Sexual injury of circumcision: Difference between revisions

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  |date=2008-08
  |date=2008-08
  |accessdate=
  |accessdate=
}}</ref>-->  <!--In a 2009 study, Cortés-González ''et al.'' reported a statistically significant improvement in "perception of sexual events" (p=0.04).<ref name="cortes2009">{{REFjournal
}}</ref>-->   
|last=Cortés-González
|first=J.R.
|last2=Arratia-Maqueo
|first2=J.A.
|last3=Martínez-Montelongo
|first3=R.
|last4=Gómez-Guerra
|first4=L.S.
|title=Does Circumcision Affect Male's Perception of Sexual Satisfaction?
|journal=Arch. Esp. Urol.
|volume=62
|issue=9
|pages=733-736
|url=http://www.arch-espanoles-de-urologia.es/apartados/sumarios/popup.php?ano=2009&id=62-09-18
|quote=
|pubmedID=19955598
|pubmedCID=
|DOI=
|date=2009-11
|accessdate=
}}</ref>-->


=== Glans sensitivity ===
=== Glans sensitivity ===
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  |date=2000-06
  |date=2000-06
  |accessdate=2006-07-09
  |accessdate=2006-07-09
}}</ref> <!--Bleustein ''et al.'' (2003) tested the sensitivity of the glans penis, and found no difference between circumcised and uncircumcised men.<ref name="bleustein2003">{{REFconference
}}</ref>  
|place=Chicago, Illinois
|title=Effects of Circumcision on Male Penile Sensitivity
|url=http://www.circs.org/library/bleustein/
|last=Bleustein
|first=Clifford B.
|coauthors=Haftan Eckholdt, Joseph C. Arezzo and Arnold Melman
|source=American Urological Association 98th Annual Meeting
|date=2003-04-26
|note=April 26-May 1, 2003
|accessdate=2019-09-29
}}</ref> Bleustein ''et al.'' (2005) divided 125 patients (62 uncircumcised men and 63 neonatally circumcised men) into groups based on their sexual dysfunction using the [[Sexological_testing#IIEF_.28International_Index_of_Erectile_Function.29|IIEF]](International Index of Erectile Function).  Twenty-nine were placed in the functional group, and 96 in the dysfunctional group.  Quantitative somatosensory testing (including vibration, pressure, spatial perception, and warm and cold thermal thresholds) was used on the dorsal midline glans of the penis.  In the dysfunctional group, circumcised men (49 +/- 16 years) were significantly younger (P <0.01) than uncircumcised men (56 +/- 13 years). When controlling for age, hypertension, and diabetes, there was no difference in sensitivity.<ref name= "bleustein2005">{{REFjournal
|last=Bleustein
|first=Clifford B.
|last2=Fogarty
|first2=J.D.
|last3=Eckholdt
|first3=H.
|last4=Arezzo
|first4=J.C.
|last5=Melman
|first5=A.
|title=Effect of neonatal circumcision on penile neurologic sensation
|journal=Urology
|volume=65
|issue=4
|pages=773-777
|url=http://linkinghub.elsevier.com/retrieve/pii/S0090-4295(04)01343-3
|quote=
|pubmedID=15833526
|pubmedCID=
|DOI=10.1016/j.urology.2004.11.007
|date=2005-04
|accessdate=
}}</ref>-->


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"/> <!--In a letter to BJU International, however, on the basis of the unadjusted data, Waskett and Morris stated "we find no significant differences [...], consistent with previous findings."<ref name="waskett2007">{{REFjournal
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"/> <
|last=Waskett
|first=Jake H.
|author-link=Jake H. Waskett
|first2=Brian J.
|last2=Morris
|author2-link=Brian J. Morris
|title=Fine touch pressure thresholds in the adult penis
|journal=BJU International
|volume=99
|issue=6
|pages=1551-1552
|url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTARThttp://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTART
|quote=
|pubmedID=17537227
|pubmedCID=
|DOI=10.1111/j.1464-410X.2007.06970_6.x
|date=2007-05
|accessdate=
}}</ref>  However, in a further letter to ''BJU International'', Young responded to Waskett and Morris, stating that Sorrells ''et al.'' found that one point, at least, on the glans of the circumcised penis was less sensitive than that of the intact penis.<ref name="young">{{REFjournal
|last=Young
|first=Hugh
|author-link=Hugh Young
|title=Fine touch pressure thresholds in the adult penis
|journal=BJU International
|volume=100
|issue=3
|pages=699
|url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508003/HTMLSTART
|quote=
|pubmedID=17669150
|pubmedCID=
|DOI=10.1111/j.1464-410X.2007.07072_1.x
|date=2007-07
|accessdate=
}}</ref>-->
 
<!--Payne ''et al.'' (2007), in a study of the glans and shaft sensitivity of twenty circumcised and twenty uncircumcised men, reported that "No differences in genital sensitivity were found between the uncircumcised and circumcised groups."<ref name="payne2007">{{REFjournal
|last=Payne
|first=Kimberley
|last2=Thaler
|first2=Lea
|last3=Kukkonen
|first3=Tuuli
|last4=Carrier
|first4=Serge
|last5=Binik
|first5=Yitzchak
|author5-link=Irving M. Binik
|title=Sensation and Sexual Arousal in Circumcised and Uncircumcised Men
|journal=Journal of sexual medicine
|volume=4
|issue=3
|pages=667-674
|url=http://www.blackwell-synergy.com/doi/abs/10.1111/j.1743-6109.2007.00471.x
|quote=
|pubmedID=17419812
|pubmedCID=
|DOI=10.1111/j.1743-6109.2007.00471.x
|date=2007-05
|accessdate=
}}</ref>-->


<
=== Foreskin sensitivity ===
=== Foreskin sensitivity ===


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  |DOI=
  |DOI=
  |date=1980
  |date=1980
  |accessdate=
  |accessdate=2019-12-19
}}</ref>
}}</ref>


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  |date=2006
  |date=2006
  |accessdate=
  |accessdate=
}}</ref> <ref name="Laumann1997"/> in erectile dysfunction among circumcised men, while other studies have shown little to no effect.<ref name="masood2005"/><!--<ref name="krieger2008">{{REFjournal
}}</ref> <ref name="Laumann1997"/> in erectile dysfunction among circumcised men, while other studies have shown little to no effect.<ref name="masood2005"/<ref name="senkul2004"/><ref name="Collins2002">{{REFjournal
|last=Krieger
|first=J.N.
|last2=Mehta
|first2=S.D.
|last3=Bailey
|first3=R.C.
|etal=yes
|title=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya
|journal=The journal of sexual medicine
|volume=5
|issue=11
|pages=2610-2622
|url=
|quote=
|pubmedID=18761593
|pubmedCID=
|DOI=10.1111/j.1743-6109.2008.00979.x
|date=2008-08
|accessdate=
}}</ref>--><ref name="senkul2004"/><ref name="Collins2002">{{REFjournal
  |last=Collins
  |last=Collins
  |first=S.
  |first=S.
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  |date=2002
  |date=2002
  |accessdate=
  |accessdate=
}}</ref><!--<ref name="kigozi2007">{{REFjournal
}}</ref><ref name="kimpang2006"/>
|last=Kigozi
|first=G.
|last2=Watya
|first2=S.
|last3=Polis
|first3=C.B.
|last4=Buwembo
|first4=D.
|last5=Kiggundu
|first5=V.
|last6=Wawer
|first6=M.J.
|last7=Serwadda
|first7=D.
|last8=Nalugoda
|first8=F.
|last9=Kiwanuka
|first9=N.
|last10=Bacon
|first10=M.C.
|last11=Ssempijja
|first11=V.
|last12=Makumbi
|first12=F.
|last13=Gray
|first13=R.H.
|etal=yes
|title=The effect of male circumcision on sexual satisfaction and function, results from a randomized trial of male circumcision for human immunodeficiency virus prevention, Rakai, Uganda
|journal=[[British Journal of Urology|BJU International]]
|volume=101
|issue=1
|pages=65-70
|url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119420541/PDFSTART
|quote=
|pubmedID=18086100
|pubmedCID=
|DOI=10.1111/j.1464-410X.2007.07369.x
|date=2007-01
|accessdate=
}}</ref>--><ref name="kimpang2006"/>


Fink ''et al.'', in an American study of 123 men, found that medically necessitated circumcision resulted in worsened erectile function (p=0.01).<ref name=fink2002/>
Fink ''et al.'', in an American study of 123 men, found that medically necessitated circumcision resulted in worsened erectile function (p=0.01).<ref name=fink2002/>


Kim and Pang reported no significant difference in erection.<ref name="kimpang2006">{{REFjournal
Kim & Pang (2007) reported no significant difference in erection.<ref name="kimpang2006">{{REFjournal
  |last=DaiSik
  |last=DaiSik
  |first=Kim
  |first=Kim
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  |DOI=10.1111/j.1464-410X.2006.06646.x
  |DOI=10.1111/j.1464-410X.2006.06646.x
  |date=2007-03
  |date=2007-03
  |accessdate=
  |accessdate=2019-12-19
}}</ref>
}}</ref>


Laumann ''et al.'' reported that the likelihood of having difficulty in maintaining an erection was lower for circumcised men, but only at the 0.07 level (OR 0.66; 95% CI, 0.42-1.03).<ref name="Laumann1997"/>
Laumann ''et al.'' reported that the likelihood of having difficulty in maintaining an erection was lower for circumcised men, but only at the 0.07 level (OR 0.66; 95% CI, 0.42-1.03).<ref name="Laumann1997"/>


<!--Cortés-González ''et al.'' reported a statistically significant improvement in erectile function following circumcision (p=0.0007).<ref name="cortes2009"/>-->


== Ejaculatory function ==
== Ejaculatory function ==
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In a telephone survey of 10,173 Australian men, 22% of uncircumcised men and 26% of circumcised men reported reaching orgasm too quickly for at least one month in the previous year. The difference was not statistically significant.<ref name="richters2006"/>
In a telephone survey of 10,173 Australian men, 22% of uncircumcised men and 26% of circumcised men reported reaching orgasm too quickly for at least one month in the previous year. The difference was not statistically significant.<ref name="richters2006"/>
<!--Kigozi ''et al.'' reported that, in a randomised controlled trial of 4,456 men of whom 2,474 were selected to be circumcised, the authors did not find a statistically significant effect on premature ejaculation.<ref name="kigozi2007"/>
Krieger ''et al.'' reported on a randomised controlled trial of 2,784 participants, of whom 1,391 were randomised to be circumcised. 54.5% of circumcised men described their ease of reaching orgasm as "much more" at 24 months after randomisation.<ref name="krieger2008"/>-->


In a study of 255 circumcised men and 118 uncircumcised men, Kim and Pang reported no statistically significant difference in ejaculation or ejaculation latency time between circumcised and uncircumcised participants.<ref name="kimpang2006"/>
In a study of 255 circumcised men and 118 uncircumcised men, Kim and Pang reported no statistically significant difference in ejaculation or ejaculation latency time between circumcised and uncircumcised participants.<ref name="kimpang2006"/>
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== Satisfaction ==
== Satisfaction ==


Kim and Pang found that 20% reported that their sex life was worse after circumcision and 6% reported that it had improved.  They concluded that "there was a decrease ... sexual enjoyment after circumcision, indicating that adult circumcision adversely affects sexual function in many men, possibly because of complications of the surgery and a loss of nerve endings."<ref name="kimpang2006"/>
Kim & Pang (2007) found that 20% reported that their sex life was worse after circumcision and 6% reported that it had improved.  They concluded that "there was a decrease ... sexual enjoyment after circumcision, indicating that adult circumcision adversely affects sexual function in many men, possibly because of complications of the surgery and a loss of nerve endings."<ref name="kimpang2006"/>


Masood ''et al.'', in their study mentioned earlier of men circumcised for benign disease, found that 61% reported satisfaction with the results, while 17% felt it made things worse, and 22% expressed neutral sentiments. 44% of the patients (p = 0.04) and 38% of the partners (p = 0.02) thought the penis appearance improved after circumcision. The authors of the study concluded that the satisfaction rate was a 'poor outcome,' given the pre-procedure penile disease state and recommended discussing with prospective patients the results of this study during the informed consent process.<ref name=masood2005/>
Masood ''et al.'', in their study mentioned earlier of men circumcised for benign disease, found that 61% reported satisfaction with the results, while 17% felt it made things worse, and 22% expressed neutral sentiments. 44% of the patients (p = 0.04) and 38% of the partners (p = 0.02) thought the penis appearance improved after circumcision. The authors of the study concluded that the satisfaction rate was a 'poor outcome,' given the pre-procedure penile disease state and recommended discussing with prospective patients the results of this study during the informed consent process.<ref name=masood2005/>
Krieger ''et al.'' reported that in a controlled trial of circumcision to reduce HIV incidence in Kisumu, Kenya, in which 1,391 men elected to be circumcised, more than 99% were "satisfied" with their circumcisions.<ref name="krieger2008"/>
Kigozi ''et al.'' reported finding "no trend in satisfaction among circumcised men". The authors concluded that "[a]dult male circumcision does not adversely affect sexual satisfaction or clinically significant function in men".<ref name="kigozi2007"/>


Shen ''et al.'' reported that adult circumcision appeared to result in improved satisfaction in 34 cases (of 95 adults being circumcised), the association was statistically significant.<ref name="shen2004"/>
Shen ''et al.'' reported that adult circumcision appeared to result in improved satisfaction in 34 cases (of 95 adults being circumcised), the association was statistically significant.<ref name="shen2004"/>
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  |accessdate=
  |accessdate=
}}</ref> Bailey ''et al''. report that there is a preference by women for circumcised men, mentioning that the circumcised penis enters a woman more easily and is less likely to cause injury to the vagina.<ref>''AIDS Care''. 2002 Feb;14(1):27-40. The acceptability of male circumcision to reduce HIV infections in Nyanza Province, Kenya. Bailey RC, Muga R, Poulussen R, Abicht H. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11798403&dopt=Abstract]</ref>{{Verify source|date=2008-10}}
}}</ref> Bailey ''et al''. report that there is a preference by women for circumcised men, mentioning that the circumcised penis enters a woman more easily and is less likely to cause injury to the vagina.<ref>''AIDS Care''. 2002 Feb;14(1):27-40. The acceptability of male circumcision to reduce HIV infections in Nyanza Province, Kenya. Bailey RC, Muga R, Poulussen R, Abicht H. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11798403&dopt=Abstract]</ref>{{Verify source|date=2008-10}}
 
<!--
== Summary of research findings (Wikipedia table) ==
== Summary of research findings (Wikipedia table) ==


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| Prospective; adult circumcision patients
| Prospective; adult circumcision patients
| Yes || 43 || No difference found || No; p = 0.07
| Yes || 43 || No difference found || No; p = 0.07
|}
|}-->


== Notes ==
== Notes ==