Elsevier

Urology

Volume 65, Issue 4, April 2005, Pages 773-777
Urology

Adult urology
Effect of neonatal circumcision on penile neurologic sensation

https://doi.org/10.1016/j.urology.2004.11.007Get rights and content

Abstract

Objectives

To evaluate penile sensory thresholds in neonatally circumcised and uncircumcised men.

Methods

We evaluated 125 patients, 62 uncircumcised men and 63 neonatally circumcised men. All patients completed the Erectile Function domain of the International Index of Erectile Function questionnaire. Of the 125 patients, 29 (International Index of Erectile Function score of between 25 and 30) were placed in the functional group, and 96 in the dysfunctional group. The patients were tested on the dorsal midline glans of the penis (foreskin retracted). Quantitative somatosensory testing was performed and included vibration, pressure, spatial perception, and warm and cold thermal thresholds.

Results

In the functional group, t-test analysis demonstrated a significant (P <0.001) difference, with worse vibration and better pressure sensation for uncircumcised men. When controlling for age, hypertension, and diabetes, all t-test significance was lost. In the dysfunctional group, circumcised men (49 ± 16 years) were significantly younger (P <0.01) than uncircumcised men (56 ± 13 years). For the dysfunctional group, t-test analysis also demonstrated worse vibration sensation for uncircumcised men (P <0.01). Again, when controlling for age, hypertension, and diabetes, all t-test significance was lost.

Conclusions

We present a comparative analysis of uncircumcised and circumcised men using a battery of quantitative somatosensory tests that evaluate the spectrum of small to large axon nerve fiber function. Our study controlled for factors, including age, erectile function status, diabetes, and hypertension, that have been shown to alter neurologic testing. In our study of neonatally circumcised men, we demonstrated that circumcision status does not significantly alter the quantitative somatosensory testing results at the glans penis.

Section snippets

Material and methods

The institutional review board for the protection of human subjects in research at Montefiore Medical Center approved all procedures. Any person unable to understand English was excluded from participation. After each subject provided informed consent, a medical history was recorded with a focus on any history of diabetes or hypertension. These procedures have been described previously 7 and are repeated briefly below.

A total of 125 patients were recruited from the Department of Urology in 2001

Sample

In the cohort evaluated, 29 subjects (23%) scored within the normal range and constituted the normal group. In the normal group, the uncircumcised men were 43 ± 14 years old and the circumcised men were 51 ± 16 years old. The other 96 subjects (77%) had evidence of ED by history (dysfunctional group). In the ED group, the uncircumcised men were 56 ± 13 years old, and the circumcised men were 49 ± 16 years old. In the overall cohort of 125 patients evaluated, 62 (50%) were uncircumcised and 63

Comment

Controversy surrounding circumcision’s effect on erectile function and penile sensitivity continues. A recent article by Fink et al., 18 using multiple questionnaires, demonstrated that adult circumcision appeared to result in worsened erectile function, decreased penile sensitivity (P = 0.08), no change in sexual activity, and improved satisfaction. Another survey study by Collins et al. 19 evaluated men before and after circumcision with the Brief Male Sexual Function Inventory and found no

Acknowledgment

To Physitemp Instruments, Clifton, NJ for the use of their Physitemp NTE-2A Thermal Sensitivity Tester.

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    A. Melman and C. Bleustein are owners of Neurotest, LLC.

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