Lower clinical neurophysiological elicitability of the penilo-cavernosus reflex
Lower clinical neurophysiological elicitability of the penilo-cavernosus reflex is classified as a late complication of circumcision by Iacob et al. (2021). This classification was based on the work of Simon Podnar in Slovenia. Podnar relates that he had observed in clinical practice that the penilo-cavernosus reflex seemed to be more difficult to elicit clinically in circumcised men. A formal study was established to test these obverations.
The bulbocavernosus reflex has been found to be delayed or absent at a higher rate than the general population of intact men in diabetic men with complaints of erectile impotence, men whose penises have been circumcised, and in intact men who have permanent retraction of the foreskin behind the glans penis.
Podnar cited previous research in explaining his findings. Among other works, Taylor et al. (1996) carried out a histological study of the foreskin which found large numbers of Meissner's corpuscles arranged in a ridged band. and Sorrells et al. (2007) carried out a study of the fine-touch pressure thresholds on the human penis and found that the most sensitive areas are all on the foreskin.
Men who have suffered the loss of their foreskin to amputation and men whose foreskin has been desensitized by permanent retraction evidently are unable to sense the stimulation necessary to trigger the penilo-cavernosus reflex..
|“||Clinical elicitation of the penilo-cavernosus reflex in circumcised men |
The findings presented in this study might also explain the possible difference in sexual function between these two groups of men.
– Simon Podnar (BJU Int)
Podnar's study highlights the importance of the sensory input from the nerves of the foreskin in the regulation of physiological functions through the autonomic nervous system.
- Iacob SI, Feinn RS, Sardi L. Systematic review of complications arising from male circumcision . BJUI Compass. 11 November 2021; : 1–25. DOI. Retrieved 1 March 2022.
- Podnar, Simon. Clinical elicitation of the penilo-cavernosus reflex in circumcised men. BJU Int. February 2012; 109(4): 582-5. PMID. DOI. Retrieved 1 March 2022.
- Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol. 1996; 77: 291-5. PMID. DOI. Retrieved 23 September 2019.
- Sorrells ML, Snyder JL, Reiss MD, Eden C, Milos MF, Wilcox N, Van Howe RS. Fine‐touch pressure thresholds in the adult penis. BJUI. 19 March 2007; 99(4): 864-9. PMID. DOI. Retrieved 10 January 2021.