Category Archives: Circumcision and penile sensitivity

Intravaginal ejaculatory latency time and circumcision

Dr. Reed,  Does circumcision affect penile sensitivity. Ed

Dear Ed,

Undoubtedly you will hear from groups who disfavor circumcision that it effects sensitivity.  However, if you use the concept of how long a man can last during sex, or intravaginal ejaculatory latency time (IELT), several studies show no difference.  There is more variability in the performance of one adult male, uncircumcised or circumcised with repeated coitus than between average scores of circumcised vs. uncircumcised men.

The effect of circumcision on ejaculation was researched by several authors. Some of them found that circumcision was independently associated with PE. Tang and Khoo and O’Hara and O’Hara.reported that circumcised males were more likely to have PE than the uncircumcised males. According to these studies, the reasons for PE in circumcised males may be hyperstimulation of the nerves of the glandis corona or thickening/keratinization of the glans penis. Some others obtained contrary results to the aforementioned studies. Namavar et al. reported that IELT significantly increased from 64.25 s before surgery to 731.49 s after surgery, and they recommended that circumcision in adults is an effective modality in selective patients of PE. Senkul et al. found that circumcision improves IELT, but it has no effect on the scope of the questions in brief male sexual function Iinventory (BMSFI). Cortes-Gonzalez et al. observed in a Hispanic population that PE diminished from 31.8 to 13.6% after circumcision. In their study on 500 males, Waldinger et al. reported that the mean IELT is 6 min in uncircumcised males and 6.7 min in circumcised males, which is statistically not significant. In the present study, we used IELT in conjunction with a newly validated questionnaire and found that circumcision improved both ejaculation time and PEDT scores 3 months after circumcision.

Some authors could not find any difference between circumcised and uncircumcised males and they advocated that male circumcision has no deleterious effect on female sexual satisfaction. Son et al. did a research with 3980 cases by applying the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) questionnaire over the internet and found 18.3% PE percentage with no difference between circumcised and uncircumcised males. Kim et al. reached the conclusion that circumcision does not have any effect on ejaculation time and BMSFI is not enough to review PE on its own in their study done on 255 circumcised and 118 uncircumcised patients.

Many factors, including geographic factors, ethnicity, lifestyle, sociocultural phobias, psychiatric (such as depression or anxiety) or other diseases (such as diabetes, prostate diseases and erectile dysfunction), may affect ejaculatory function. Another important factor is the age at circumcision. Cuceloglu et al.] revealed that circumcision at ≥7 years of age was associated with an increase in the risk of PE compared to circumcision at <7 years of age. On the other hand, Aydur et al. reported that this difference was not at the level of dysfunction of sexual avoidance.

In our study, when IELT limit was taken as 1 min, only 1 case had suspected PE according to PEDT. Even though a part of the volunteers we included in our study had an IELT of less than 60 s, they did not complain of PE. The lack of correlation between IELT and PEDT showed once again that the definition of PE should not be entirely based on IELT. Therefore, the combination of IELT and PEDT could provide a better understanding of ejaculatory functions. Again, we are reminded about the importance of using the criteria of the stress and discomfort that PE causes for diagnosis.

The most important limitation of this study is that the number of patients is too small. In our country, circumcision is a widespread procedure in childhood and is very rare in adulthood. Another important issue in our study is the inexistence of a control group with a definite PE problem.