[Male circumcision is not associated with an increased prevalence of erectile dysfunction: results of the Cottbus...

There are conflicting data regarding the significance of the presence of the male prepuce or circumcision on erectile function and sexual satisfaction in men.

A total of 10,000 men selected according to the age distribution of the city of Cottbus (Brandenburg, Germany) were provided with a questionnaire comprised of 35 items integrating the International Index of Erectile Function (IIEF-6) and further questions on sexual quality of life, comorbidities and previous surgical treatment. Of the men who completed the questionnaire 2,499 were living in a partnership and formed the study group for this survey. Based on the IIEF-6, two study endpoints (SEP) were defined (point values ≤ 25/SEP1 and ≤ 21/SEP2). By multivariable logistic regression analysis the independent influence of previous circumcision on both endpoints was assessed. Furthermore, a correlation between sexual satisfaction of men and circumcision was also analyzed.

Of the study group167 men had undergone circumcision (6.7 %). Erectile dysfunction (ED) was present in 40.1 % of men based on SEP1 (minor to severe ED) and in 27.8 % based on SEP2 (moderate to severe ED). Based on SEP1 as well as SEP2 age, history of smoking, hypertension, diabetes, chronic ischemic heart disease, peripheral arterial obstructive disease, cirrhosis of the liver and history of pelvic surgery were found to have an independent influence on the presence of ED. A status after circumcision did not show an independent influence on either study endpoints (SEP1: OR 1.36, p=0.174; SEP2: OR 1.42, p=0.175). Furthermore, there was no significant correlation between sexual satisfaction of men and a history of circumcision.

Based on the present study which represents the largest survey worldwide on male ED using the IIEF as a validated instrument, it could not be confirmed that the prevalence of ED is increased in men following circumcision. Sexual satisfaction of men in this study was independent of the presence of the prepuce.