Date: Tue, 2 Apr 1996 20:01:52 -0800 (PST)
Reply-To: noharmm-l@eskimo.com
Originator: noharmm-l@eskimo.com
Precedence: bulk
From: Chuff@prodigy.com (MR MARTIN B NOVOA)
To: noharmm-l@eskimo.com
Subject: Meatal sphincter
X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas

-- [ From: Martin B.L. Novoa * EMC.Ver #2.10P ] --


On Tuesday 2 April 1996 J.H. wrote

"Yep.  The Townsend Letter was a bit confused on this.  I think (NB
Hugh) that they meant to ref to the f. as sphincter not the meatus 
(only the former makes sense)."

Actually, it is indeed the meatus of the glans penis that forms a
sphincter to keep pathogens out of the genito-urinary tract.  The
closest the foreskin could come to this function is via the frenar band,
which does not generally close as a true sphincter (although sometimes
if you sit funny it squishes shut and stays that way for a few minutes.
That is another matter altogether).

What happens to the meatus after circumcision is a tragedy and is quite
illustrative of the sphincter function.  A normal glans penis has
meatal "lips" that open to reveal a short, vertical slit that is the
normal meatus.  In some boys and men, these lips are rather pronounced.
Following circumcision, the glans penis typically is immersed in diaper
ammonia and feces for much of the day.  These irritants, combined with
occasional infectious agents, typically inflame the delicate, raw
circumcision wound; the tender, raw foreskin remnant behind the glans;
and the tender, raw glans penis itself, including the meatus.  When
there is sufficient inflammation around the meatus, the meatal lips
become inflamed/infected and swell up.  In the healing process, they
tend to crust and form scar tissue.  This is generally uncomfortable,
if not downright painful, for the baby, and occasionally leads to UTIs 
(urinary tract infections).  As the irritated meatus heals, what used
to be lips have disappeared and the infant is often left with a "hole"
through which to urinate for the rest of his life.

News flash to those circumcised men who thought you were supposed to
have an open hole in the end of your glans:  you're not.

Generally, this hole is smaller in total diameter than the sphinctered,
whorled slit that intact babies have.  This is problematic, because any
reduction in size of this opening has a restrictive effect on the flow
of urine.  The urinary tract is finely designed to become
infinitessimaly wider in increments as the urethra proceeds from
bladder to meatus, and any disruption of this increase in gauge will
result in a certain amount of "backpressure", if you will, on the flow
of urine.  This creates a hazard of urinary tract infections and
discomfort throughout childhood and possibly adulthood.  Anecdotally, I
have heard people observe that intact men have a stronger and more
definitive "whoosh" when voiding, quite likely for this reason.  One
function of the meatal lips is to funnel this increased voiding
capacity into a whorl, or swirl, like the spin of a well-thrown
football.  It has been theorized that this swirling motion also cleans
out the area underneath the foreskin effectively if the foreskin is
long and not retracted during urination.  This helps little boys
eliminate the normal "pearls" of epithelial sloughing -- sometimes
called infant smegma -- and helps adult men move smegma along its
course.  Another stroke of genius, courtesy of Mother Nature.  (NB --
smegma moves from the coronal sulcus out through the foreskin, since it
is a mixture of normal skin sloughing and pheromone-laden sebum [oil]
that lubricates between the glans and inner lining of the foreskin. 
This is part of a complex, normal and fascinating self-cleaning
mechanism of the intact penis.  Smegma, in fact, is the ancent Greek
word for SOAP.)

The stricture of the meatus is called meatal stenosis, and it is
estimated that it afflicts OVER 50% of all men circumcised as infants. 
This has been recognized as one of the most widely observed
"complications" from infant circumcision, more than almost all the
other complications combined.  Many other men do not have a true
stenosis, but their meatus nevertheless is merely a slit or a hole and
lacks the natural lips of the intact, covered glans.  Finally, there
are some intact men who have either very pronounced or only barely
discernable meatal lips, and some intact men who also have lost this
sphincter through inflammation.  Even whole infants are not immune to
inflammation and infection, although the medical literature points out
that meatal stenosis is effectively unknown among intact infants 
(reason enough, in my book, to stop routine circumcision universally
today).

It is interesting to see that American men refer to the "pee hole" as
if it were the norm to have a "hole" in the end of your penis.  Never
once have I overheard a reference to "pee lips," but then again, few
American men still have these.

Hope this helps explain the reference in the Townsend Letter.

Reletlessly,

Martin