Circumcision Doesn't Reduce Sexual Satisfaction And Performance, Says Study Of 4,500 Men

The randomised trial, carried out by researchers from Uganda and the USA, was undertaken because previous studies showed that the procedure -- which is now recommended as an efficient way to reduce HIV transmission - showed conflicting results.

"Previous studies have been problematic and shown contradictory results" points out co-author Professor Ronald H Gray from the Bloomberg School of Health at Johns Hopkins University, Baltimore, USA.

"Studies focusing on men circumcised in adulthood were highly selective, because there were medical indications for surgery, circumcised infants can't provide before and after comparisons and in most studies sample sizes were small and follow-up was short.

"This study, carried out as part of an HIV prevention initiative, enabled us to compare two groups of men with the same demographic profiles and levels of sexual satisfaction and performance at the start of the study."

The research team looked at 4,456 sexually experienced Ugandan men aged from 15 to 49 who did not have the HIV virus. 2,210 were randomised to receive circumcision and 2,246 had their circumcision delayed for 24 months.

They followed up both sets of men at six, 12 and 24 months and then compared the information on sexual desire, satisfaction and sexual performance for the circumcised men and the control group.

Their research showed that:

• 98.6 per cent of the circumcised men reported no problems in penetration, compared with 99.4 per cent of the control group.
• 99.4 per cent of the circumcised men reported no pain on intercourse, compared with 98.8 per cent of the control group.

Sexual satisfaction was more or less constant in the circumcision group -- 98.5 per cent on enrolment and 98.4 per cent after two years -- but rose slightly from 98 per cent to 99.9 per cent in the control group. This difference was not felt to be clinically significant.

At the six-month visit there was a small, but statistically significant, difference in problems with penetration and pain among the circumcised group, but this was temporary and was not reported at subsequent follow-up visits.

There was considerable consistency between the men in each group when it came to age, religion, marital status, education and number of sexual partners in the last year. The majority of the men were Catholic, married, had one sexual partner and were educated to primary school level.

"Our study clearly shows that being circumcised did not have an adverse effect on the men who underwent the procedure when we compared them with the men who had not yet received surgery" concludes Professor Gray.

"Other studies have already shown that being able to reassure men that the procedure won't affect sexual satisfaction or performance makes them much more likely to be circumcised."

"BJU International was very keen to publish this large-scale study as there has been a lot of conflicting evidence about the effects of circumcision" says the journal's Editor, Professor John Fitzpatrick from University College Dublin, Ireland.

"We believe that these findings are very important as they can be used to support public health messages that promote circumcision as an effective way of reducing HIV transmission."

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. Kigozi et al. BJU International. Volume 101, pp 65-70. January 2008.