Document Type : Original Article (s)
Authors
1
Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2
Associate Professor, Department of Pediatric Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3
Student of Medicine, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Circumcision of boys has been the tradition of all the prophets and has also been emphasized in Islam. Despite the religious teachings, reference books do not provide a standard on how much of the prepuce to leave. It was thus decided to investigate a number of nerve receptors in the inner and outer layers of the prepuce.Methods: This was a descriptive, analytical study. The target group consisted of 32 boys at the age range of 3 months to 10 years who referred to pediatric surgery ward of Alzahra Hospital (Isfahan, Iran) for circumcision surgery from June to November 2009. In this study, inner and outer layers of prepuce were removed through classic circumcision surgery by local or general anesthesia. Inner and outer layers of prepuce were marked and separately placed in formalin. Immunohistochemistry staining was used after cutting and preparation of samples for chemical staining. Substance P (SP), protein gene product (PGP 9.5), and calcitonin gene-related peptide (CGRP) antibodies were prepared and their existence was investigated in the tissue. Student's t-test was used to compare mean density of nerve receptors between the two areas.Findings: In this study, 32 male candidates for elective circumcision through classic method were evaluated. The mean age of subjects was 1.37 ± 0.53 years (range: 4 months-5 years). Mean nerve fibers of PGP 9.5 in the outer and inner layers of prepuce was 6.3 ± 2.3 and 13.4 ± 2.04, respectively (P = 0.001). Mean nerve fibers of SP in the outer and inner layers of prepuce was 2.1 ± 1.6 and 3.2 ± 2.1, respectively (P = 0.09). Mean nerve fibers of CGRP in the outer and inner layers of prepuce was 2.5 ± 1.1 and 5.6 ± 1.7, respectively (P = 0.02).Conclusion: Leaving more of prepuce may cause inappropriate irritation and lack of proper sexual function at the time of puberty. Therefore, in order for better sexual functioning and avoiding potential complications, it is recommended to remove the highest possible amount of prepuce in circumcision surgery.
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