The inclusion criteria were met by 36 studies, which reported data for 40,473 men, including 19,542 not circumcised and 20,931 circumcised. Just under half of those circumcised had had the procedure carried out in infancy. Over half the studies had collected data on premature ejaculation, erectile dysfunction, or sexual satisfaction or pleasure, while around a quarter had collected information on time to ejaculation, pain during sex, orgasm difficulties or sensitivity.
The research is discussed by study. The 36 studies only included two randomised controlled trials (RCTs) – though this is not especially surprising as most adult men would not volunteer to be randomly assigned to be circumcised or not, unless there was a pressing health reason to do so.
One RCT was from Kenya, it including included 2,784 men, used a behavioural questionnaire to examine sexual performance or satisfaction between those randomised to be circumcised and those not, and found no significant differences between the groups. The second, from Uganda, included around 4,500 men and again found no differences in sexual performance or satisfaction between those randomised to be circumcised and not.
In observational studies, a US Health and Social Life Survey of almost 1,500 men found that erectile dysfunction was more common among uncircumcised men, while an Australian telephone survey found reports of fewer sexual difficulties among circumcised men.
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