Examining Penile Sensitivity in Neonatally Circumcised and Intact Men Using Quantitative Sensory Testing

Bossio, Jennifer A.; Pukall, Caroline F.; Steele, Stephen

doi:10.1016/j.juro.2015.12.080

Cited by 61 publications

(63 citation statements)

References 22 publications

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“…Some large nationally representative cross-sectional surveys24, 25 have included countries with high and low male circumcision rates, controlling for demographic factors that might influence attitudes toward circumcision. Several studies have compared intravaginal ejaculatory latency time11, 24, 25, 26, 27, 28 and a few small studies have reported direct physiologic measurements of penile sensitivity and sexual response27, 29, 30, 31 in circumcised and uncircumcised men, finding no evidence for detrimental physiologic effects of male circumcision. Two cohort studies using data from RCTs12, 13 in Africa offer the best evidence to date on the effects of VMMC on male sexual function and satisfaction, suggesting no significant impairments in sexual function or satisfaction and some improvements in sexual function after male circumcision.…”

Section: Discussionmentioning

confidence: 99%

Medical Male Circumcision Is Associated with Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya

Nordstrom

Westercamp

Jaoko

et al. 2017

The Journal of Sexual Medicine

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BackgroundTwo cohort studies using data from randomized controlled trials in Africa offer the best evidence to date on the effects of voluntary medical male circumcision (VMMC) on male sexual function and satisfaction, suggesting no significant impairments in sexual function or satisfaction and some improvements in sexual function after male circumcision.AimTo assess the effects of VMMC on sexual function and satisfaction in a large population-based cohort of men circumcised as adults and uncircumcised controls in Kenya.MethodsSexual function and satisfaction of young (median age = 20 years) sexually active men (1,509 newly circumcised men and 1,524 age-matched uncircumcised controls after 5% loss to follow-up) were assessed at baseline and 6, 12, 18, and 24 months, with data collected in 2008 to 2012. Self-reported data on lack of sexual interest or pleasure, difficulty getting or maintaining erections, orgasm difficulties, premature ejaculation, pain during intercourse, and satisfaction with sexual intercourse were analyzed with mixed-effect models to detect differences between circumcised and uncircumcised men and changes over time.OutcomesChanges over time in sexual interest, desire and pleasure, erectile and ejaculatory function, and pain during intercourse (dyspareunia) in circumcised and uncircumcised men; group differences in time trends; satisfaction with sexual performance; and enjoyment of sex before and after circumcision.ResultsSexual dysfunctions decreased in the two study groups from 17% to 54% at baseline to 11% to 44% at 24 months (P < .001), except dyspareunia, which decreased only in circumcised men (P < .001). Sexual satisfaction outcomes increased in the two study groups from 34% to 82% at baseline to 66% to 93% at 24 months (P < .001), with greater improvements in circumcised men (P < .001). On average, 97% of circumcised men were satisfied with sexual intercourse and 92% rated sex as more enjoyable or no different after circumcision compared with before circumcision.Clinical TranslationResults are applicable to VMMC programs seeking to increase the acceptability of male circumcision as part of comprehensive HIV prevention.Strengths and LimitationsLarge-scale population-based longitudinal data restricted to sexually active individuals and adjusted for differences in baseline levels of outcomes and potential confounders are used. The questionnaire used, although not a standardized survey instrument, includes all major domains of male sexual function and satisfaction used in the most common standardized tools.ConclusionsResults are consistent with large cohort studies of VMMC using data from randomized controlled trials and indicate that VMMC has no significant detrimental effect or might have beneficial effects on male sexual function and satisfaction for the great majority of men circumcised as adults.Nordstrom MPC, Westercamp N, Jaoko W, et al. Medical Male Circumcision Is Associated With Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya. J Sex Med 2017;14:601–612.

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Section: Discussionmentioning

confidence: 99%

Medical Male Circumcision Is Associated with Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya

Nordstrom

Westercamp

Jaoko

et al. 2017

The Journal of Sexual Medicine

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“…A subsequent study across all sensation types (touch, warmth and pain) by Canadian researchers, Bossio et al [70] concluded that, "the foreskin is not the most sensitive part of the penis". Although the foreskin was sensitive to fine-touch, in referring to Sorrells et al [68], Bossio et al stated that their study, "challenges past research suggesting that the foreskin is the most sensitive part of the adult penis" [70].…”

Section: Denialismmentioning

confidence: 99%

Expertise and Ideology in Statistical Evaluation of Circumcision for Protection against HIV Infection

Morris¹,

Barboza²,

Wamai³

et al. 2017

WJA

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Aim: To critically evaluate data and arguments by Van Howe defending his stance opposing male circumcision (MC), in particular his meta-regression analyses evaluating the ability of MC to reduce HIV infection risk in heterosexual populations within and outside Africa. Methods: We performed metaregression analysis of log odds of HIV infection between uncircumcised and circumcised men using a single covariate (MC prevalence) in the meta-regression model involving the metareg package in STATA 13 for 103 populations worldwide and for populations within Africa. The meta-regression of log odds and MC prevalence was fitted to a line, as were empirical Bayes estimates resulting from post-estimation. Results: Our critical evaluation of Van Howe's arguments attempting to undermine the scientific evidence in support of the benefits of MC in protection of men against HIV during heterosexual intercourse, as well as other infections and conditions, together with his use of statistics to support his beliefs, revealed serious flaws, obfuscation and missing data. We therefore performed our own meta-regression analysis using a trivariate model. Doing so revealed that for MC prevalences of 50%, 75% and 100% for general populations within Africa, odds ratios for HIV risk in uncircumcised vs. circumcised men were 1.35, 1.58 and 1.85, respectively. Our meta-regression analysis of data for all countries yielded similar findings. For a general population outside Africa with 100% MC prevalence, OR was 1.5. Van Howe failed to acknowledge that since MC prevalence in US whites (91%) and blacks (76%) exceeds 75% his results support MC having a protective effect in those population groups. Conclusions: The protective effect of MC against How to cite this paper: Morris, B

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“…British pediatricians now tend to dismiss routine infant circumcision, American physicians keep on advocating it quite generally [47][48][49]. Nowadays, most clinicians would not remove an appendix or the tonsils prophylactically.…”

Section: Clinical Aspectsmentioning

confidence: 99%

“…Interestingly, although by circumcision corpuscular receptors of touch are removed, a recent sensory testing study found no long-term implications for penile sensitivity in circumcised males and even challenges the image of the foreskin to be the most sensitive part of the penis [48]. It is rather that, due to circumcision, loss of sensitivity of the glans as a result of keratinization will handicap ejaculation.…”

Section: Clinical Aspectsmentioning

confidence: 99%

A “Snip” in Time: Circumcision Revisited

Egloff¹

2017

Sexual Dysfunction

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The publication of an Italian study on etiology and interactions of frenulum breve, frenulectomy, and premature ejaculation, and the results of a popular Austrian sex study initiated a survey on this topic, accompanied by collecting a small sample of data in an urban practice environment in Germany. Since frenulectomy, for practical reasons, often leads to a complete removal of the prepuce, circumcision has come to the fore anew. Moreover, under the heading, "Ending a myth: male circumcision is not associated with higher prevalence of erectile dysfunction," a recent study relating circumcision to sexual dysfunction has been published. In this chapter, an overview of research results as well as of psychological and clinical aspects of circumcision and associated subjects is given. There seem to be advantages of circumcision as to sexual dysfunction and premature ejaculation. Depending on etiopathology, some treatment options may require psychosomatic reasoning.

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Examining Penile Sensitivity in Neonatally Circumcised and Intact Men Using Quantitative Sensory Testing

Cited by 61 publications

References 22 publications

Medical Male Circumcision Is Associated with Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya

Medical Male Circumcision Is Associated with Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya

Expertise and Ideology in Statistical Evaluation of Circumcision for Protection against HIV Infection

A “Snip” in Time: Circumcision Revisited

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