Intentional

A week or so ago, on a website I frequent which has nothing at all to do with restoration, I bumped into a quasi – local guy who is in his mid-20s and was only just recently circumcised. In a number of “online” places, I have included mention of restoration and this usually sparks conversation. I’m always surprised at how many men have at least looked into it. Most have done only the most basic research on the matter, but a few have gone deeper and know some of the options available. And I’ll also occasionally run into someone who is a friend of someone who is restoring.

Far less common, though, is the occurrence of a grown male opting for circumcision. Naturally, I was very curious. This guy makes only the second grown male I’ve known of who wanted circumcised. The first is a Latino neighbor of mine. I think, if I recall, he cited phimosis or something as his reason for being cut. I also recall this man admitting that intercourse was yet quite painful – he’d fully healed and was completely able to engage in intercourse, but the new tightness he experienced was a source of displeasure. The second guy, a younger man, basically just followed suite … the example set by his older brother.

As I understood from our conversation, he and his older brother were both circumcised by the same doctor – someone in the Seattle area. We didn’t talk much about his brother aside from the mention that he went to the same guy his brother did and that this guy “does good work.” When I asked why he wanted circumcised I assumed that he would cite having a too-tight foreskin or trouble keeping everything clean or some other legit issue, but to my surprise he mentioned nothing of that sort. Instead, he detailed that he didn’t like the extra effort in cleaning it (note the difference between having trouble keeping the area clean and not want to have to invest the effort to do as much), that he didn’t like that his glans stayed moist, etc…. Nothing dysfunctional or otherwise pathological. Just disdain for the general experience of having a foreskin. He didn’t even cite that others he’d dated or been intimate with had been repulsed or otherwise adverse.

He did share with me a pic of the new shape of things, so to speak. I’ll include it here so that you can see the Seattle MD’s handiwork.

Thanks for reading.

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Supplemental Pee

This post isn’t likely to be as substantial as some other posts have been. That’s primarily because it was started in early December, 2015, and it’s now after the first week of April, 2016. On any of my blogs, I hate to let drafts go unfinished for so long because I’ll either forget what I wanted originally to share or I’ll change my thoughts on the topic, altogether. A significant part of why I keep this blog and others is that I want to document parts of my journey as a human being and that should necessarily include my unique evolution – which can’t well be logged if I start things and let then go unfinished for so long.

At any rate, this is one such post and I’ll apologize now for it. The content below is probably something copied from the forum site or a post in one of the restoration groups I am a member of on Facebook. As best I can recall from what I’ll be sharing below, this seems to have been part of a dialogue discussing nutrients that help with skin growth and maintenance.

At this point, I can’t even tell you who said this, but he was talking about using his own urine (which would be sterile to himself) as a mean of achieving what he has called, “Poor-man’s stem cell therapy.” I did have a note in my draft that there might be an email stashed somewhere with links, but I’ve yet to locate that email. If I’m able to find the time for digging and have luck enough to locate what I think might have been sent to me, which I imagine were just links to places online that seem to indicate a connection between urine / stem cells / rubbing stem cells into your own skin, then I’ll update this post accordingly.

Without having researched this at all on my own I can’t say anything more about what science might be behind this – if there is any. My intuition tells me very little science at all supports this, but I’ll let you read below for yourself and allow you to come to your own conclusion. Thanks for reading.

“Urine contains pluripotent cells (stem cells) and urea increases the water-holding capacity of tissues. What I do is:

  1. Make sure I’m drinking enough water (~1gal/day, distilled)
  2. Every time I go to pee (and have a couple of minutes to spare) I’ll wet my fingers with urine, and massage it into the glans, foreskin, frenulum remnant etc.)

Poor-man’s stem cell therapy. Not just “restoring”, but combining it with a slow-action stem-cell growth to eventually RENEW the foreskin. When it is massaged into the skin until dry, it does not leave that “piss” stink. The piss-stink comes when urea oxidizes and starts breaking down into ammonia. Of course, your mileage will vary depending on your hydration levels/diet etc.”

Meatus

I’m a generally knowledgeable person. I’ve gone to school for a number of things, and for a brief stint touched on premed studies. And yet, I’m amazed sometimes when I learn something – amazed that I didn’t know it! Human physiology and anatomy have been subjects I’ve done really well in historically, but my journey so far into foreskin restoration has been surprisingly educational with regard to my own body.

For example, I recently learned a new word. Meatus. I would wager that 99% of all humans with a penis don’t know what a meatus actually is, let alone that they have one. From what I understand, a meatus is any passage or opening that leads into the body. With that definition in mind, you can instantly understand that all humans have at least one meatus. Multiple, in fact.

The focus of this post is the male urinary meatus – AKA your pee hole. According to Wikipedia, the male urinary meatus should look like a vertical slit that may or may not have its own labia. The site also indicates that this opening can be somewhat round and that this roundness may occur naturally or in correlation to excessive tissue removal such as during circumcision.

Wikipedia doesn’t offer much more information except to briefly mention a few “disorders” of the meatus which could include epispadias ( misplacement to the uppser aspect ), hypospadias ( misplacement to the underside of the penis ), and meatal stenosis ( causing partial or total blockage or bifurcation of the urinary stream, etc… ).

Luckily, I was able to come across additional information on the meatus, specifically discussed in the context of circumcision. This additional information can be found by clicking here. Below is detailed the information I’ve gained from the letter linked to.

  1. The meatus naturally should serve as a kind of gatekeeper – preventing pathogens from entering the body through the urethral opening.
  2. A normal penile meatus has the aforementioned labia, which would normally need to be separated in order to view the vertical slit forming the opening of the urethra.
  3. In circumcised infant boys, the glans stays exposed to the diaper environment which is acidic and often unclean and which, due to these factors, becomes inflamed and quite irritated – often resulting in swelling and crusting of the labia, which later form scar tissue. The result is that the labia are missing and the infant is left with an open penile hole instead of the original structure.
  4. The intact structure of a penis also helps govern the release of urine and also is a functionary aid in keeping the penis clean.
  5. Because of complications associated with circumcision, more than half of all cut men have meatal stenosis or some other complication.

So that’s the long-n-short of the meatus. I’ll do what I can to add my own pics for reference of a real one. By my own judgement, I think my meatus has remained very open and I think I could say that I have also retained the labia, too – at least for the most part and more so when I am not erect.

See the pics below, and thanks for reading.

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Meatus

 

Rollover Already!

“Rollover” is something most restoring men look forward to. It’s surely one of the milestones noted along the way to fully restored foreskin. We start with none – thanks to circumcision. Some of us start having been cut very very tightly.

Then we get what might be called some breathing room. The skin begins to “move.” For me, with a relatively loose circumcision, I found breathing room within two months of starting my own restoration process. You can see as much in an earlier post here where I shared some progress.

A while after hitting the “breathing room” mark, you might find yourself at a point in restoration that could be labeled the “bunching phase.” It’s at this point that the extra skin gained begins to gather at the corona. It’s also around this stage that many restoring me begin to lament being “stuck” and complain some about how much more effort and time is required to keep progressing.

Recently on “the” restoring site I saw a post created by a member and he’d added his own illustration. He’s been restoring for a while and has progressed through the aforementioned stages – and like many before him, was kinda stuck. But he noticed something else, he was bunching… and bunching… and bunching. And not ever rolling over. He provided the illustration below to depict the predicament.

Image taken from UpwardLemon's blog post on RF site
Image taken from UpwardLemon’s blog post on RF site

You can see his frustration, visible in the drawing and his handwriting – and rightly so! There is an actual self-pic of his penis posted on the restoring website, but I didn’t feeling posting that here is really warranted. Trust me, after having viewed his actual pic I can attest that he’s not kidding or exaggerating. He’s got loads and loads of bunching and has yet to achieve “rollover.”

I’m not as far along as he is, but I can certainly begin to sympathize. Progress feels too slow already and then to get “stuck” doesn’t help one’s mood. As encouragement, other members commented on his post and assured that it’s a temporary frustration and will essentially fix itself with time and through gaining additional skin.

Apparently, it’s not at all unheard of for this continued bunching to take place and there eventually is reached a tipping point whereat the bunching basically becomes too much for its own good and succumbs to providing actual rollover – which I’m sure is helped by the restorer making sure there is ample inner and outer skin to facilitate rollover and a retaining routine established to help train the skin more and more forward.

Overall, I was really glad to happen across the post and the illustration. Frankly, a lot of things like this that I happen across feel very “common sense” to me. In that light, I don’t feel I gain much information from them really. However, seeing what might be down the road for me is helpful and knowing the things others on a similar path have dealt with – what was found to be frustrating, what was helpful or not, and seeing that the obstacle is something that will eventually be left behind are all very encouraging things for me and where the real value for me stays. I’m glad to see others posting things like this!

Thanks for reading!

Coverage Index

The posts here are starting to become numerous enough that looking back through them to review the things I’ve covered is kind of a hassle. With that in mind, I’ll ask you now to pardon me if from here on out I touch on things you may already have read about.

This post will be mostly one of pictures – something “readers” here usually enjoy more than paragraph after paragraph of black-n-white words. I thought it would be useful to publish a post about something called a Coverage Index (aka CI). I think in past posts I’ve mentioned this and maybe even linked to it – I know there are sites that show what I’m sharing here, but some of those require you to create an account, etc… to view the content you want to see. I’m putting it here for easy reference and access, since you aren’t required to subscribe or anything to view this blog.

The digest version of an explanation for what the CI / RCI is, is … An index that allows you to gauge how much foreskin coverage you currently have. The amount of coverage a male might have can vary greatly even when uncircumcised. Some have what could be considered excessive “overhang” while others are hardly covered at all and even might experience constriction. (You might Google the terms “acroposthion” and “phimosis” to learn more about these things … I might cover / have covered those topics here, too.)  So even in uncut males there can be a wide range of glans coverage. When you look at this from the cut side of things and factor in that each circumcised male also started from a slightly different place and then was circumcised using any number of available techniques, it’s not tough at all to understand how not every guy has the same level of foreskin coverage.

The benefit of the CI / RCI for men who are circumcised and pursuing restoration is that being able to know where we are starting helps us to assess what might be our best initial approach. In truth, most restoring men will use a variety of methods or devices, and some even insist on a variety, but regardless of variety that might occur down the road each must know where he’s starting, and so I’m sharing images here to help you gauge where you are currently, whether cut or uncut.

I hope this is helpful and thanks for reading.

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“Significant Trauma”

Natural News is a site that pops up on my Facebook feed periodically – usually through the post or repost of a Facebook friend. I find myself with more and more friends on Facebook who are restoring their foreskin or who are intactivists. Recently there was a post to an article on Natural News ( which can be accessed directly by clicking here ) about the trauma experienced by infant males when circumcision is performed.

The piece begins with mention of the double standard (here in the USA, anyway) in regard to male genital mutilation versus the same for females. That opener is more emotionally charged than I prefer, but it elsewise cuts right to the chase which is to say that the experience of removing foreskin from infant males is traumatic enough to actually make changes to the brain in regard to the parts of the brain associated with reasoning, perception and emotions. (When I read this, I couldn’t help but see some irony in the fact that there are a great number of men who are determined to restore and also happen to be quite emotional about their own circumcision – some even hating their own parents for being such sheeple.

The article then moves on to a study conducted, which sounds very reasonable. Scans were done of the brains of infant boys both pre- and post circumcision. The scans before the surgery were to establish the norm / baseline for the infant and the scans afterward were to reveal changes occurring because of the surgery. The scans revealed that the “significant trauma” experienced by these infant males affected specific parts of the brain, namely the Amygdala, frontal lobes, and temporal lobes. Follow up tests were conducted later at the intervals of one day, one week, and one month after the circumcision. Those follow up scans revealed the changes (again, which were caused by the trauma of the circumcision) were permanent.

I’ve read descriptions of the procedure. I’ve heard comparisons between the procedure and other things that paint a vivid picture of the pain experienced. In fact, my own mother-in-law remarked only a few weeks ago that she still remembers when my husband was circumcised and how obviously dreadful it was for her new son – so obvious was his anguish, she said, that her “mothering instinct” almost took over and interrupted the procedure. Can you even imagine? How absolutely horrible this practice must truly be for it to have the effect of actually changing a new human’s brain and thereby quite literally affecting the rest of his life.

I can’t wait for this to be a thing of the past and for the USA to catch up to the rest of the world.

Thanks for reading.

Penis Transplant in USA

Penis Transplants Being Planned to Heal Troops’ Hidden Wounds

By DENISE GRADYDEC. 6, 2015

Within a year, maybe in just a few months, a young soldier with a horrific injury from a bomb blast in Afghanistan will have an operation that has never been performed in the United States: a penis transplant.

The organ will come from a deceased donor, and the surgeons, from Johns Hopkins University School of Medicine in Baltimore, say they expect it to start working in a matter of months, developing urinary function, sensation and, eventually, the ability to have sex. From 2001 to 2013, 1,367 men in military service sustained wounds to the genitals in Iraq or Afghanistan, according to the Department of Defense Trauma Registry. Nearly all were under 35 years old and were hurt by homemade bombs, commonly called improvised explosive devices, or I.E.D.s, sometimes losing all or part of their penises or testicles — what doctors call genitourinary injuries.

Missing limbs have become a well-known symbol of these wars, but the genital damage is a hidden wound — and, to many, a far worse one — cloaked in shame, stigma and embarrassment. “These genitourinary injuries are not things we hear about or read about very often,” said Dr. W. P. Andrew Lee, the chairman of plastic and reconstructive surgery at Johns Hopkins. “I think one would agree it is as devastating as anything that our wounded warriors suffer, for a young man to come home in his early 20s with the pelvic area completely destroyed.”

Only two other penis transplants have been reported in medical journals: a failed one in China in 2006 and a successful one in South Africa last year. The surgery is considered experimental, and Johns Hopkins has given the doctors permission to perform 60 transplants. The university will monitor the results and decide whether to make the operation a standard treatment. The risks, like those of any major transplant operation, include bleeding, infection and the possibility that the medicine needed to prevent transplant rejection will increase the odds of cancer. Dr. Lee cautioned that patients should be realistic and not “think they can regain it all.” But doctors can give the recipients a range of what to expect. “Some hope to father children,” Dr. Lee said. “I think that is a realistic goal.”

Just the penis will be transplanted, not the testes, where sperm are produced. So if a transplant recipient does become a father, the child will be his own genetically, not the offspring of the donor. Men who have lost testicles completely may still be able to have penis transplants but will not be able to have their own biological children.

In the 2006 case in China, the recipient asked that the transplant be removed a few weeks after the operation, because of “apparent psychological rejection,” the Johns Hopkins doctors said, adding that in photographs the transplant had patches of dead and peeling skin, possibly from inadequate blood flow. But the South African recipient, a young man whose penis had been amputated because of a botched circumcision, recently became a father, said Dr. Gerald Brandacher, the scientific director of the reconstructive transplantation program at Johns Hopkins.

Doctors who treat young men wounded in combat say that no matter how bad their other injuries are, the first thing the men ask about when they wake up from surgery is whether their genitals are intact. “Our young male patients would rather lose both legs and an arm than have a urogenital injury,” said Scott E. Skiles, the polytrauma social work supervisor at the Veterans Affairs Palo Alto Health Care System. Army Sgt. First Class Aaron Causey, who lost both legs, one testicle and part of the other from an I.E.D. in Afghanistan in 2011, said the testicular damage was the most troubling of his injuries. “I don’t care who you are — military, civilian, anything — you have an injury like this, it’s more than just a physical injury,” Sergeant Causey said.

Some doctors have criticized the idea of penis transplants, saying they are not needed to save the patient’s life. But Dr. Richard J. Redett, director of pediatric plastic and reconstructive surgery at Johns Hopkins, said, “If you meet these people, you see how important it is.”

“To be missing the penis and parts of the scrotum is devastating,” Dr. Redett said. “That part of the body is so strongly associated with your sense of self and identify as a male. These guys have given everything they have.” Jeffrey Kahn, a bioethicist at Johns Hopkins, said that at a conference convened last year by the Bob Woodruff Foundation, which aids injured veterans, wives said that genitourinary injuries had eroded their husbands’ sense of manhood and identity. Most telling, Dr. Kahn said, was that the men themselves attended the conference but did not speak about their wounds.

Although surgeons can create a penis from tissue taken from other parts of a patient’s own body — an operation being done more and more on transgender men — erections are not possible without an implant, and the implants too often shift position, cause infection or come out, Dr. Redett said. For that reason, he said, the Johns Hopkins team thinks transplants are the best solution when the penis cannot be repaired or reconstructed. If the transplant fails, he said, it will be removed, leaving the recipient no worse off than before the surgery. But can men — and their partners — get used to the idea that their most intimate part came from another man’s body?

The best analogy is hand transplants, Dr. Brandacher said, because hands are personal and distinctive — a transplant that the recipient can see, unlike a kidney or liver.
“I can tell you from all the patients — and I’ve been involved since 1998 — every single one, after surgery, look at the graft, try to move it and they immediately call it ‘my hand,’ ” Dr. Brandacher said. “They immediately incorporate it as part of their body. I would assume, extrapolating, that this is going to be the same for this kind of transplant.”

Dr. Kahn said it was essential that the families of organ donors be asked specifically for permission to use the penis, just as special permission was required for face and hand transplants. It is not assumed that people willing to donate kidneys or livers will also consent to having their loved one’s genitals removed. The surgeons want a relatively young donor to increase the odds that the transplanted organ will function sexually.

For now, the operation is being offered only to men injured in combat, Dr. Lee said. It is not available to transgender people, though that may change in the future. “Once this becomes public and there’s some sense that this is successful and a good therapy, there will be all sorts of questions about whether you will do it for gender reassignment,” Dr. Kahn said. “What do you say to the donor? A 23-year-old wounded in the line of duty has a very different sound than somebody who is seeking gender reassignment.” For a transplant to be possible, certain nerves and blood vessels have to be intact in the recipient, as does the urethra, the tube that carries urine out of the body.

The screening process, as for any organ transplant, also involves making sure that the candidate is psychologically ready, understands the risks and benefits, can stick to the regimen of anti-rejection medicine and has a family support network. A few initial candidates are being evaluated. “We have one that we’re moving forward with, and we’re very far in the process,” Dr. Redett said, adding that he expected the patient to be put on the transplant waiting list soon. “That means you are really only waiting for a donor.”

A spokeswoman for Johns Hopkins said the candidates and their families had declined to be interviewed. The university will pay for the first transplant, Dr. Lee said, adding that he had asked the Defense Department for money to cover more operations. The surgeons are donating their time, he said. Comparing the surgery to hand transplants performed at Johns Hopkins, he estimated the cost at $200,000 to $400,000 per operation. He said the Department of Veterans Affairs would pay for the drug that the men will need to prevent transplant rejection.

The project has been years in the making, the doctors said, with extensive research and practice surgery on cadavers. Some of the work involved injecting brightly colored food dyes into the cadavers to map out the circulatory system in the penis. Dr. Lee said the research had found previously unknown aspects of its blood supply, which will be critical to the transplant’s success.

The operation should take about 12 hours, Dr. Lee said. The surgeons will connect two to six nerves, and six or seven veins and arteries, stitching them together under a microscope. For the first few weeks after the surgery, a catheter will be left in place to drain urine. Sexual function will take longer to develop — probably a few months, Dr. Lee said. He said nerves would grow from the recipient into the transplant at a rate of about one inch per month, so the timing will depend in part on the extent of the recipient’s injuries and how far the nerves need to go. After the transplant, the men will begin taking anti-rejection medication and will need it for the rest of their lives. Such drugs work by suppressing the immune system and can increase the odds of infections and cancer.

To minimize the risks, the Johns Hopkins team has found a way to use just one drug, rather than the three usually needed for other transplants. At the time of the penis transplant, they will treat the recipient with a medication that reduces immune system cells. About two weeks later, he will receive an infusion of stem cells from the donor. The infusion dials back the tendency of the recipient’s immune system to attack the transplant, and just one anti-rejection drug, tacrolimus, is then enough to keep it in check. Doctors have used this technique successfully in patients who have had hand transplants.

Ultimately, the goal is to restore function, not just form or appearance, Dr. Brandacher emphasized. That is what the recipients want most. “They say, ‘I want to feel whole again,’ ” Dr. Brandacher said. “It’s very hard to imagine what it means if you don’t feel whole. There are very subtle things that we take for granted that this transplant is able to give back.”

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