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{{Construction Site}}
'''This article was borrowed from Wikipedia on [http://en.wikipedia.org/w/index.php?title=Sexual_effects_of_circumcision&oldid=429623060 21:11, 17 May 2011]'''
The '''sexual effects of [[circumcision]]''' are the subject of some debate. Studies have been conducted to investigate whether circumcision has any effect on sexual drive, erectile function, premature and delayed ejaculation, sexual satisfaction, sexual sensation and penile sensitivity. Studies have also assessed whether circumcision affects masturbation or other sexual practices, and whether a heterosexual woman's experience of sex is affected by her partner's circumcision status.
Those reviewing the literature have reached differing conclusions. 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
| last=
| first=
| coauthors=
| title=Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision
| journal=Pediatrics
| volume=103
| issue=3
| pages=686-93
| url=
| quote=
| pubmedID=10049981
| pubmedCID=
| DOI=10.1542/peds.103.3.686
| date=March 1999
| accessdate=
}}</ref> 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. [...] No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction."<ref name="AAFP"/> Conversely, a 2002 review by Boyle ''et al.'' stated that "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision, with an inevitable reduction in sexual sensation experienced by circumcised males." They concluded, "intercourse is less satisfying for both partners when the man is circumcised".<ref>{{Cite web|url=http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1036&context=hss_pubs |title=Male circumcision: pain, trauma, and psychosexual sequelae |first=Gregory J |last=Boyle |coauthors=Svoboda, J Steven; Goldman, Ronald; Fernandez, Ephrem |publisher=Bond University Faculty of Humanities and Social Sciences |year=2002}}</ref>
== 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.'' 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
| coauthors=Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK
| title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?
| journal=Urol Internationalalis
| volume=75
| issue=1
| pages=62-6
| url=http://www.cirp.org/library/sex_function/masood1/
| quote=
| pubmedID=16037710
| pubmedCID=
| DOI=10.1159/000085930
| date=2005
| accessdate=
}}</ref> In a survey of men circumcised as adults for medical (93%) or elective (7%) reasons, Fink ''et al.'' 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.
| coauthors=C.C. Carson and R.F. DeVillis
| title=Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction
| journal=Journal of Urology
| volume=167
| issue=5
| pages=2113-6
| url=http://www.circs.org/library/fink/
| quote=
| pubmedID=11956453
| pubmedCID=
| DOI=10.1016/S0022-5347(05)65098-7
| date=May 2002
| accessdate=
}}</ref>
In a 2008 study, Krieger ''et al.'' 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=JN
| coauthors=Mehta SD, Bailey RC, Agot K, Ndinya-Achola JO, Parker C, Moses 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=2610–22
| url=
| quote=
| pubmedID=18761593
| pubmedCID=
| DOI=10.1111/j.1743-6109.2008.00979.x
| date=August 2008
| 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
| last=Cortés-González JR, Arratia-Maqueo JA, Martínez-Montelongo R, Gómez-Guerra LS
| first=
| coauthors=
| 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=November 2009
| accessdate=
}}</ref>
=== Glans sensitivity ===
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="masters1966">{{cite book
|last = Masters
|first = W.H.
|coauthors = Johnson, V.E.
|title = Human Sexual Response
|year = 1966
|publisher = Bantam Books
|location = Toronto; New York
|isbn = 0-553-20429-7
|url = http://www.circs.org/library/masters/index.html }}</ref> Sorrells ''et al.'' criticised this early study for being poorly documented and not subject to peer review.<ref name="sorrells">{{REFjournal
| last=Sorrells
| first=Morris L.
| coauthors=James L. Snyder, Mark D. Reiss, Christopher Eden, Marilyn F. Milos, Norma Wilcox and Robert S. Van Howe
| title=Fine-touch pressure thresholds in the adult penis
| journal=BJU International
| volume=99
| issue=4
| pages=864-869
| url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/PDFSTART
| quote=
| pubmedID=17378847
| pubmedCID=
| DOI=10.1111/j.1464-410X.2006.06685.x
| date=March 2007
| accessdate=
}}</ref> 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">{{cite web
| url = http://www.aafp.org/online/en/home/clinical/clinicalrecs/circumcision.html
| title = Circumcision: Position Paper on Neonatal Circumcision
| accessdate = 2007-01-30
| year = 2007
| publisher = [[American Academy of Family Physicians]]
}}
</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
| last=Yang
| first=CC
| coauthors=Bradley WE
| title=Neuroanatomy of the penile portion of the human dorsal nerve of the penis
| journal=British Journal Urology
| volume=82
| issue=1
| pages=109-113
| url=http://www.cirp.org/library/anatomy/yang1/
| quote=
| pubmedID=9698671
| pubmedCID=
| DOI=10.1046/j.1464-410x.1998.00669.x
| date=July 1998
| accessdate=
}}</ref>
An examination of 7 circumcised and 6 uncircumcised males found no difference in [[keratin]]ization of the [[glans penis]].<ref name="Szabo">{{REFjournal
| last=Szabo
| first=Robert
| coauthors=Roger V. Short
| title=How does male circumcision protect against HIV infection?
| journal=BMJ
| volume=320
| issue=7249
| pages=1592-1594
| url=http://bmj.bmjjournals.com/cgi/reprint/320/7249/1592
| quote=
| pubmedID=10845974
| pubmedCID=1127372
| DOI=10.1136/bmj.320.7249.1592
| date=June 2000
| 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">{{cite conference | last = Bleustein | first = Clifford B. | coauthors = Haftan Eckholdt, Joseph C. Arezzo and Arnold Melman | title = Effects of Circumcision on Male Penile Sensitivity | booktitle = American Urological Association 98th Annual Meeting | place = Chicago, Illinois | date = April 26-May 1, 2003 | url = http://www.circs.org/library/bleustein/ }}</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=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Bleustein
| first = Clifford B.
| coauthors = Fogarty JD, Eckholdt H, Arezzo JC, Melman A
| year = 2005
| month = April
| title = Effect of neonatal circumcision on penile neurologic sensation
| journal = Urology
| volume = 65
| pages = 773–7
| url = http://linkinghub.elsevier.com/retrieve/pii/S0090-4295(04)01343-3
| pmid = 15833526
| doi = 10.1016/j.urology.2004.11.007
| issue = 4
}}</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="sorrells"/> 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
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Waskett
| first = Jake H.
| coauthors = Brian J. Morris
| year = 2007
| month = May
| 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/HTMLSTART
| doi = 10.1111/j.1464-410X.2007.06970_6.x
| pmid = 17537227
}}</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=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Young
| first = Hugh
| year = 2007
| month = July
| 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
| doi = 10.1111/j.1464-410X.2007.07072_1.x
| pmid = 17669150
}}</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=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Payne
| first = Kimberley
| coauthors = Thaler, Lea; Kukkonen, Tuuli; Carrier, Serge; and [[Irving M. Binik|Binik, Yitzchak]]
| year = 2007
| month = May
| 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
| pmid = 17419812
| doi = 10.1111/j.1743-6109.2007.00471.x
}}</ref>
===Foreskin sensitivity===
Some recent researchers have asserted that the [[foreskin]] may be sexually responsive.<ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Winkelmann
| first = R.K.
| year = 1956
| month = January
| title = The cutaneous innervation of human newborn prepuce
| journal = Journal of investigative dermatology
| volume = 26
| issue = 1
| pages = 53–67
| url = http://www.cirp.org/library/anatomy/winkelmann2/
| pmid = 13295637
}}</ref><ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Winkelmann
| first = R.K.
| year = 1959
| month = January
| title = The erogenous zones: their nerve supply and significance
| journal = Proceedings of the staff meetings of the mayo clinic
| volume = 34
| issue = 2
| pages = 39–47
| url = http://www.cirp.org/library/anatomy/winkelmann/
| pmid = 13645790
}}</ref><ref name="taylor">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Taylor
| first = J.R.
| coauthors = A.P. Lockwood and A.J. Taylor
| year = 1996
| month = February
| title = The prepuce: Specialized mucosa of the penis and its loss to circumcision
| journal = British journal of urology
| volume = 77
| issue = 2
| pages = 291–295
| url = http://www.cirp.org/library/anatomy/taylor/
| pmid = 8800902
| doi=10.1046/j.1464-410X.1996.85023.x
}}</ref><ref name="taylorcold1999">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Taylor
| first = J.R.
| coauthors = C.J. Cold
| year = 1999
| month = February
| title = The prepuce
| journal = British journal of urology
| volume = 83
| issue = Supplement 1
| pages = 34–44
| url = http://www3.interscience.wiley.com/cgi-bin/fulltext/119091418/PDFSTART
| format = PDF
| pmid =
}}</ref> Opponents of circumcision have cited these studies, which report on the sensitivity or innervation of the foreskin, claiming a sexual role based upon the presence of nerve-endings in the foreskin sensitive to light touch, stroking and fluttering sensations.
Circumcision removes the [[ridged band]] at the end of the foreskin.<ref name="taylor" /> Taylor (1996) observed that the [[ridged band]] had more [[Meissner's corpuscle]]s — a kind of nerve ending that is concentrated in areas of greatest sensitivity {{Citation needed|date=August 2007}} — than the areas of the foreskin with smooth mucus membranes. <!-- commented out until someone can explain how blood vessels relate to sensitivity: and a rich blood supply (intense vascularity)--> Taylor postulated that the ridged band is sexually sensitive and plays a role in normal sexual function. He also suggested that the [[gliding action]], possible only when there was enough loose skin on the shaft of the penis, serves to stimulate the ridged band through contact with the corona of the [[glans penis]] during vaginal intercourse.<ref name="taylor2">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Taylor
| first = J.R.
| coauthors =
| year = 2000
| month = October
| title = Back and forth (letter)
| journal = Pediatric news
| volume = 34
| issue = 10
| pages = 50
| url = http://www.cirp.org/library/anatomy/taylor2/
| pmid =
}}</ref> This gliding action was also described by Lakshmanan (1980).<ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Lakshmanan
| first = S
| coauthors = S. Parkash
| year = 1980
| month =
| title = Human prepuce: some aspects of structure and function
| journal = Indian journal of surgery
| volume = 44
| issue =
| pages = 134–137
| url = http://www.cirp.org/library/anatomy/lakshmanan/
| pmid =
}}</ref>
Sorrells ''et al.'' (2007), in the study discussed above, measured fine-touch pressure thresholds of the penis, and concluded "The transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates" (removes) "the most sensitive parts of the penis." According to Sorrells ''et al.'', the five penile areas most sensitive to fine-touch are located on the foreskin.<ref name="sorrells" /> This is disputed by Waskett and Morris, who argue that when they re-analyse Sorrells' data, no significant differences are found; that light touch is only one form of sensitivity, and that sexual pleasure may sometimes require less sensitivity. They also criticized Sorrells' recruitment methods.<ref name="waskett2007"/> In response, Young criticizes Waskett and Morris's use of the [[Bonferroni correction]] and argues that the methods of selecting subjects would not affect the results, that the two most sensitive positions on the circumcised penis represent small areas of [[circumcision scar]], as compared to a much larger area of sensitive tissue on the foreskin, and that sales of sensation-dulling products do not necessarily indicate that such are widely used other than on scar tissue.<ref name="young"/> In 2009, Schober ''et al'' reported on self-assessed sexual sensitivity in 81 men, 11 of whom were uncircumcised. When assessing areas producing sexual pleasure, the foreskin was ranked 7th, after the glans, lower and upper shaft, and the left and right sides of the penis, but above the area between scrotum and anus, the scrotum itself, and the anus.<ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
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| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal |author=Schober JM, Meyer-Bahlburg HF, Dolezal C |title=Self-ratings of genital anatomy, sexual sensitivity and function in men using the 'Self-Assessment of Genital Anatomy and Sexual Function, Male' questionnaire |journal=BJU Int. |volume=103 |issue=8 |pages=1096–103 |year=2009 |month=April |pmid=19245445 |doi=10.1111/j.1464-410X.2008.08166.x |url=}}</ref>
Boyle ''et al.'' (2002) argued that circumcision and frenectomy remove tissues with "heightened erogenous sensitivity," stating "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision."<ref name="boyle2002">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal | last = Boyle | first = Gregory J. | coauthors = Gillian A. Bensley | year = 2001 | month = July | title = Adverse Sexual and Psychological Effects of Male Infant Circumcision | journal = Psychological reports | volume = 88 | issue = 3,Part 2 | pages = 1105–1106 | url = http://www.cirp.org/library/psych/boyle5/ | format = | pmid = 11597060 | doi = }}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."
==Erectile function==
Reports detailing the effect of circumcision on [[erectile dysfunction]] have been mixed. Studies have variously found a statistically significant increase,<ref name=fink2002/><ref name="shen2004">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Shen
| first = Z
| coauthors = Chen S, Zhu C, Wan Q, Chen Z
| year = 2004
| month = January
| title = Erectile function evaluation after adult circumcision
| journal = Zhonghua Nan Ke Xue
| volume = 10
| issue = 1
| pages = 18–9
| pmid = 14979200
}}</ref> or decrease,<ref name="cortes2009"/><ref name= "richters2006">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Richters
| first = J
| coauthors = Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK
| year = 2006
| title = Circumcision in Australia: prevalence and effects on sexual health
| journal = International Journal of Sexually Transmissible Diseases and AIDS
| volume = 17
| pages = 547–554
| url = http://www.cirp.org/library/general/richters1/
| pmid = 16925903
| issue = 8
| doi = 10.1258/095646206778145730
}}</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
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
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| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal |author=Krieger JN, Mehta SD, Bailey RC, ''et al.'' |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= 2610–22|year=2008 |month=August |pmid=18761593 |doi=10.1111/j.1743-6109.2008.00979.x |url=}}</ref><ref name="senkul2004"/><ref name="Collins2002">{{REFjournal
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| DOI=
| date=
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}}{{cite journal
| last = Collins
| first = S
| coauthors = Upshaw J, Rutchik S, Ohannessian C, Ortenberg J, Albertsen P
| year = 2002
| title = Effects of circumcision on male sexual function: debunking a myth?
| journal = Journal of Urology
| volume = 167
| pages = 2111–2112
| url = http://www.circs.org/library/collins/
| doi = 10.1016/S0022-5347(05)65097-5
| pmid = 11956452
| issue = 5
}}</ref><ref name="kigozi2007">{{REFjournal
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}}{{cite journal
| last = Kigozi
| first = G
| coauthors = Watya S, Polis CB, Buwembo D, Kiggundu V, Wawer MJ, Serwadda D, Nalugoda F, Kiwanuka N, Bacon MC, Ssempijja V, Makumbi F, Gray RH.
| year = 2007
| month = January
| 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
| format = PDF
| pmid = 18086100
| doi = 10.1111/j.1464-410X.2007.07369.x
}}</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/>
Kim and Pang reported no significant difference in erection.<ref name="kimpang2006">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Kim
| first = DaiSik
| coauthors = Myung-Geol Pang
| year = 2007
| month = March
| title = The effect of male circumcision on sexuality
| journal = BJU International
| volume = 99
| issue = 3
| pages = 619–622
| url = http://www3.interscience.wiley.com/cgi-bin/fulltext/118508378/PDFSTART
| format = PDF
| pmid = 17155977
| doi = 10.1111/j.1464-410X.2006.06646.x
}}</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"/>
Cortés-González ''et al.'' reported a statistically significant improvement in erectile function following circumcision (p=0.0007).<ref name="cortes2009"/>
==Ejaculatory function==
Waldinger ''et al.'' recruited 500 men (98 circumcised and 261 not-circumcised) from five countries: the [[Netherlands]], [[United Kingdom]], [[Spain]], [[Turkey]], and the [[United States]] and studied their ejaculation times during [[sexual intercourse]]. They found that the circumcised men in the study took on average 6.7 minutes to ejaculate, compared with 6.0 minutes for the uncircumcised men. This difference was not statistically significant. The comparison excluded Turkey, which was significantly different from the other countries studied.<ref name="Waldinger2005">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Waldinger
| first = M.D.
| coauthors = Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M
| year = 2005
| title = Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
| journal = Journal of Sexual Medicine
| volume = 2
| pages = 492–497
| url = http://www3.interscience.wiley.com/journal/118719267/abstract
| doi = 10.1111/j.1743-6109.2005.00070.x
| pmid = 16422843
| issue = 4
}}</ref> Commenting on the study, Sorrells ''et al.'' said "Turkish men, the vast majority of whom are circumcised, had the shortest IELT [Intravaginal ejaculation latency time]."<ref name="sorrells"/>
Collins ''et al.'' conducted a prospective study of 15 adult circumcision patients, using the Brief Male Sexual Function Inventory (BMSFI). The authors did not find a statistically significant effect on ejaculation scores.<ref name="Collins2002"/>
In a study of 42 Turkish men circumcised for religious reasons, Senkul ''et al.'' did not find a statistically significant difference in BMSFI ejaculation scores, but found a significant increase in the mean time to ejaculate. The authors suggested that delayed ejaculation may be seen as a benefit.<ref name="senkul2004">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Senkul
| first = T
| coauthors = C. Iseri, B. Sen, K. Karademir, F. Saracoglu and D. Erden
| year = 2004
| title = Circumcision in Adults: Effect on Sexual Function
| journal = Urology
| pmid = 14751371
| volume = 63
| pages = 155–8
| url = http://www.circs.org/library/senkul/
| doi = 10.1016/j.urology.2003.08.035
| issue=1
}}</ref>
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 men circumcised for benign disease, Masood ''et al.'' reported that of those who stated they had prior premature ejaculation, 13% reported improvement after circumcision, 33% reported that it became worse, and 53% reported no change.<ref name="masood2005"/>
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.<ref name="cortes2009"/>
== Sexual practice and masturbation ==
In a study by Korean researchers of 255 men circumcised after the age of 20 and 18 who were not circumcised, Kim and Pang reported that masturbatory pleasure decreased in 48% of the respondents and increased in 8%. [[Masturbation|Masturbatory]] difficulty increased in 63% but was easier in 37%. They concluded that there was a decrease in masturbatory pleasure after circumcision.<ref name="kimpang2006"/>
Laumann ''et al.'' reported that circumcised men in their survey displayed a greater rates of experience of various sexual practices, including oral sex, anal sex, and masturbation.<ref name="Laumann1997">{{REFjournal
| last=Laumann
| first=E.O.
| coauthors=C.M. Masi and E.W. Zuckerman
| title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
| journal=[[Journal of the American Medical Association|JAMA]]
| volume=277
| issue=13
| pages=1052–7
| url=http://www.circs.org/library/laumann/
| quote=
| pubmedID=9091693
| pubmedCID=
| DOI=10.1001/jama.277.13.1052
| date=1997
| accessdate=
}}</ref> For example, among whites the "estimated ratio of the odds of masturbating at least once a month for circumcised men was 1.76 that for uncircumcised men." Dr. Laumann provides two explanations for the difference in sexual practices. "One is that uncircumcised men, a minority in this country, may feel a stigma that inhibits them. Another is that circumcision reduces sensitivity in the penis, leading circumcised men to try a range of sexual activities."<ref>Study Is Adding to Doubts About Circumcision
By SUSAN GILBERT
Published: April 2, 1997. New York Times. [http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C07E4D91F3AF931A35757C0A961958260]</ref>
Fink ''et al.'' did not find a change in sexual activity with adult circumcision (p=0.22).<ref name="fink2002"/>
== Sexual drive ==
Several studies have investigated the effect of circumcision on sexual drive. Studies that did not find a statistically significant difference include Kim and Pang,<ref name="kimpang2006"/> Collins ''et al.'',<ref name="Collins2002"/> Senkul ''et al.'',<ref name="senkul2004"/> and Cortés-González ''et al.''.<ref name="cortes2009"/>
== 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"/>
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"/>
Senkul ''et al.'' reported that they did not find a statistically significant difference in BMSFI satisfaction scores in their study of 42 adult circumcision patients.<ref name="senkul2004"/>
Collins ''et al.'' reported on a study of 15 adult circumcision patients. No statistically significant difference in BMSFI scores was observed.<ref name="Collins2002"/>
Fink ''et al.'' reported improved satisfaction (p=0.04). Half of the circumcised men reported benefits, while 38% reported harm. "Overall, 62% of men were satisfied with having been circumcised." Fink attributes the improved satisfaction to the respondee's aesthetic considerations and to a resolution of previous painful conditions.<ref name="fink2002"/>
Cortés-González ''et al.'' found no statistically significant differences in terms of overall sexual satisfaction (p=0.15), pain during intercourse (p=0.23), or enjoyment of intercourse (p=0.32).<ref name="cortes2009"/>
==Female preferences and response==
O'Hara and O'Hara argue that foreskin is a natural gliding stimulator of the vaginal walls during intercourse, increasing a woman's overall clitoral stimulation and helping her achieve orgasm more quickly and more often. Without the foreskin's gliding action, they suggest, it can be more difficult for a woman to achieve orgasm during intercourse.<ref name= "OHara1999">{{REFjournal
| last=O'Hara
| first=K.
| coauthors=J. O'Hara
| title=The effect of male circumcision on the sexual enjoyment of the female partner
| journal=BJU International
| volume=83
| issue=Supplement 1
| pages=79–84
| url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091407/PDFSTART
| quote=
| pubmedID=10349418
| pubmedCID=
| DOI=10.1046/j.1464-410x.1999.0830s1079.x
| date=January 1999
| accessdate=
}}</ref> A study by psychologists Bensley & Boyle (2003) reported that vaginal dryness can be a problem when the male partner is circumcised.<ref>{{REFjournal
| last=Bensley
| first=Gillian A.
| coauthors=Gregory J. Boyle
| title=Effects of male circumcision on female arousal and orgasm
| journal=New Zealand medical journal
| volume=116
| issue=1181
| pages=595-596
| url=http://www.nzma.org.nz/journal/116-1181/595/
| quote=
| pubmedID=14581975
| pubmedCID=
| DOI=
| date=September 2003
| 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=October 2008}} 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=October 2008}} 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>{{REFjournal
| last=Cortés-González JR, Arratia-Maqueo JA, Gómez-Guerra LS
| first=
| coauthors=
| title=[Does circumcision has an effect on female's perception of sexual satisfaction?]
| journal=Rev. Invest. Clin.
| volume=60
| issue=3
| pages=227–30
| url=
| quote=
| pubmedID=18807735
| pubmedCID=
| DOI=
| date=2008
| accessdate=
| language=Spanish; Castilian
}}</ref>
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 G, Lukabwe I, Kagaayi J, ''et al.''
| first=
| coauthors=
| 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=1698–701
| url=
| quote=
| pubmedID=19522862
| pubmedCID=
| DOI=10.1111/j.1464-410X.2009.08683.x
| date=June 2009
| 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
| last=Wildman RW, Wildman RW, Brown A, Trice C
| first=
| coauthors=
| title=Note on males' and females' preferences for opposite-sex body parts, bust sizes, and bust-revealing clothing
| journal=Psychological Reports
| volume=38
| issue=2
| pages=485-6
| url=http://circs.org/library/wildman/index.html
| quote=
| pubmedID=1265180
| pubmedCID=
| DOI=
| date=1976
| 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=October 2008}}
== 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 MG, Sen B, Karademir K, Sen H, Saraçoğlu M
| first=
| coauthors=
| title=The effect of male circumcision on pudendal evoked potentials and sexual satisfaction
| journal=Acta Neurol Belg
| volume=108
| issue=3
| pages=90-3
| url=
| quote=
| pubmedID=19115671
| pubmedCID=
| DOI=
| date=September 2008
| 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.
| coauthors=Hill G.
| title=Circumcision in adults: effect on sexual function
| journal=Urology
| volume=64
| issue=6
| pages=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=DM
| coauthors=Lin H, Zhang B, Guo 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=April 2008
| accessdate=16 April 2008
}}</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.
-->
{{SEEALSO}}
* [[Foreskin]]
* [[Erection]]
* [[Circumcision]]
* [[Ridged band]]
{{REF}}
[[Category:Circumcision]]
[[Category:From IntactWiki]]
'''This article was borrowed from Wikipedia on [http://en.wikipedia.org/w/index.php?title=Sexual_effects_of_circumcision&oldid=429623060 21:11, 17 May 2011]'''
The '''sexual effects of [[circumcision]]''' are the subject of some debate. Studies have been conducted to investigate whether circumcision has any effect on sexual drive, erectile function, premature and delayed ejaculation, sexual satisfaction, sexual sensation and penile sensitivity. Studies have also assessed whether circumcision affects masturbation or other sexual practices, and whether a heterosexual woman's experience of sex is affected by her partner's circumcision status.
Those reviewing the literature have reached differing conclusions. 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
| last=
| first=
| coauthors=
| title=Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision
| journal=Pediatrics
| volume=103
| issue=3
| pages=686-93
| url=
| quote=
| pubmedID=10049981
| pubmedCID=
| DOI=10.1542/peds.103.3.686
| date=March 1999
| accessdate=
}}</ref> 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. [...] No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction."<ref name="AAFP"/> Conversely, a 2002 review by Boyle ''et al.'' stated that "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision, with an inevitable reduction in sexual sensation experienced by circumcised males." They concluded, "intercourse is less satisfying for both partners when the man is circumcised".<ref>{{Cite web|url=http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1036&context=hss_pubs |title=Male circumcision: pain, trauma, and psychosexual sequelae |first=Gregory J |last=Boyle |coauthors=Svoboda, J Steven; Goldman, Ronald; Fernandez, Ephrem |publisher=Bond University Faculty of Humanities and Social Sciences |year=2002}}</ref>
== 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.'' 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
| coauthors=Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK
| title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?
| journal=Urol Internationalalis
| volume=75
| issue=1
| pages=62-6
| url=http://www.cirp.org/library/sex_function/masood1/
| quote=
| pubmedID=16037710
| pubmedCID=
| DOI=10.1159/000085930
| date=2005
| accessdate=
}}</ref> In a survey of men circumcised as adults for medical (93%) or elective (7%) reasons, Fink ''et al.'' 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.
| coauthors=C.C. Carson and R.F. DeVillis
| title=Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction
| journal=Journal of Urology
| volume=167
| issue=5
| pages=2113-6
| url=http://www.circs.org/library/fink/
| quote=
| pubmedID=11956453
| pubmedCID=
| DOI=10.1016/S0022-5347(05)65098-7
| date=May 2002
| accessdate=
}}</ref>
In a 2008 study, Krieger ''et al.'' 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=JN
| coauthors=Mehta SD, Bailey RC, Agot K, Ndinya-Achola JO, Parker C, Moses 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=2610–22
| url=
| quote=
| pubmedID=18761593
| pubmedCID=
| DOI=10.1111/j.1743-6109.2008.00979.x
| date=August 2008
| 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
| last=Cortés-González JR, Arratia-Maqueo JA, Martínez-Montelongo R, Gómez-Guerra LS
| first=
| coauthors=
| 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=November 2009
| accessdate=
}}</ref>
=== Glans sensitivity ===
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="masters1966">{{cite book
|last = Masters
|first = W.H.
|coauthors = Johnson, V.E.
|title = Human Sexual Response
|year = 1966
|publisher = Bantam Books
|location = Toronto; New York
|isbn = 0-553-20429-7
|url = http://www.circs.org/library/masters/index.html }}</ref> Sorrells ''et al.'' criticised this early study for being poorly documented and not subject to peer review.<ref name="sorrells">{{REFjournal
| last=Sorrells
| first=Morris L.
| coauthors=James L. Snyder, Mark D. Reiss, Christopher Eden, Marilyn F. Milos, Norma Wilcox and Robert S. Van Howe
| title=Fine-touch pressure thresholds in the adult penis
| journal=BJU International
| volume=99
| issue=4
| pages=864-869
| url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/PDFSTART
| quote=
| pubmedID=17378847
| pubmedCID=
| DOI=10.1111/j.1464-410X.2006.06685.x
| date=March 2007
| accessdate=
}}</ref> 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">{{cite web
| url = http://www.aafp.org/online/en/home/clinical/clinicalrecs/circumcision.html
| title = Circumcision: Position Paper on Neonatal Circumcision
| accessdate = 2007-01-30
| year = 2007
| publisher = [[American Academy of Family Physicians]]
}}
</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
| last=Yang
| first=CC
| coauthors=Bradley WE
| title=Neuroanatomy of the penile portion of the human dorsal nerve of the penis
| journal=British Journal Urology
| volume=82
| issue=1
| pages=109-113
| url=http://www.cirp.org/library/anatomy/yang1/
| quote=
| pubmedID=9698671
| pubmedCID=
| DOI=10.1046/j.1464-410x.1998.00669.x
| date=July 1998
| accessdate=
}}</ref>
An examination of 7 circumcised and 6 uncircumcised males found no difference in [[keratin]]ization of the [[glans penis]].<ref name="Szabo">{{REFjournal
| last=Szabo
| first=Robert
| coauthors=Roger V. Short
| title=How does male circumcision protect against HIV infection?
| journal=BMJ
| volume=320
| issue=7249
| pages=1592-1594
| url=http://bmj.bmjjournals.com/cgi/reprint/320/7249/1592
| quote=
| pubmedID=10845974
| pubmedCID=1127372
| DOI=10.1136/bmj.320.7249.1592
| date=June 2000
| 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">{{cite conference | last = Bleustein | first = Clifford B. | coauthors = Haftan Eckholdt, Joseph C. Arezzo and Arnold Melman | title = Effects of Circumcision on Male Penile Sensitivity | booktitle = American Urological Association 98th Annual Meeting | place = Chicago, Illinois | date = April 26-May 1, 2003 | url = http://www.circs.org/library/bleustein/ }}</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=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Bleustein
| first = Clifford B.
| coauthors = Fogarty JD, Eckholdt H, Arezzo JC, Melman A
| year = 2005
| month = April
| title = Effect of neonatal circumcision on penile neurologic sensation
| journal = Urology
| volume = 65
| pages = 773–7
| url = http://linkinghub.elsevier.com/retrieve/pii/S0090-4295(04)01343-3
| pmid = 15833526
| doi = 10.1016/j.urology.2004.11.007
| issue = 4
}}</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="sorrells"/> 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
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Waskett
| first = Jake H.
| coauthors = Brian J. Morris
| year = 2007
| month = May
| 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/HTMLSTART
| doi = 10.1111/j.1464-410X.2007.06970_6.x
| pmid = 17537227
}}</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=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Young
| first = Hugh
| year = 2007
| month = July
| 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
| doi = 10.1111/j.1464-410X.2007.07072_1.x
| pmid = 17669150
}}</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=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Payne
| first = Kimberley
| coauthors = Thaler, Lea; Kukkonen, Tuuli; Carrier, Serge; and [[Irving M. Binik|Binik, Yitzchak]]
| year = 2007
| month = May
| 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
| pmid = 17419812
| doi = 10.1111/j.1743-6109.2007.00471.x
}}</ref>
===Foreskin sensitivity===
Some recent researchers have asserted that the [[foreskin]] may be sexually responsive.<ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Winkelmann
| first = R.K.
| year = 1956
| month = January
| title = The cutaneous innervation of human newborn prepuce
| journal = Journal of investigative dermatology
| volume = 26
| issue = 1
| pages = 53–67
| url = http://www.cirp.org/library/anatomy/winkelmann2/
| pmid = 13295637
}}</ref><ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Winkelmann
| first = R.K.
| year = 1959
| month = January
| title = The erogenous zones: their nerve supply and significance
| journal = Proceedings of the staff meetings of the mayo clinic
| volume = 34
| issue = 2
| pages = 39–47
| url = http://www.cirp.org/library/anatomy/winkelmann/
| pmid = 13645790
}}</ref><ref name="taylor">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Taylor
| first = J.R.
| coauthors = A.P. Lockwood and A.J. Taylor
| year = 1996
| month = February
| title = The prepuce: Specialized mucosa of the penis and its loss to circumcision
| journal = British journal of urology
| volume = 77
| issue = 2
| pages = 291–295
| url = http://www.cirp.org/library/anatomy/taylor/
| pmid = 8800902
| doi=10.1046/j.1464-410X.1996.85023.x
}}</ref><ref name="taylorcold1999">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Taylor
| first = J.R.
| coauthors = C.J. Cold
| year = 1999
| month = February
| title = The prepuce
| journal = British journal of urology
| volume = 83
| issue = Supplement 1
| pages = 34–44
| url = http://www3.interscience.wiley.com/cgi-bin/fulltext/119091418/PDFSTART
| format = PDF
| pmid =
}}</ref> Opponents of circumcision have cited these studies, which report on the sensitivity or innervation of the foreskin, claiming a sexual role based upon the presence of nerve-endings in the foreskin sensitive to light touch, stroking and fluttering sensations.
Circumcision removes the [[ridged band]] at the end of the foreskin.<ref name="taylor" /> Taylor (1996) observed that the [[ridged band]] had more [[Meissner's corpuscle]]s — a kind of nerve ending that is concentrated in areas of greatest sensitivity {{Citation needed|date=August 2007}} — than the areas of the foreskin with smooth mucus membranes. <!-- commented out until someone can explain how blood vessels relate to sensitivity: and a rich blood supply (intense vascularity)--> Taylor postulated that the ridged band is sexually sensitive and plays a role in normal sexual function. He also suggested that the [[gliding action]], possible only when there was enough loose skin on the shaft of the penis, serves to stimulate the ridged band through contact with the corona of the [[glans penis]] during vaginal intercourse.<ref name="taylor2">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Taylor
| first = J.R.
| coauthors =
| year = 2000
| month = October
| title = Back and forth (letter)
| journal = Pediatric news
| volume = 34
| issue = 10
| pages = 50
| url = http://www.cirp.org/library/anatomy/taylor2/
| pmid =
}}</ref> This gliding action was also described by Lakshmanan (1980).<ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Lakshmanan
| first = S
| coauthors = S. Parkash
| year = 1980
| month =
| title = Human prepuce: some aspects of structure and function
| journal = Indian journal of surgery
| volume = 44
| issue =
| pages = 134–137
| url = http://www.cirp.org/library/anatomy/lakshmanan/
| pmid =
}}</ref>
Sorrells ''et al.'' (2007), in the study discussed above, measured fine-touch pressure thresholds of the penis, and concluded "The transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates" (removes) "the most sensitive parts of the penis." According to Sorrells ''et al.'', the five penile areas most sensitive to fine-touch are located on the foreskin.<ref name="sorrells" /> This is disputed by Waskett and Morris, who argue that when they re-analyse Sorrells' data, no significant differences are found; that light touch is only one form of sensitivity, and that sexual pleasure may sometimes require less sensitivity. They also criticized Sorrells' recruitment methods.<ref name="waskett2007"/> In response, Young criticizes Waskett and Morris's use of the [[Bonferroni correction]] and argues that the methods of selecting subjects would not affect the results, that the two most sensitive positions on the circumcised penis represent small areas of [[circumcision scar]], as compared to a much larger area of sensitive tissue on the foreskin, and that sales of sensation-dulling products do not necessarily indicate that such are widely used other than on scar tissue.<ref name="young"/> In 2009, Schober ''et al'' reported on self-assessed sexual sensitivity in 81 men, 11 of whom were uncircumcised. When assessing areas producing sexual pleasure, the foreskin was ranked 7th, after the glans, lower and upper shaft, and the left and right sides of the penis, but above the area between scrotum and anus, the scrotum itself, and the anus.<ref>{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal |author=Schober JM, Meyer-Bahlburg HF, Dolezal C |title=Self-ratings of genital anatomy, sexual sensitivity and function in men using the 'Self-Assessment of Genital Anatomy and Sexual Function, Male' questionnaire |journal=BJU Int. |volume=103 |issue=8 |pages=1096–103 |year=2009 |month=April |pmid=19245445 |doi=10.1111/j.1464-410X.2008.08166.x |url=}}</ref>
Boyle ''et al.'' (2002) argued that circumcision and frenectomy remove tissues with "heightened erogenous sensitivity," stating "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision."<ref name="boyle2002">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal | last = Boyle | first = Gregory J. | coauthors = Gillian A. Bensley | year = 2001 | month = July | title = Adverse Sexual and Psychological Effects of Male Infant Circumcision | journal = Psychological reports | volume = 88 | issue = 3,Part 2 | pages = 1105–1106 | url = http://www.cirp.org/library/psych/boyle5/ | format = | pmid = 11597060 | doi = }}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."
==Erectile function==
Reports detailing the effect of circumcision on [[erectile dysfunction]] have been mixed. Studies have variously found a statistically significant increase,<ref name=fink2002/><ref name="shen2004">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
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| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Shen
| first = Z
| coauthors = Chen S, Zhu C, Wan Q, Chen Z
| year = 2004
| month = January
| title = Erectile function evaluation after adult circumcision
| journal = Zhonghua Nan Ke Xue
| volume = 10
| issue = 1
| pages = 18–9
| pmid = 14979200
}}</ref> or decrease,<ref name="cortes2009"/><ref name= "richters2006">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Richters
| first = J
| coauthors = Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK
| year = 2006
| title = Circumcision in Australia: prevalence and effects on sexual health
| journal = International Journal of Sexually Transmissible Diseases and AIDS
| volume = 17
| pages = 547–554
| url = http://www.cirp.org/library/general/richters1/
| pmid = 16925903
| issue = 8
| doi = 10.1258/095646206778145730
}}</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
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal |author=Krieger JN, Mehta SD, Bailey RC, ''et al.'' |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= 2610–22|year=2008 |month=August |pmid=18761593 |doi=10.1111/j.1743-6109.2008.00979.x |url=}}</ref><ref name="senkul2004"/><ref name="Collins2002">{{REFjournal
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| first=
| coauthors=
| title=
| journal=
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| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Collins
| first = S
| coauthors = Upshaw J, Rutchik S, Ohannessian C, Ortenberg J, Albertsen P
| year = 2002
| title = Effects of circumcision on male sexual function: debunking a myth?
| journal = Journal of Urology
| volume = 167
| pages = 2111–2112
| url = http://www.circs.org/library/collins/
| doi = 10.1016/S0022-5347(05)65097-5
| pmid = 11956452
| issue = 5
}}</ref><ref name="kigozi2007">{{REFjournal
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| first=
| coauthors=
| title=
| journal=
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| DOI=
| date=
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}}{{cite journal
| last = Kigozi
| first = G
| coauthors = Watya S, Polis CB, Buwembo D, Kiggundu V, Wawer MJ, Serwadda D, Nalugoda F, Kiwanuka N, Bacon MC, Ssempijja V, Makumbi F, Gray RH.
| year = 2007
| month = January
| 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
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| format = PDF
| pmid = 18086100
| doi = 10.1111/j.1464-410X.2007.07369.x
}}</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/>
Kim and Pang reported no significant difference in erection.<ref name="kimpang2006">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Kim
| first = DaiSik
| coauthors = Myung-Geol Pang
| year = 2007
| month = March
| title = The effect of male circumcision on sexuality
| journal = BJU International
| volume = 99
| issue = 3
| pages = 619–622
| url = http://www3.interscience.wiley.com/cgi-bin/fulltext/118508378/PDFSTART
| format = PDF
| pmid = 17155977
| doi = 10.1111/j.1464-410X.2006.06646.x
}}</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"/>
Cortés-González ''et al.'' reported a statistically significant improvement in erectile function following circumcision (p=0.0007).<ref name="cortes2009"/>
==Ejaculatory function==
Waldinger ''et al.'' recruited 500 men (98 circumcised and 261 not-circumcised) from five countries: the [[Netherlands]], [[United Kingdom]], [[Spain]], [[Turkey]], and the [[United States]] and studied their ejaculation times during [[sexual intercourse]]. They found that the circumcised men in the study took on average 6.7 minutes to ejaculate, compared with 6.0 minutes for the uncircumcised men. This difference was not statistically significant. The comparison excluded Turkey, which was significantly different from the other countries studied.<ref name="Waldinger2005">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Waldinger
| first = M.D.
| coauthors = Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M
| year = 2005
| title = Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
| journal = Journal of Sexual Medicine
| volume = 2
| pages = 492–497
| url = http://www3.interscience.wiley.com/journal/118719267/abstract
| doi = 10.1111/j.1743-6109.2005.00070.x
| pmid = 16422843
| issue = 4
}}</ref> Commenting on the study, Sorrells ''et al.'' said "Turkish men, the vast majority of whom are circumcised, had the shortest IELT [Intravaginal ejaculation latency time]."<ref name="sorrells"/>
Collins ''et al.'' conducted a prospective study of 15 adult circumcision patients, using the Brief Male Sexual Function Inventory (BMSFI). The authors did not find a statistically significant effect on ejaculation scores.<ref name="Collins2002"/>
In a study of 42 Turkish men circumcised for religious reasons, Senkul ''et al.'' did not find a statistically significant difference in BMSFI ejaculation scores, but found a significant increase in the mean time to ejaculate. The authors suggested that delayed ejaculation may be seen as a benefit.<ref name="senkul2004">{{REFjournal
| last=
| first=
| coauthors=
| title=
| journal=
| volume=
| issue=
| pages=
| url=
| quote=
| pubmedID=
| pubmedCID=
| DOI=
| date=
| accessdate=
}}{{cite journal
| last = Senkul
| first = T
| coauthors = C. Iseri, B. Sen, K. Karademir, F. Saracoglu and D. Erden
| year = 2004
| title = Circumcision in Adults: Effect on Sexual Function
| journal = Urology
| pmid = 14751371
| volume = 63
| pages = 155–8
| url = http://www.circs.org/library/senkul/
| doi = 10.1016/j.urology.2003.08.035
| issue=1
}}</ref>
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 men circumcised for benign disease, Masood ''et al.'' reported that of those who stated they had prior premature ejaculation, 13% reported improvement after circumcision, 33% reported that it became worse, and 53% reported no change.<ref name="masood2005"/>
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.<ref name="cortes2009"/>
== Sexual practice and masturbation ==
In a study by Korean researchers of 255 men circumcised after the age of 20 and 18 who were not circumcised, Kim and Pang reported that masturbatory pleasure decreased in 48% of the respondents and increased in 8%. [[Masturbation|Masturbatory]] difficulty increased in 63% but was easier in 37%. They concluded that there was a decrease in masturbatory pleasure after circumcision.<ref name="kimpang2006"/>
Laumann ''et al.'' reported that circumcised men in their survey displayed a greater rates of experience of various sexual practices, including oral sex, anal sex, and masturbation.<ref name="Laumann1997">{{REFjournal
| last=Laumann
| first=E.O.
| coauthors=C.M. Masi and E.W. Zuckerman
| title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
| journal=[[Journal of the American Medical Association|JAMA]]
| volume=277
| issue=13
| pages=1052–7
| url=http://www.circs.org/library/laumann/
| quote=
| pubmedID=9091693
| pubmedCID=
| DOI=10.1001/jama.277.13.1052
| date=1997
| accessdate=
}}</ref> For example, among whites the "estimated ratio of the odds of masturbating at least once a month for circumcised men was 1.76 that for uncircumcised men." Dr. Laumann provides two explanations for the difference in sexual practices. "One is that uncircumcised men, a minority in this country, may feel a stigma that inhibits them. Another is that circumcision reduces sensitivity in the penis, leading circumcised men to try a range of sexual activities."<ref>Study Is Adding to Doubts About Circumcision
By SUSAN GILBERT
Published: April 2, 1997. New York Times. [http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C07E4D91F3AF931A35757C0A961958260]</ref>
Fink ''et al.'' did not find a change in sexual activity with adult circumcision (p=0.22).<ref name="fink2002"/>
== Sexual drive ==
Several studies have investigated the effect of circumcision on sexual drive. Studies that did not find a statistically significant difference include Kim and Pang,<ref name="kimpang2006"/> Collins ''et al.'',<ref name="Collins2002"/> Senkul ''et al.'',<ref name="senkul2004"/> and Cortés-González ''et al.''.<ref name="cortes2009"/>
== 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"/>
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"/>
Senkul ''et al.'' reported that they did not find a statistically significant difference in BMSFI satisfaction scores in their study of 42 adult circumcision patients.<ref name="senkul2004"/>
Collins ''et al.'' reported on a study of 15 adult circumcision patients. No statistically significant difference in BMSFI scores was observed.<ref name="Collins2002"/>
Fink ''et al.'' reported improved satisfaction (p=0.04). Half of the circumcised men reported benefits, while 38% reported harm. "Overall, 62% of men were satisfied with having been circumcised." Fink attributes the improved satisfaction to the respondee's aesthetic considerations and to a resolution of previous painful conditions.<ref name="fink2002"/>
Cortés-González ''et al.'' found no statistically significant differences in terms of overall sexual satisfaction (p=0.15), pain during intercourse (p=0.23), or enjoyment of intercourse (p=0.32).<ref name="cortes2009"/>
==Female preferences and response==
O'Hara and O'Hara argue that foreskin is a natural gliding stimulator of the vaginal walls during intercourse, increasing a woman's overall clitoral stimulation and helping her achieve orgasm more quickly and more often. Without the foreskin's gliding action, they suggest, it can be more difficult for a woman to achieve orgasm during intercourse.<ref name= "OHara1999">{{REFjournal
| last=O'Hara
| first=K.
| coauthors=J. O'Hara
| title=The effect of male circumcision on the sexual enjoyment of the female partner
| journal=BJU International
| volume=83
| issue=Supplement 1
| pages=79–84
| url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091407/PDFSTART
| quote=
| pubmedID=10349418
| pubmedCID=
| DOI=10.1046/j.1464-410x.1999.0830s1079.x
| date=January 1999
| accessdate=
}}</ref> A study by psychologists Bensley & Boyle (2003) reported that vaginal dryness can be a problem when the male partner is circumcised.<ref>{{REFjournal
| last=Bensley
| first=Gillian A.
| coauthors=Gregory J. Boyle
| title=Effects of male circumcision on female arousal and orgasm
| journal=New Zealand medical journal
| volume=116
| issue=1181
| pages=595-596
| url=http://www.nzma.org.nz/journal/116-1181/595/
| quote=
| pubmedID=14581975
| pubmedCID=
| DOI=
| date=September 2003
| 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=October 2008}} 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=October 2008}} 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>{{REFjournal
| last=Cortés-González JR, Arratia-Maqueo JA, Gómez-Guerra LS
| first=
| coauthors=
| title=[Does circumcision has an effect on female's perception of sexual satisfaction?]
| journal=Rev. Invest. Clin.
| volume=60
| issue=3
| pages=227–30
| url=
| quote=
| pubmedID=18807735
| pubmedCID=
| DOI=
| date=2008
| accessdate=
| language=Spanish; Castilian
}}</ref>
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 G, Lukabwe I, Kagaayi J, ''et al.''
| first=
| coauthors=
| 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=1698–701
| url=
| quote=
| pubmedID=19522862
| pubmedCID=
| DOI=10.1111/j.1464-410X.2009.08683.x
| date=June 2009
| 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
| last=Wildman RW, Wildman RW, Brown A, Trice C
| first=
| coauthors=
| title=Note on males' and females' preferences for opposite-sex body parts, bust sizes, and bust-revealing clothing
| journal=Psychological Reports
| volume=38
| issue=2
| pages=485-6
| url=http://circs.org/library/wildman/index.html
| quote=
| pubmedID=1265180
| pubmedCID=
| DOI=
| date=1976
| 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=October 2008}}
== 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 MG, Sen B, Karademir K, Sen H, Saraçoğlu M
| first=
| coauthors=
| title=The effect of male circumcision on pudendal evoked potentials and sexual satisfaction
| journal=Acta Neurol Belg
| volume=108
| issue=3
| pages=90-3
| url=
| quote=
| pubmedID=19115671
| pubmedCID=
| DOI=
| date=September 2008
| 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.
| coauthors=Hill G.
| title=Circumcision in adults: effect on sexual function
| journal=Urology
| volume=64
| issue=6
| pages=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=DM
| coauthors=Lin H, Zhang B, Guo 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=April 2008
| accessdate=16 April 2008
}}</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.
-->
{{SEEALSO}}
* [[Foreskin]]
* [[Erection]]
* [[Circumcision]]
* [[Ridged band]]
{{REF}}
[[Category:Circumcision]]
[[Category:From IntactWiki]]