26. ^ WHIDDON D (1953). "I. Should baby be circumcised?". Lancet. 265 (6781): 337–8. PMID 13085774. {{cite journal}}: Unknown parameter |month= ignored (help)
  27. ^ The Unkindest Cut of All, http://www.cirp.org/news/1966.07_Foley/, ප්‍රතිෂ්ඨාපනය 2009-03-01 
  28. ^ Balanitis and the uncircumcised male
  29. ^ Immunological Functions of the Human Prepuce
  30. ^ STI -- eLetters for Fleiss et al., 74 (5) 364-367, http://sti.bmjjournals.com/cgi/eletters/74/5/364#112, ප්‍රතිෂ්ඨාපනය 2009-03-01 
  31. ^ "Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision". Pediatrics. 103 (3): 686–93. 1999. PMID 10049981. {{cite journal}}: Unknown parameter |month= ignored (help)
  32. ^ O'Farrell N, Quigley M, Fox P (2005). "Association between the intact foreskin and inferior standards of male genital hygiene behaviour: a cross-sectional study". Int J STD AIDS. 16 (8): 556–9. doi:10.1258/0956462054679151. PMID 16105191.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  33. ^ Birley: Management of Recurrent Balanitis
  34. ^ Kayaba: Normal Development of the Prepuce
  35. ^ The causes of adolescent phimosis
  36. ^ Jung, K. M. 1971. A study on the foreskin and circumcision of the penis of Korean male. Korean Journal of Public Health 8:369
  37. ^ Kim, D. S., J. Y. Lee, & M. G. Pang. 1999. Male circumcision: A South Korean perspective. British Journal of Urology International, 83, Supplement; 1:28-33.
  38. ^ International Encyclopedia of Sexuality, South Korea, The Kinsey Institute. Edited by Hyung-Ki Choi, M.D., Ph.D., and Huso Yi, Ph.D.
  39. ^ eMedicine - Paraphimosis : Article by Jong M Choe, MD, FACS
  40. ^ a b c McCoombe SG, Short RV (2006). "Potential HIV-1 target cells in the human penis". AIDS. 20 (11): 1491–5. doi:10.1097/01.aids.0000237364.11123.98. PMID 16847403.
  41. ^ "How does male circumcision protect against HIV infection?". සම්ප්‍රවේශය 2007-11-30.
  42. ^ de Witte L, Nabatov A, Pion M; et al. (2007). "Langerin is a natural barrier to HIV-1 transmission by Langerhans cells". Nat. Med. 13 (3): 367–71. doi:10.1038/nm1541. PMID 17334373. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  43. ^ UQ researchers unlock another koala secret
  44. ^ "Reproductive System". MSN Encarta. Seattle, WA, USA: Microsoft Corporation. 2006. http://encarta.msn.com/encyclopedia_761553537_2/Reproductive_System.html. ප්‍රතිෂ්ඨාපනය 2009-03-01. 
  45. ^ McKie, Robin (1999-04-04). "Foreskins for Skin Grafts". The Toronto Star. {{cite news}}: |access-date= requires |url= (help)
  46. ^ "The Skinny On 'Miracle' Wrinkle Cream". NBC10.com. NBC Universal, Inc. 2002. සම්ප්‍රවේශය 2008-08-20. {{cite web}}: Unknown parameter |month= ignored (help)
  47. ^ "High-Tech Skinny on Skin Grafts". www.wired.com:science:discoveries. CondéNet, Inc. 02.16.99. 2012-05-30 දින මුල් පිටපත වෙතින් සංරක්ෂණය කරන ලදී. සම්ප්‍රවේශය 2008-08-20. {{cite web}}: Check date values in: |date= (help)
  48. ^ "Skin Grafting". www.emedicine.com. WebMD. සම්ප්‍රවේශය 2008-08-20.
  49. ^ Amst, Catherine (July 27, 1998). "Biotech Bodies". www.businessweek.com. The McGraw-Hill Companies Inc. සම්ප්‍රවේශය 2008-08-20. {{cite web}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  50. ^ Cowan, Alison Leigh (April 19, 1992). "Wall Street; A Swiss Firm Makes Babies Its Bet". New York Times:Business. New York Times. සම්ප්‍රවේශය 2008-08-20.
  51. ^ Hovatta, O. (2003). "A culture system using human foreskin fibroblasts as feeder cells allows production of human embryonic stem cells". Human Reproduction. 18 (7): 1404–1409. PMID 12832363. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
[සංස්කරණය]
(WMP, streaming) http://www.doctorsopposingcircumcision.org/video/prepuce.html සංරක්ෂණය කළ පිටපත 2012-02-04 at the Wayback Machine
(WMP, download) http://www.doctorsopposingcircumcision.org/video/Circumcision_WM7NTSC_256k_D.wmv සංරක්ෂණය කළ පිටපත 2012-02-04 at the Wayback Machine
  • Anatomy photo:42:01-0107 at the SUNY Downstate Medical Center - "The Male Perineum and the Penis: The Surface Anatomy of the Penis"

සැකිල්ල:Male reproductive system

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