Effects of circumcision on male sexual functions: a systematic review and meta-analysis

Abstract

This meta-analysis was performed to assess sexual functions following adult male circumcision. We searched the Cochrane Central Register of Controlled Trials, PUBMED, EMBASE, the Cochrane Database of Systematic Review and Web of Science from their inception until January 2013 to identify all eligible studies that reported on men's sexual function after circumcision. The Cochrane Collaboration's RevMan 5.2 software was employed for data analysis, and the fixed or the random effect model was selected depending on the proportion of heterogeneity. We identified 10 studies, which described a total of 9317 circumcised and 9423 uncircumcised men who were evaluated for the association of circumcision with male sexual function. There were no significant differences in sexual desire (odds ratio (OR): 0.99; 95% confidence interval (CI): 0.92-1.06), dyspareunia (OR: 1.12; 95% CI: 0.52-2.44), premature ejaculation (OR: 1.13; 95% CI: 0.83-1.54), ejaculation latency time (OR: 1.33; 95% CI: 0.69-1.97), erectile dysfunctions (OR: 0.90; 95% CI: 0.65-1.25) and orgasm difficulties (OR: 0.97; 95% CI: 0.83-1.13). These findings suggest that circumcision is unlikely to adversely affect male sexual functions. However, these results should be evaluated in light of the low quality of the existing evidence and the significant heterogeneity across the various studies. Well-designed and prospective studies are required for a further understanding of this topic.

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

“…Systematic reviews have found no adverse effect of MC on sexual function, 28 , 29 , 33 sensitivity, or satisfaction 29 . A meta-analysis of all common male sexual dysfunctions found none were related to MC status 28 . Furthermore, the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a large national probability survey, which used a new, comprehensive, validated measure of sexual function, the Natsal-SF, presented findings for 6,293 men and 8,869 women aged 16–74 years, broadly representative of the British population.…”

Abridged version: CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

“…A recent meta-analysis included 10 studies to assess the impact of MC on sexual function 72 . There were no significant differences in sexual desire, dyspareunia, premature ejaculation, ejaculation latency time or erectile dysfunctions between circumcised and uncircumcised men.…”

“I Feel Like More of a Man”: A Mixed Methods Study of Masculinity, Sexual Performance, and Circumcision for HIV Prevention

“…There is scant evidence to suggest that men's perceptions of improved sexual performance post-circumcision (e.g., more potent erections, increased sexual desire, and increased time to ejaculation) is caused by the removal of the man's foreskin. A systematic review of rigorous clinical studies and a separate meta-analysis indicated no significant differences in time to ejaculation, premature ejaculation, or sexual desire between circumcised men and uncircumcised men (Morris & Krieger, 2013; Tian et al, 2013). There is significant social meaning attached to the penis and its performance during sex (Castro-Vázquez, 2013a; Reeser, 2010; Richters, 2006) and thus men's sexual performance following VMMC is more complex than the simple removal of one's foreskin.…”