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Sexual effects of circumcision

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<!--In a 2008 study, Krieger ''et al.'' (2008) stated that "Adult male circumcision was not associated with sexual dysfunction. Circumcised men reported increased penile sensitivity and enhanced ease of reaching orgasm."<ref name="Krieger2008">{{REFjournal |last=Krieger |first=J.N. |last2=Mehta |first2=S.D. |last3=Bailey |first3=R.C. |last4=Agot |first4=K. |last5=Ndinya-Achola |first5=J.O. |last6=Parker |first6=C. |last7=Moses |first7=S. |title=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya |journal=The journal of sexual medicine |volume=Epub ahead of print |issue=11 |pages=2610-2622 |url= |quote= |pubmedID=18761593 |pubmedCID= |DOI=10.1111/j.1743-6109.2008.00979.x |date=2008-08 |accessdate=}}</ref>-->
=== Glans sensitivity ===
A number of studies have looked at the question of whether sensitivity of the glans is affected by circumcision.
<!--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=
| url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/circumcision.html
| title=Circumcision: Position Paper on Neonatal Circumcision
| last=
| first=
| publisher=[[American Academy of Family Physicians]]
| website=
| date=2007
| accessdate=2007-01-30
}}</ref>-->
Yang ''et al.'' (1998) concluded in their study into the innervation of the penile shaft and glans penis that: "The distinct pattern of innervation of the glans emphasizes the role of the glans as a sensory structure."<ref name="yang1998">{{REFjournal
=== Foreskin sensitivity ===
Some recent researchers have asserted assert that the [[foreskin]] is sexually sensitive highly-innervated erogenous tissue.<ref name="winkleman1956" /><ref name="winkleman1959" /> <ref name="taylor1996">{{REFjournal
|last=Taylor
|first=J.R.
|date=2004-01
|accessdate=
}}</ref> or decrease,<ref name="cortes2009"/><ref name= "richters2006">{{REFjournal
|last=Richters
|first=J.
In a study of 22 men circumcised as adults, Cortés-González ''et al.'' reported that 31.8% suffered from premature ejaculation before the procedure; this diminished to 13.6% afterwards.
 
== Sexual practice and masturbation ==
|accessdate=
}}</ref> Boyle & Bensley (2001) reported that the lack of a foreskin in the male partner produces symptoms similar to those of female arousal disorder.{{Verify source|date=2008-10}} The authors hypothesized that the gliding action possibly involved intercourse with an uncircumcised partner might help prevent the loss of vaginal lubrication.{{Verify source|date=2008-10}} They stated that the respondents were self-selected, and that larger sample sizes are needed.<ref name="boyle2002" />
 
Cortés-González ''et al.'' studied 19 female partners of men scheduled for circumcision. They reported a significant reduction in vaginal lubrication following circumcision, from 78% to 63%, but found no statistically significant differences in "general sexual satisfaction, pain during vaginal penetration, desire, [or] vaginal orgasm".<ref name="cortes2008"/>
 
Kigozi ''et al.'' reported on a prospective study of 455 female partners of men, in Rakai Uganda, circumcised as part of a randomised trial. 39.8% reported improved sexual satisfaction following circumcision, 57.3% reported no change, and 2.9% reported reduced sexual satisfaction after their partners were circumcised.<ref>{{REFjournal
|last=Kigozi
|first=G.
|last2=Lukabwe
|first2=I.
|last3=Kagaayi
|first3=J.
|etal=yes
|title=Sexual satisfaction of women partners of circumcised men in a randomized trial of male circumcision in Rakai, Uganda
|journal=BJU Int
|volume=104
|issue=11
|pages=1698-1701
|url=
|quote=
|pubmedID=19522862
|pubmedCID=
|DOI=10.1111/j.1464-410X.2009.08683.x
|date=2009-06
|accessdate=
}}</ref>
Williamson ''et al.'' (1988) studied randomly selected young mothers in Iowa, where most men are circumcised, and found that 76% would prefer a circumcised penis for achieving sexual arousal through viewing it.<ref>[http://www.circs.org/library/williamson/index.html Williamson ML, Williamson PS. Women's Preferences for Penile Circumcision in Sexual Partners.] J Sex Educ Ther 1988; 14: 8</ref> Wildman and Wildman (1976) surveyed 55 young women in Georgia, US, reporting that 47 (89%) of respondents preferred the circumcised penis (the remainder preferred the uncircumcised penis).<ref>{{REFjournal
|accessdate=
}}</ref>
<!--
== Summary of research findings (Wikipedia table) ==
 
{| class="wikitable"
! scope="col" | Study
! scope="col" | Design
! scope="col" | Peer reviewed
! scope="col" | Sample size
! scope="col" | Finding
! scope="col" | Significant¹
|-
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Sexual drive
|-
! scope="row" | Collins (2002)<ref name="Collins2002"/>
| Prospective; adult circumcision patients
| Yes || 15 || No difference found || No; p > 0.68
|-
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
| Prospective; adult circumcision patients
| Yes || 42 || No difference found || No; p = 0.32
|-
! scope="row" | Kim and Pang (2006)<ref name="kimpang2006"/>
| Prospective; adult circumcision patients
| Yes || 373 || No difference found || Not stated
|-
! scope="row" | Senol (2008)<ref name="senol2008">{{REFjournal
|last=Senol
|first=M.G.
|last2=Sen
|first2=B.
|last3=Karademir
|first3=K.
|last4=Sen
|first4=H.
|last5=Saraçoğlu
|first5=M.
|title=The effect of male circumcision on pudendal evoked potentials and sexual satisfaction
|journal=Acta Neurol Belg
|volume=108
|issue=3
|pages=90-93
|url=
|quote=
|pubmedID=19115671
|pubmedCID=
|DOI=
|date=2008-09
|accessdate=
}}</ref>
| Prospective; adult circumcision patients
| Yes || 43 || No difference found || No; p = 0.11
|-
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Erectile function
|-
! scope="row" | Fink (2002)<ref name="fink2002"/>
| Cross-sectional; adult circumcision patients
| Yes || 40 || Worse after circumcision || Yes; p = 0.01
|-
! scope="row" | Collins (2002)<ref name="Collins2002"/>
| Prospective; adult circumcision patients
| Yes || 15 || No difference found || No; p > 0.96
|-
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
| Prospective; adult circumcision patients
| Yes || 42 || No difference found || No; p = 0.89
|-
! scope="row" | Masood (2005)<ref name= "masood2005"/>
| Not stated; adult circumcision patients
| Yes || 88 || No difference found || No; p = 0.40
|-
! scope="row" | Shen (2004)<ref name="shen2004"/>
| Not stated; adult circumcision patients
| Yes || 95 || Worse after circumcision || Yes; p = 0.001
|-
! scope="row" | Laumann (1997)<ref name="Laumann1997"/>
| National probability study
| Yes || 1410 || Better in circumcised males || Yes; p < 0.10
|-
! scope="row" | Richters (2006)<ref name= "richters2006"/>
| Telephone survey
| Yes || 10,173 || Better in circumcised males || Yes; p=0.022
|-
! scope="row" | Kim and Pang (2006)<ref name="kimpang2006"/>
| Prospective; adult circumcision patients
| Yes || 373 || No difference found || Not stated
|-
! scope="row" | Senol (2008)<ref name="senol2008"/>
| Prospective; adult circumcision patients
| Yes || 43 || No difference found || No; p = 0.23
|-
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Ejaculation
|-
! scope="row" | Collins (2002)<ref name="Collins2002"/>
| Prospective; adult circumcision patients
| Yes || 15 || No difference found || No; p > 0.48
|-
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
| Prospective; adult circumcision patients
| Yes
| 42 || No difference found in BMSFI (Brief Male Sexual Function Inventory)<br>Greater time to ejaculate after circumcision
| No; p = 0.85<br>Yes; p = 0.02
|-
! scope="row" | Shen (2004)<ref name="shen2004"/>
| Not stated; adult circumcision patients
| Yes || 95 || Greater time to ejaculate after circumcision || Yes; p=0.04
|-
! scope="row" | Laumann (1997)<ref name="Laumann1997"/>
| National probability study
| Yes || 1410 || Circumcised men less likely to ejaculate prematurely || Yes; p < 0.10
|-
! scope="row" | Waldinger (2005)<ref name="Waldinger2005"/>
| Multinational, stopwatch assessment
| Yes || 500 || No difference found || No
|-
! scope="row" | Richters (2006)<ref name= "richters2006"/>
| Telephone survey
| Yes || 10,173 || Circumcised men more likely to ejaculate prematurely || No; p = 0.11
|-
! scope="row" | Senol (2008)<ref name="senol2008"/>
| Prospective; adult circumcision patients
| Yes || 43 || No difference found in BMSFI<br>Greater time to ejaculate after circumcision|| No; p = 0.48<br>Yes; p = 0.001
|-
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Penile sensation
|-
! scope="row" | Fink (2002)<ref name="fink2002"/>
| Cross-sectional, adult circumcision patients
| Yes || 40 || Worse after circumcision || No; p = 0.08
|-
! scope="row" | Masood (2005)<ref name= "masood2005"/>
| Not stated; adult circumcision patients
| Yes || 88 || Better after circumcision in 38%, worse in 18% || Yes; p = 0.01
|-
! scope="row" | Denniston (2004), cited by Denniston (2004)<ref name= "Dennniston2004">{{REFjournal
|last=Denniston
|first=G.C.
|author-link=George C. Denniston
|last2=Hill
|first2=G.
|author2-link=George Hill
|title=Circumcision in adults: effect on sexual function
|journal=Urology
|volume=64
|issue=6
|page=1267
|url=http://www.cirp.org/library/sex_function/denniston3/http://www.cirp.org/library/sex_function/denniston3/
|quote=
|pubmedID=15596221
|pubmedCID=
|DOI=10.1016/j.urology.2004.03.059
|date=2006
|accessdate=
}}</ref>
| Not stated; survey of males circumcised in adulthood
| No || 38 || Better after circumcision in 34%, worse in 58% || Not stated
|-
! scope="row" | Masters (1966)<ref name="masters1966"/>
| Neurologic testing; subjects matched for age
| No || 70<br>(35 c, 35 uc)² || No difference found || Not stated
|-
! scope="row" | Bleustein (2003)<ref name="bleustein2003"/>
| Quantitative somatosensory testing
| No || 79<br>(36 c, 43 uc)² || No difference found when controlled for other variables || No; p = 0.08
|-
! scope="row" | Bleustein (2005)<ref name= "bleustein2005"/>
| Quantitative somatosensory testing
| Yes || 125<br>(63 c, 62 uc)² || No difference found when controlled for other variables || No
|-
! scope="row" | Richters (2006)<ref name= "richters2006"/>
| Telephone survey
| Yes || 10,163 || Better in circumcised males || No; p = 0.192
|-
! scope="row" | Yang (2008)<ref name="yang2008">{{REFjournal
|last=Yang
|first=D.M.
|last2=Lin
|first2=H.
|last3=Zhang
|first3=B.
|last4=Guo
|first4=W.
|title=[Circumcision affects glans penis vibration perception threshold]
|journal=Zhonghua Nan Ke Xue
|volume=14
|issue=4
|pages=328-330
|publisher = Nanjing Jun Qu Nanjing Zong Yi Yuan zhu ban, Zhonghua Nan Ke Xue Za Zhi Bian Ji Bu bian ji chu ban
|location = China
|url=
|quote=
|pubmedID=18481425
|pubmedCID=
|DOI=
|date=2008-04
|accessdate=2008-04-16
}}</ref>
| Used biological vibration measurement instrument to determine sensitivity
| Yes || 169 (73 uc, 96 c) || Worse after circumcision || Yes; p < 0.05
|-
! scope="row" | Payne (2007)<ref name="payne2007"/>
| Sensory testing to determine sensitivity to touch and pain
| Yes || 40 (20 uc, 20 c) || No difference found || No
|-
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Overall satisfaction
|-
! scope="row" | Fink (2002)<ref name="fink2002"/>
| Cross-sectional; adult circumcision patients
| Yes || 40 || Better after circumcision || Yes; p=0.04
|-
! scope="row" | Collins (2002)<ref name="Collins2002"/>
| Prospective; adult circumcision patients
| Yes || 15 || No difference found || No; p > 0.72
|-
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
| Prospective; adult circumcision patients
| Yes || 42 || No difference found || No; p=0.46
|-
! scope="row" | Masood (2005)<ref name= "masood2005"/>
| Not stated; adult circumcision patients
| Yes || 88
| "Sixty-one percent were satisfied with the circumcision (p = 0.04) ... Fourteen patients (17%) were not satisfied with the circumcision, but only one patient in this group had any obvious post-operative complications (bleeding)."
| Not stated
|-
! scope="row" | Shen (2004)<ref name="shen2004"/>
| Not stated; adult circumcision patients
| Yes || 95 || Improved satisfaction in 34 cases || Yes; p = 0.04
|-
! scope="row" | Kim and Pang (2006)<ref name="kimpang2006"/>
| Prospective; adult circumcision patients
| Yes || 373 || Better after circumcision in 6%, worse in 20% || Yes; p < 0.05
|-
! scope="row" | Kigozi (2007)<ref name="kigozi2007"/>
| Randomised trial; adult circumcision patients
| Yes || 4456 || "no trend in satisfaction among circumcised men" || No; p = 0.8
|-
! scope="row" | Senol (2008)<ref name="senol2008"/>
| Prospective; adult circumcision patients
| Yes || 43 || No difference found || No; p = 0.07
|}-->
 
== Notes ==
# If stated, author's analysis is used. Otherwise, significance is considered to be p <= 0.05.
# c = circumcised; uc = uncircumcised.
 
<!-- commented out due to not being used in the article:
* Denniston GC, Hill G (2004) [http://www.cirp.org/library/sex_function/denniston3/ Circumcision in adults: effect on sexual function]. ''Urology'', '''64'''(6);1267.
-->
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