Circumcision is arguably one of the most performed procedures in the world and transcends cultures, nationalities, and religions. New insights into the motivations of men seeking circumcision reversal was the incentive to further investigate known reconstructive therapies. Therefore, the purpose of this study is to present an overview of the historical context and treatment options known for foreskin reconstruction. This review was written after a comprehensive literature search on PubMed, EMBASE, Web of Science, MEDLINE, SCHOLAR databases, and additional Google searches. The practice of foreskin manipulation and the undoing of penile circumcision has a long and turbulent history going back to antiquity. Nowadays, the available data on treatment options remains sparse, focusing primarily on surgical techniques and is generally poorly documented. Nonsurgical methods of reconstruction are rarely mentioned in literature. Nonetheless, nonsurgical methods, such as manual stretching and device-assisted tissue expansion, are commonplace among those who pursue foreskin reconstruction. Although the nonsurgical methods have yielded good results with minimal adverse effects, no proper medical research has been performed to quantify these outcomes. Future studies should also be performed to assess the impact that foreskin reconstruction has on quality of life in this population.
Subscribe to Journal
Get full journal access for 1 year
only $32.38 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Pubmed Search: ((“Foreskin”[Mesh] OR foreskin*[tiab] OR prepuce*[tiab] OR praeputium[tiab] OR preputium[tiab] OR praeputial[tiab] OR preputial[tiab]) AND (“Reconstructive Surgical Procedures”[Mesh] OR reconstruct*[tiab] OR restor*[tiab] OR rehab*[tiab] OR repair*[tiab])) AND (“Circumcision, Male”[Mesh] OR circumcis*[tiab] OR uncircumcis*[tiab] OR post-circumcision[tiab]OR decircumcision[tiab] OR uncircumcision[tiab]). Embase/Medline Search: Circumcision AND Decircumcision OR Foreskin OR Foreskin Restoration OR Reconstruction OR Restoration AND Uncircumcision.
UNAIDS. Male circumcision: global trends and determinants of prevalence, safety and acceptability. UNAIDS; WHO; 2019. p. 42.
Raveenthiran V. The evolutionary saga of circumcision from a religious perspective. J Pediatr Surg. 2018;53:1440–3.
Cox G, Krieger JN, Morris BJ. Histological correlates of penile sexual sensation: does circumcision make a difference? Sex Med. 2015;3:76–85.
Nayyar C, Chander R, Gupta P, Sherwal B. Co-infection of human immunodeficiency virus and sexually transmitted infections in circumcised and uncircumcised cases in India. Indian J Sexually Transmitted Dis. 2014;35:114–7.
Gebremedhin S. Assessment of the protective effect of male circumcision from HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in Sub-Saharan Africa. East Afr J public health. 2010;7:295–9.
Morris BJ, Moreton S, Krieger JN. Critical evaluation of arguments opposing male circumcision: a systematic review. J Evid Based Med. 2019;12:263–90.
Ozer M, Timmermans F. An insight into circumcised men seeking foreskin reconstruction: a prospective cohort study. Int J Impot Res. 2020;32:641.
Moher DLA, Tetzlaff J, Altman DG,The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097
Hodges F. The ideal prepuce in ancient Greece and Rome: male genital aesthetics and their relation to lipodermos, circumcision, foreskin restoration, and the kynodesme. Bull Hist Med. 2001;75:375–405.
Isaacs D. Circumcision. J Paediatrics Child Health. 2011;47:1–2.
Tushnet L. Uncircumcisio. Med. Times. 1965;93:588–93.
Schultheiss D, Truss M, Stief C, Jonas U. Uncircumcision: a historical review of preputial restoration. Plast Reconstr Surg. 1998;101:1990–8.
Brandes S, McAninch J. Surgical methods of restoring the prepuce: a critical review. BJU Int. 1999;1999:109–113.
Futaba K, Bowley D. The foreskin: problems and pathology. Surgery (Oxford). 2010;28:387–90.
Lascaratos J, Kostakopoulos A, Liapi E, Lascaratos G. Unknown methods of uncircumcision according to Oribasius (4th century AD). Urology. 2003;2003:62.
Werblowsky R. The Oxford dictionary of the Jewish religion. Oxford: Oxford University Press; 1997.
Rubin J. Celsus’ decircumcision operation: medical and historical implications. Urology. 1980;16:121–4.
Gilman S. Decircumcision: the first aesthetic surgery. Mod Jud. 1997;17:201–10.
Feriz H. A simple method of plastic surgery of the prepuce after radical (ritual) circumcision. Munch Med Wochenschr. 1962;104:1406–7.
Penn J. Penile reform. Br J Plast Surg. 1963;16:287–8.
Greer D. Technique for foreskin reconstruction and some preliminary results. J Sex Res. 1982;18:324–30.
Goodwin W. Uncircumcision: a technique for plastic reconstruction of a prepuce after circumcision. J Urol. 1990;144:1203–5.
Lynch M, Pryor J. Uncircumcision: a one-stage procedure. Br J Urol. 1993;72:257–8.
Haseebuddin M, Brandes S. The prepuce: preservation and reconstruction. Curr Opin Urol. 2008;18:575–82.
McAninch J. Reconstruction of extensive urethral strictures: circular fasciocutaneous penile flap. J Urol. 1993;149:488–91.
Foregen. Foregen: promoting genital integrity through regenerative medicine. 2017.
Purpura V, Bondioli E, Cunningham EJ, de Luca G, Capirossi DEN. The development of a decellularized extracellular matrix-based biomaterial scaffold derived from human foreskin for the purpose of foreskin reconstruction in circumcised males. J Tissue Eng. 2018;9:1–11.
MOHARMM. NOHARMM—National Organization to halt the abuse and route mutilation of males. 2020.
Griffiths. Restoration devices. NORM. 2017.
Bigelow J. The joy of uncircumcising! Hourglass Book Pub; 1994.
Foreskin Restoration. A recourse for techniques, advice and information about non-surgical foreskin restoration. In: Restoration. FgbF; 2020.
Restoring with T-Tape—a graphic guide. 2020. RestoringForeskin.org.
Foreskinrestorationinfo. 2020. Foreskinrestoration.info.PUD.
How To Tug. 2020. TLCTugger.com.
The DILE Insert Foreskin Restoration System. 2020. Dileinsert.com.
DTR. 2020. Foreskinrestore.com.
Foreskin Restoration—CAT II Q Device—regrow penile foreskin for better male sexual health. 2020. Catstretcher.com.
TLCTugger.com. Images of TCL-tugger: by courtesy of Ron Low to use these images for non-commercial purposes. 2017.
Wallace W. An undeniable need for recognition: What do you call a man who has undergone foreskin restoration? “Uncircumcised”? “Restored”? How about just BRAVE? A response to Hill. Clin Anat. 2015;28:962–3.
McLeod D, Alpert S. Double-V scrotoplasty for repair of congenital penoscrotal webbing: a hidden scar technique. J Pediatr Urol. 2014;10:810–4.
Conflict of interest
The authors declare no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Timmermans, F.W., Mokken, S.E., Poor Toulabi, S.C.Z. et al. A review on the history of and treatment options for foreskin reconstruction after circumcision. Int J Impot Res (2021). https://doi.org/10.1038/s41443-021-00438-3