Advertisement

Effect of neonatal circumcision on penile neurologic sensation

      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • American Academy of Pediatrics
        Circumcision policy statement.
        Pediatrics. 1999; 103: 686-693
      1. American Academy of Family Physicians. 2004 (Available at: http://www.aafp.org/x1462.xml. Accessed October 7)
      2. American Urological Association: Circumcision policy statement. Available at: http://www.urologyhealth.org/search/index.cfm?topic=350&search=circumcision&se_archtype=and. Accessed October 7, 2004.

        • American Urological Association
        Circumcision—a continuing controversy. Lesson 21.
        Update Series. 1995; XIV: 170-175
        • Masters W.H.
        • Johnson V.E.
        The penis. Part 2, circumcision.
        in: Masters W.H. Johnson V.E. Human Sexual Response. Little Brown, Boston1966: 189-191
        • Fink K.S.
        • Carson C.C.
        • DeVellis R.F.
        Adult circumcision outcomes study.
        J Urol. 2002; 167: 2113-2116
        • Bleustein C.B.
        • Arezzo J.C.
        • Eckholdt H.
        • et al.
        The neuropathy of erectile dysfunction.
        Int J Impot Res. 2002; 14: 433-439
        • Derby C.A.
        • Araujo A.B.
        • Johannes C.B.
        • et al.
        Measurement of erectile dysfunction in population-based studies.
        Int J Impot Res. 2000; 12: 197-204
        • Rosen R.C.
        • Riley A.
        • Wagner G.
        • et al.
        The International Index of Erectile Function (IIEF).
        Urology. 1997; 49: 822-830
        • Gruener G.
        • Dyck P.J.
        Quantitative sensory testing.
        J Clin Neurophysiol. 1994; 11: 568-583
        • Neuman H.F.
        Vibratory sensitivity of the penis.
        Fertil Steril. 1970; 21: 791-793
        • Bell-Krotoski J.
        • Tomancik E.
        The repeatability of testing with Semmes-Weinstein monfilaments.
        J Hand Surg. 1987; 12: 155-161
        • Vileikyte L.
        • Hutchings G.
        • Hollis S.
        • et al.
        The tactile circumferential discriminator.
        Diabetes Care. 1997; 20: 623-626
        • Romanzi L.J.
        • Groutz A.
        • Feroz F.
        • et al.
        Evaluation of female external genitalia sensitivity to pressure/touch.
        Urology. 2001; 57: 1145-1150
        • Lefaucheur J.
        • Yiou R.
        • Colombel M.
        • et al.
        Relationship between penile thermal sensory threshold measurement and electrophysiologic tests to assess neurogenic impotence.
        Urology. 2001; 57: 306-309
        • Yarnitsky D.
        • Sprecher E.
        • Vardi Y.
        Penile thermal sensation.
        J Urol. 1996; 156: 391-393
        • Lefaucheur J.P.
        • Yiou R.
        • Salomon L.
        • et al.
        Assessment of penile small nerve fiber damage after transurethral resection of the prostate by measurement of penile thermal sensation.
        J Urol. 2000; 164: 1416-1419
        • Fink K.S.
        • Carson C.C.
        • DeVellis R.F.
        Adult circumcision outcomes study.
        J Urol. 2002; 167: 2113-2116
        • Collins S.
        • Upshaw J.
        • Rutchik S.
        • et al.
        Effects of circumcision on male sexual function.
        J Urol. 2002; 167: 2111-2112
        • Nehra A.
        • Moreland R.B.
        Neurologic erectile dysfunction.
        Urol Clin North Am. 2001; 28: 289-308
        • de Tejada I.S.
        • Goldstein I.
        Diabetic penile neuropathy.
        Urol Clin North Am. 1988; 15: 17-22
        • Bird S.J.
        • Hanno P.M.
        Bulbocavernosus reflex studies and autonomic testing in the diagnosis of erectile dysfunction.
        J Neurol Sci. 1998; 154: 8-13
        • Kellner B.
        • Stief G.C.
        • Hinrichs H.
        • et al.
        Computerized classification of corpus cavernosum electromyogram signals by the use of discriminant analysis and artificial neural networks to support diagnosis of erectile dysfunction.
        Urol Res. 2000; 28: 6-13
        • Vodusek D.B.
        • Ravnik-Oblak M.
        • Oblak C.
        Pudendal versus limb nerve electrophysiological abnormalities in diabetics with erectile dysfunction.
        Int J Impot Res. 1993; 5: 37-42
        • Sartucci F.
        • Piaggesi A.
        • Logi F.
        • et al.
        Impaired ascendant central pathways conduction in impotent diabetic subjects.
        Acta Neurol Scand. 1999; 99: 381-386
        • Neuman H.F.
        Vibratory sensitivity of the penis.
        Fertil Steril. 1970; 21: 791-793
        • Bleustein C.B.
        • Eckholdt H.
        • Arezzo J.C.
        • et al.
        Quantitative somatosensory testing of the penis.
        J Urol. 2003; 169: 2266-2269
        • Wilkes M.S.
        • Blum S.
        Current trends in routine newborn male circumcision in New York State.
        NY State J Med. 1990; 90: 231-232