How to reverse the irreversible

Many men bitterly regret being circumcised. A new method allows them to repair the damage.

Hundreds of British men are walking around with small metal weights attached with sticky tape to the ends of their penises. This curious tackle is not evidence of some bizarre sexual perversion, but a desperate attempt to restore their bodies to normal. They are men who have been circumcised and who are trying to reverse the procedure by "redeveloping" their foreskins.

The weights-and-tape method was devised by Jim Bigelow, a Californian psychologist who successfully undid the effects of his own circumcision: he says he spent four years gently stretching the skin of the penile shaft over the glans, or head of the penis, keeping it in place with surgical adhesive tape.The protective covering of new skin, he says, resulted in a more sensitive penis - and a better sex life.

He subsequently wrote a book about the experience, and "uncircumcising" was tried out by hundreds of men in the US. Now his stretching technique is being championed in Britian by Norm UK, a group that campaigns against circumcision. The group has been contacted by more than 400 men.

Foreskin restoration may sound like just another whacky Californian idea but it is based on the principle of tissue expansion, by which existing skin is progressively stretched, a technique common in plastic and reconstructive surgery. Doctors in the US say they have seen "reasonable" results on men who have stretched the skin themselves.

Keith Barker, a 47-year-old education officer in Glasgow, is one of the British men who is restoring his foreskin using the tape-and-weights method."The skin is starting to cover my penis now, and it feels far more comfortable."

Although circumcision is less common here than in the US, it is still carried out for religious and, occasionally, medical reasons, with some 5 to 10 per cent of boys having lost the foreskin by the age of 16. Dr John Warren, a chest physician in Harlow, Essex, and the founder of Norm UK, is one of a growing number of doctors who wants to see circumcision abandoned altogether, except in rare cases where it is absolutely necessary. Dr Warren, who was circumcised himself when he was one year old claims the operation is cruel, dangerous, unnecessary and mutilating.

"My brother wasn't circumcised so I grew up knowing something had been taken away from my penis," he says. "I was told it didn't matter, but I never liked it - I felt altered. As I got older I noticed more and more discomfort. The glans got sore from rubbing against clothing, so I always looked for tight, supportive underwear to minimise friction. The skin of the penile shaft felt tight during erection, and during sex it was very insensitive." Some researchers say that without its protective covering, the skin of the glans gradually develops a thicker layer of keratin, a fibrous protein, so that it becomes tougher and less sensitive, taking on the character of external skin rather than mucous membrane.

After visiting anti-circumcision groups in California, Dr Warren, who is married, decided to try to restore his foreskin by using surgical tape and progressively heavier weights. "With the tape holding the skin in place over the glans I found I was more comfortable than I had ever been."

In Britain, most circumcisions are carried out on babies as a religious ritual, normally without anaesthetic, with the foreskin being pulled forward and amputated. It is the only non-essential surgery to which the patient does not consent, and Dr Warren maintains that it flouts the human rights laid down by the UN, to self-determination and dignity.

Circumcision is also painful. Research has shown that babies are typically distressed and withdrawn for days after circumcision. In addition, the operation carries risks: there have been cases of babies dying from post- circumcision infection, and even from gangrene. And sometimes the knife slips. In the US, where 80 per cent of boys are still circumcised, there have been cases of children damaged so badly that their penis has been unsalvagable and the child has been physically reconstructed as a girl.

Dr Leela Kapila, a Nottingham doctor who has studied the after-effects of circumcision, estimates that the complication rate is between 2 and 10 per cent. The so-called health benefits of circumcision are no longer upheld by most doctors. Studies published 20 and 30 years ago showed a lower risk of penile cancer among circumcised men and a reduced risk of cervical cancer in their partners. The reason is almost certainly that circumcision prevents the accumulation of the potentially infective glandular deposit called smegma - as does regular washing. Those who may have developed cancer as a result of smegma-induced infections probably laid the foundation of their disease years earlier. Today penile cancer is very rare.

The most common medical reason for circumcision is phimosis - in which the foreskin becomes difficult to retract. Scarring and loss of sensitivity are the main complaints of men who have had the operation in adulthood, with many complaining that sex is less enjoyable.

Keith Barker had the operation five years ago after suffering recurrent infections. Sexual intercourse then became a "non-event", he says, and he was left in permanent discomfort. "Circumcision was the biggest mistake I have ever made and I have to live with it for the rest of my life."

Dr Warren hopes to complete his restoration within two or three years. "The foreskin is not just ordinary skin but a unique structure with specialised sensory nerve endings," he says.

"Sex is much better. During arousal the skin used to be very tight, but now intercourse is much more comfortable and I am beginning to get feeling back. I find that for the first time I can wear boxer shorts without feeling discomfort. I realise what I was looking for in the underwear department all those years - a foreskin."

Tormented by a vivid childhood nightmare

Graham Edwards, 48, a freelance publishing consultant, was circumcised as a baby after doctors told his parents he had a tight foreskin.

Until the age of five he suffered severe recurrent nightmares which he thinks indicate a subconscious memory of the operation.

"I would dream looming shapes were coming at me with knives and cutting me. They are the most vivid dreams I have ever had and I remember them very clearly. I would go down to the living room where my parents were, still dreaming, but I would back away when they put their arms out to comfort me.

"Part of the horror of the dream was that I was being held down forcibly, and I remember choking, a feeling of suffocating.

"It has always been a source of discomfort, and it makes me annoyed that I will never know what it feels like to be intact. Inescapably, one feels resentment against one's parents, but I don't think that it is a very useful emotion because they were just prisoners of the medical profession. Male circumcision should be seen on a par with female circumcision, in that it is no more acceptable."

Mr Edwards, who is married and lives in Oxford, has been restoring for nearly a year. He uses three fishermen's weights that together weigh about 6oz.

"I think it will take about another year. Although restoration is rather uncomfortable it is still better than being uncovered."

HOW RESTORATION WORKS

Foreskin restoration is a slow process of stretching the penile skin over the naked glans, and can take several years. Many men, however, report an improvement in comfort and sensitivity after only a couple of weeks.

The shaft skin can be pulled as far as possible over the glans, and then fastened with surgical tape. Gradually, the skin will expand until it covers the glans naturally. Alternatively, the skin can be stretched manually on a daily basis.

A small weighted device, costing about pounds 40-pounds 50, can also be attached to the tape, (Norm has the name of the supplier) although some men adapt, using the lead weight from a plumb line or fishing weights. Weights can range from 8 oz to 16 oz, and should feel comfortable to the wearer.

The foreskin should always be stretched gradually and gently.

Some men restore just enough of the skin to cover the circumcision in the first place, and the amount required. Some men restore just enough to cover the circumcision scar, while others try to restore more than that.

Surgical uncircumcision is possible, but is considered to be unsatisfactory, and is unusual in Britain. In the US, the success rate is only 70 per cent.

Norm UK, PO Box 71, Stone, Staffs ST15 OSF.