UroToday- There has been suggestion and debate about whether circumcision affects sexual sensation of the penis but there have been few relevant studies to examine this possible consequence of the procedure. South Korea has one of the highest circumcision rates in the world and most are not performed in the neonatal period. This allows a unique opportunity to examine the effect of adult circumcision on sexuality. A prospective study was performed to compare men who were circumcised or not, and to compare the sex lives of men before and after circumcision. The study, by D. Kim and M.G. Pang from Gyungki-Do Korea, is published in the March 2007 issue of BJU International.

The study included 373 sexually active men aged 30-57 years of whom 255 were circumcised (mean age 37.1 years) and 118 were not (mean age 38.2 years). Of the 255 circumcised men, 138 were sexually active before circumcision, and all were circumcised after the age of 20 years. To address the effects of circumcision on the quality of sex life, including masturbation, a modified Brief Male Sexual Function Inventory (BMSFI) which included additional questions about whether sex life and masturbatory pleasure had improved or worsened after circumcision.

Analysis of the results showed that there were no significant differences in sexual drive, erection, ejaculation and ejaculatory latency time between circumcised and uncircumcised men. Masturbatory pleasure decreased after circumcision in 48% of the respondents, while 8% reported increased pleasure. Masturbatory difficulty increased after circumcision in 63% of the respondents but it was easier in 37%. About 6% answered that their sex lives improved, while 20% reported a worse sex life after circumcision.

This study suggests that adult circumcision adversely affects sexual function in a significant number of men, and the authors suggest that it may be due to loss of nerve endings in the removed skin. In addition, there was an approximately 9% incidence of severe penile scarring or uncomfortable erections from curvature or tethering after circumcision.

DaiSik Kim and Myung-Geol Pang

BJU Int. 2007 March; 99(3):619-22
Reviewed by UroToday Contributing Editor Michael J. Metro, MD

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