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The Male Prepuce

Andrew J. Smatko, M.D.
JAMA. 1961;175(13):1186. doi:10.1001/jama.1961.03040130069028.
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To the Editor:—  I was much interested in the editorial comment on the epidemiology of cancer of the cervix. It appears that the editorialist is almost convinced that smegma is the offending culprit, since he states that cancer of the penis parallels cancer of the cervix in noncircumcised populations.I would like to point out a weakness in this theory. A circumcised man with good penile hygiene is largely free of smegma accumulation. Nevertheless, he still possesses many smegma-producing glands in the coronal sulcus. These glands are not removed by circumcision.Secondly, the clitoris is also surrounded by a "foreskin" or praeputium. Numerous sebaceous ( smegma-producing) glands are present in this area. The perineal hygiene of women is, on the average, poorer than that of men because of numerous folds and the semi-hidden position of the clitoris. The vulva in the clitoral region is frequently "contaminated" by smegma.Therefore, if smegma


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