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2017 ; 14
(4
): 601-612
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English Wikipedia
Medical Male Circumcision Is Associated With Improvements in Pain During
Intercourse and Sexual Satisfaction in Kenya
#MMPMID28364982
Nordstrom MP
; Westercamp N
; Jaoko W
; Okeyo T
; Bailey RC
J Sex Med
2017[Apr]; 14
(4
): 601-612
PMID28364982
show ga
BACKGROUND: Two cohort studies using data from randomized controlled trials in
Africa offer the best evidence to date on the effects of voluntary medical male
circumcision (VMMC) on male sexual function and satisfaction, suggesting no
significant impairments in sexual function or satisfaction and some improvements
in sexual function after male circumcision. AIM: To assess the effects of VMMC on
sexual function and satisfaction in a large population-based cohort of men
circumcised as adults and uncircumcised controls in Kenya. METHODS: Sexual
function and satisfaction of young (median age = 20 years) sexually active men
(1,509 newly circumcised men and 1,524 age-matched uncircumcised controls after
5% loss to follow-up) were assessed at baseline and 6, 12, 18, and 24 months,
with data collected in 2008 to 2012. Self-reported data on lack of sexual
interest or pleasure, difficulty getting or maintaining erections, orgasm
difficulties, premature ejaculation, pain during intercourse, and satisfaction
with sexual intercourse were analyzed with mixed-effect models to detect
differences between circumcised and uncircumcised men and changes over time.
OUTCOMES: Changes over time in sexual interest, desire and pleasure, erectile and
ejaculatory function, and pain during intercourse (dyspareunia) in circumcised
and uncircumcised men; group differences in time trends; satisfaction with sexual
performance; and enjoyment of sex before and after circumcision. RESULTS: Sexual
dysfunctions decreased in the two study groups from 17% to 54% at baseline to 11%
to 44% at 24 months (P < .001), except dyspareunia, which decreased only in
circumcised men (P < .001). Sexual satisfaction outcomes increased in the two
study groups from 34% to 82% at baseline to 66% to 93% at 24 months (P < .001),
with greater improvements in circumcised men (P < .001). On average, 97% of
circumcised men were satisfied with sexual intercourse and 92% rated sex as more
enjoyable or no different after circumcision compared with before circumcision.
CLINICAL TRANSLATION: Results are applicable to VMMC programs seeking to increase
the acceptability of male circumcision as part of comprehensive HIV prevention.
STRENGTHS AND LIMITATIONS: Large-scale population-based longitudinal data
restricted to sexually active individuals and adjusted for differences in
baseline levels of outcomes and potential confounders are used. The questionnaire
used, although not a standardized survey instrument, includes all major domains
of male sexual function and satisfaction used in the most common standardized
tools. CONCLUSIONS: Results are consistent with large cohort studies of VMMC
using data from randomized controlled trials and indicate that VMMC has no
significant detrimental effect or might have beneficial effects on male sexual
function and satisfaction for the great majority of men circumcised as adults.
Nordstrom MPC, Westercamp N, Jaoko W, et al. Medical Male Circumcision Is
Associated With Improvements in Pain During Intercourse and Sexual Satisfaction
in Kenya. J Sex Med 2017;14:601-612.
|*Patient Satisfaction
[MESH]
|*Pleasure
[MESH]
|Adult
[MESH]
|Circumcision, Male/*psychology/statistics & numerical data
[MESH]
|Cohort Studies
[MESH]
|HIV Infections/prevention & control
[MESH]
|Humans
[MESH]
|Kenya
[MESH]
|Male
[MESH]
|Orgasm
[MESH]
|Pain/*prevention & control
[MESH]
|Penile Erection
[MESH]
|Sexual Behavior/*statistics & numerical data
[MESH]
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