Effects of Adult Male Circumcision on Premature Ejaculation: Results from a Prospective Study in China

Abstract

The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P < 0.001 for all). Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P < 0.001 for all). These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

Current and emerging therapies in premature ejaculation: Where we are coming from, where we are going

“…Circumcision has been proposed as a permanent treatment for PE caused by hypersensitivity of the glans. In a recent prospective cohort, patients post‐circumcision at 1‐year follow up had significantly higher IELT, sexual satisfaction and subjective control over ejaculation when compared with uncircumcised controls . However, multiple systematic reviews published 2 years prior found that the rate of PE or other sexual dysfunctions were not significantly different between circumcised and uncircumcised men in the general population .…”

“…Resiniferatoxin has been shown to improve IELT in patients with PE . Strangely, resiniferatoxin was significantly more effective in patients with redundant prepuce, further complicating the relationship between circumcision and PE . Unfortunately, in patients without redundant prepuce, the treatment was not more effective than a placebo, but the study population was particularly small .…”

“…In a recent prospective cohort, patients post-circumcision at 1-year follow up had significantly higher IELT, sexual satisfaction and subjective control over ejaculation when compared with uncircumcised controls. 94 However, multiple systematic reviews published 2 years prior found that the rate of PE or other sexual dysfunctions were not significantly different between circumcised and uncircumcised men in the general population. 95,96 Another systematic review correlating the histological and anatomical differences caused by circumcision found that the prepuce does not serve a sexual function, and circumcision likely has no effect on sexual functioning.…”

“…The differences between the first study's findings could be due to a number of factors. First, circumcision is a surgical procedure, and there was no sham procedure included to account for its placebo effect . Second, there could be a fundamentally different neural or physiological response to circumcision carried out as an adult in comparison with childhood .…”

“…First, circumcision is a surgical procedure, and there was no sham procedure included to account for its placebo effect. 94 Second, there could be a fundamentally different neural or physiological response to circumcision carried out as an adult in comparison with childhood. 98 The relationship between PE and circumcision is further muddled, because circumcision after the age of 7 years has been found to be a risk factor for PE.…”