The Contrasting Evidence Concerning the Effect of Male Circumcision on Sexual Function, Sensation, and Pleasure: A Systematic Review

Abstract

Introduction: Active debate concerns whether male circumcision (MC) affects sexual function, penile sensation, or sexual pleasure. Aim: To perform a systematic review examining the effect of MC on these parameters. Methods: PRISMA-compliant searches of PubMed, EMBASE, the Cochrane Library, and Google Scholar were performed, with "circumcision" used together with appropriate search terms. Articles meeting the inclusion criteria were rated for quality by the Scottish Intercollegiate Guidelines Network system. Main Outcome Measure: Evidence rated by quality. Results: Searches identified 46 publications containing original data, as well as 4 systematic reviews (2 with meta-analyses), plus 29 critiques of various studies and 15 author replies, which together comprised a total of 94 publications. There was overall consistency in conclusions arising from high-and moderate-quality survey data in randomized clinical trials, systematic reviews and meta-analyses, physiological studies, large longitudinal studies, and cohort studies in diverse populations. Those studies found MC has no or minimal adverse effect on sexual function, sensation, or pleasure, with some finding improvements. A consensus from physiological and histological studies was that the glans and underside of the shaft, not the foreskin, are involved in neurological pathways mediating erogenous sensation. In contrast to the higher quality evidence, data supporting adverse effects of MC on function, sensation, or pleasure were found to be of low quality, as explained in critiques of those studies. Conclusion: The consensus of the highest quality literature is that MC has minimal or no adverse effect, and in some studies, it has benefits on sexual functions, sensation, satisfaction, and pleasure for males circumcised neonatally or in adulthood.

Male Circumcision Due to Phimosis as the Procedure That Is Not Only Relieving Clinical Symptoms of Phimosis But Also Improves the Quality of Sexual Life

“…In addition, data supporting adverse effects of MC sexual function, sensation, and pleasure becomes from low-quality studies. 16 Additionally, it is claimed that women prefer circumcised men as sexual partners. The main criteria they mention are better appearance, better hygiene, reduce risk of infection, greater sexual enjoyment, and enhanced sexual activity.…”

The distribution of the clinical variables in a population of adult males circumcised for phimosis: A contribution to the clinical classification of phimosis

“…around one third of men are circumcised for a variety of reasons, including religious, cultural or medical (1). While many studies have been made dealing with the theme of sexual satisfaction and orgasm in males who were circumcised during infancy, the effects on the quality of sexual life, orgasm and sensitivity following circumcision performed in adulthood on patients with phimosis have not been fully clarified (2)(3). Regarding this theme, the systematic revision of literature and analysis show contrasting results (2) and evidence of low quality (3).…”

“…While many studies have been made dealing with the theme of sexual satisfaction and orgasm in males who were circumcised during infancy, the effects on the quality of sexual life, orgasm and sensitivity following circumcision performed in adulthood on patients with phimosis have not been fully clarified (2)(3). Regarding this theme, the systematic revision of literature and analysis show contrasting results (2) and evidence of low quality (3). Probably, this is due not only to a heterogeneity of the studies (3), but also the lack of objective evaluation, relative to the initial clinical conditions of the adult patients' penis prior to circumcision surgery.…”

“…Probably, this is due not only to a heterogeneity of the studies (3), but also the lack of objective evaluation, relative to the initial clinical conditions of the adult patients' penis prior to circumcision surgery. Furthermore, in the Systematic Reviews and Meta-analyses (2)(3)(4)(5), there is no mention as to whether the considered patients for analysis were circumcised for ritual, esthetic or medical reasons, the most common being sclero-atrophic lichen (6)(7)(8)(9)(10)(11), or if the data were mixed all together. Consequently, if we want to analyze the effects of the circumcision on the quality of sexual life and orgasm in male adults circumcised for medical reasons, we must ask ourselves whether the patients undergoing this intervention all start with the same clinical conditions.…”

175 Jahre Anästhesie und Narkose – Auf dem Weg zu einem „Menschenrecht auf Ohnmacht“

“…In der Vergangenheit wurde wiederholt postuliert, dass eine Zirkumzision zu psychologischen Folgeschäden und sexuellen Funktionsstörungen führen kann [112]. Eine aktuelle Metaanalyse zeichnet jedoch ein anderes Bild: Sexuelle Funktion, Empfindung, Befriedigung und Genuss werden nicht beeinträchtigt [75].…”