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Adult male circumcision: effects on sexual function and sexual satisfaction
Presented by John N. Krieger, United States.
J.N. Krieger1, S.D. Mehta2, R.C. Bailey2, K. Agot3, J.O. Ndinya-Achola4, C. Parker5, N. Pugh5, G.A. Magoha6, S. Moses7
1University of Washington, Urology, Seattle, United States, 2University of Illinois Chicago School of Public Health, Epidemiology, Chicago, United States, 3UNIM Project, Kisumu, Kenya, 4University of Nairobi, Medical Microbiology, Nairobi, Kenya, 5RTI International, Research Triangle Park, United States, 6University of Nairobi, Surgery, Nairobi, Kenya, 7University of Manitoba, Community Health Sciences and Medicine, Winnipeg, Canada
Background: Male circumcision is being promoted in some settings for HIV prevention and other health benefits. However, there is concern that circumcision may reduce sexual pleasure and function.
Methods: We evaluated sexual function and pleasure among men aged 18-24 enrolled in a randomized, controlled trial of adult male circumcision to prevent HIV infection in Kisumu, Kenya. Participants were randomized 1:1 to circumcision or delayed circumcision (the control group). At 1, 3, 6, 12, 18 and 24 months, participants underwent detailed evaluations. This analysis compares sexual function over time between circumcised and uncircumcised men, and assesses sexual satisfaction and pleasure over time within the circumcised group.
Results: Between February 2002 and September 2005, 2,784 participants were randomized. One hundred participants were excluded from this analysis because they crossed-over, were not circumcised within 30 days of randomization, did not complete the baseline interview, or were outside the age range. For the circumcision and control groups, respectively, report of any sexual dysfunction decreased from 23.6% and 25.9% at baseline to 6.2% and 5.8% at 24 months. In generalized estimating equation analyses, circumcision status was not associated with any sexual dysfunction, or with specific sexual dysfunctions (premature ejaculation, pain during intercourse, erectile dysfunction, inability to orgasm, or lack of pleasure during intercourse) at follow-up visits. Compared to before they were circumcised, 64.0% of circumcised men available at 24 months reported their penis was “much more sensitive,” and 54.5% rated their ease of reaching orgasm as “much more”.
Conclusions: There were no differences in sexual function between circumcised and uncircumcised men. Circumcised men were generally satisfied with their circumcision and many reported increased penile sensitivity and enhanced ease of reaching orgasm. These data suggest that integration of male circumcision into programs to reduce HIV risk will not adversely effect male sexual function.
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