Smegmoma “Smegma Collection in Health and Disease”

(1)

Pediatric Surgery, Al Azher University, Cairo, Egypt

Abstract

Smegma has characteristic slimy odour, composed of epithelial debris, fat, and proteins. It has mixed bacterial flora with smegum bacillus (Mycobacterium smegmatis) in 50 % of man. It is secreted in both female and male mammalian genitalia. Smegma was originally thought to be produced by sebaceous glands near the frenulum called Tyson’s glands; however, subsequent studies have failed to find such glands.

Keywords

SmegmomaSmegmalithsSmegma clitoridisSmegma StoneMycobacterium smegmatis

Definition

The word smegma is of Greek origin meaning soap or an ointment.

Smegma has characteristic slimy odour, composed of epithelial debris, fat, and proteins. It has mixed bacterial flora with smegum bacillus (Mycobacterium smegmatis) in 50 % of man.

Nomenclatures

Smegma clitoridis: smegma in females, it collects around the clitoris and in the folds of the labia minora (Fig. 36.1).

Fig. 36.1

Smegma secretion in a female neonate
Smegmaliths: Pieces of hard contaminated and retained smegma
Smegma Stone: Accumulated hard smegma under the prepuce (Fig. 36.2).

Fig. 36.2

Smegma collection under the perpetual orifice in a neonate
Smegmoma: Perpetual smegma cyst (Fig. 36.3).

Fig. 36.3

Perpetual smegma cyst seen in the undersurface of the prepuce

36.1 Smegma in History

French physician, Claude-François Lallemand (1790–1853), pronounced that smegma could provoke erections that would lead to ‘disastrous pleasures’.

American physician Roberts Bartholow (1831–1904) formulated the theory that smegma produced ‘hyperæsthesia’ of the glans.

American urologist Abraham Wolbarst (1872–1952), who updated the demonization of the foreskin and promulgated the idea that it harboured ‘carcinogenic secretions’ [1].

36.2 Secretion

It is secreted in both female and male mammalian genitalia.

Smegma was originally thought to be produced by sebaceous glands near the frenulum called Tyson’s glands; however, subsequent studies have failed to find such glands. Wright [2] states that smegma is produced from minute microscopic protrusions of the mucosal surface of the foreskin and that living cells constantly grow towards the surface, undergo fatty degeneration, separate off, and form smegma. Parkash et al. [3] found that smegma contains 26.6 % fats and 13.3 % proteins, which they judged to be consistent with necrotic epithelial debris. It is thought to be rich in squalene (oily material gives smegma the fishy odour), and contain prostatic and seminal secretions, desquamated epithelial cells, and the mucin content of the urethral glands of Littré. Newly produced smegma has a smooth, moist texture.

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