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Sexual effects of circumcision

1,220 bytes added, 16:56, 21 December 2019
Relocate Masters & Johnson (1966) comment; Add Morgan (1967)
==History==
===In the beginning===
The human foreskin was once thought to have little or no sexual function. Sex researcher Alfred C. Kinsey (1948) placed no importance on the presence or absence of the foreskin.<ref name="kinsey1948">{{REFbook
}}</ref>
Masters & Johnson (1966) in their book, ''Human Sexual Response'', showed little interest or understanding of the human foreskin. One illustration, labelled normal pe-nis penis anatomy, showed a drawing of a penis without a foreskin. A listing of penile pathology in their book included “uncircumcised penis”! Their work was done in St. Louis, located in the highly circumcised Midwest, and almost all of their subjects were circumcised. There testing was quite limited. With regard to the foreskin, they said only:
<blockquote>
Routine neurologic testing for both exteroceptive and light tactile discrimination were conducted on the ventral and dorsal surfaces of the penile body, with particular attention directed toward the glans.</blockquote> With regard to the [[Glans Penis]], Masters & Johnson stated:<blockquote>Routine neurologic testing for both exteroceptive and light tactile discrimination were conducted on the ventral and dorsal surfaces of the penile body, with particular attention directed toward the glans. No clinically significant difference could be established between the circumcised and the uncircumcised glans during these examinations.<ref name="masters-johnson1966">{{REFbook
|last=Masters
|first=William L.
}}</ref>
</blockquote>
 
Therefore, it appears that Masters & Johnson performed little or no testing on the foreskins of their few intact subjects and provided no useful information.<ref name="sorrells2007">{{REFjournal
|last=Sorrells
|author8-link=Robert Van Howe
|title=Fine-touch pressure thresholds in the adult penis
|journal=BJU InternationalInt
|volume=99
|issue=4
|accessdate=2019-12-16
}}</ref>
 
The inaccurate reports of Kinsey (1948) and Masters & Johnson (1966) have long distorted the American view of the effects of [[circumcision]] and the loss of the [[foreskin]].
 
===The dawning of the light===
There were, however, some other little noticed papers overlooked by Masters & Johnson, that told a different story. Winkleman Winklemann (1956) investigated the innervation of the prepuce and found it to be highly innervated.<ref name="winkleman1956">{{REFjournal
|last=Winkelmann
|first=R.K.
|title=The cutaneous innervation of human newborn prepuce
|journal=Journal of investigative dermatologyInvestigative Dermatology
|volume=26
|issue=1
</blockquote>
Morgan (1967) addressed the issue again in the ''Medical Journal of Australia'':
<blockquote>
The subcutaneous tissue of the glans is provided with special sensory receptors that are concerned with appreciating the pleasurable sensations that occur during coitus. They are stimulated normally only when the glans is exposed. In the circumcised subject these receptors are constantly stimulated and lose their sensitivity. During the act of coitus, the uncircumcised phallus penetrates smoothly and without friction, the prepuce gradually retracting as the organ advances. In contrast, when the circumcised organ is introduced during coitus, friction develops between the glans and the vaginal mucosa.<ref name="morgan1967">{{REFjournal
|last=Morgan
|first=William Keith C.
|author-link=
|etal=No
|title=http://www.cirp.org/library/general/morgan2/
|trans-title=
|language=
|journal=Med J Aust
|location=
|date=1967-05-27
|volume=1
|issue=21
|pages=1102-3
|url=http://www.cirp.org/library/general/morgan2/
|quote=
|pubmedID=4226264
|pubmedCID=
|DOI=
|accessdate=2019-12-21
}}</ref>
</blockquote>
<!--Only medical trade associations, such as the [[American Academy of Pediatrics]] (AAP), which represents doctors who profit from carrying out circumcisions, still contend that circumcision does not harm sexual function. The American Academy of Pediatrics points to a survey (self-report) finding circumcised adult men had less sexual dysfunction and more varied sexual practices, but also noted anecdotal reports that penile sensation and sexual satisfaction are decreased for circumcised males.<ref name="AAP1999">{{REFjournal
== Penile sensitivity and sexual sensation ==
Results of studies of the effect on penile sensitivity have been mixed. In a British study of 150 men circumcised as adults for penile problems, Masood ''et al.'' 920050 found that 38% reported improved penile sensation (p=0.01), 18% reported worse penile sensation, while the remainder (44%) reported no change.<ref name= "masood2005">{{REFjournal
|last=Masood
|first=S.
|date=2005
|accessdate=
}}</ref> In a survey of men circumcised as adults for medical (93%) or elective (7%) reasons, Fink ''et al.'' (2002) found an association between adult circumcision and decreased penile sensitivity that "bordered on statistical significance" (p=0.08).<ref name="fink2002">{{REFjournal
|last=Fink
|first=K.S.
|last3=DeVillis
|title=Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction
|journal=Journal of UrologyJ Urol
|volume=167
|issue=5
A number of studies have looked at the question of whether sensitivity of the glans is affected by circumcision.
Masters and Johnson (1966) reported: "Routine neurologic testing for both exteroceptive and light tactile discrimination were conducted on the ventral and dorsal surfaces of the penile body, with particular attention directed toward the glans. No clinically significant difference could be established between the circumcised and the uncircumcised glans during these examinations."<ref name="masters-johnson1966"/> Sorrells ''et al.'' criticised this early study for being poorly documented and not subject to peer review.<ref name="sorrells2007" /> <!--In January 2007, The American Academy of Family Physicians (AAFP) stated "The effect of circumcision on penile sensation or sexual satisfaction is unknown. Because the epithelium of a circumcised glans becomes cornified, and because some feel nerve over-stimulation leads to desensitization, many believe that the glans of a circumcised penis is less sensitive. Opinions differ about how this decreased sensitivity, which may result in prolonged time to orgasm, affects sexual satisfaction. An investigation of the exteroceptive and light tactile discrimination of the glans of circumcised and uncircumcised men found no difference on comparison. No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction."
<ref name="AAFP">{{REFweb
| quote=
Sorrells ''et al.'' (2007) measured the fine-touch pressure thresholds of 91 circumcised and 68 uncircumcised, adult male volunteers, They reported "[the] glans of the uncircumcised men had significantly lower mean (sem) pressure thresholds than that of the circumcised men, at 0.161 (0.078) g (P = 0.040) when controlled for age, location of measurement, type of underwear worn, and ethnicity."<ref name="sorrells2007"/> <
<
=== Foreskin sensitivity ===
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