title: Free nerve ending density on skin extracted by circumcision and its relation to premature ejaculation.
abstract: Many studies have shown that skin tissue extracted by circumcision can  cause differences in sexual function, especially at the time of ejaculation.  Sensitivity changes in penile skin and sexual satisfaction deriving from  circumcision starting from premature ejaculation (PE) are discussed.  Furthermore, most of these studies rely on questionnaires. Extracted free  nerve endings (FNE) on the foreskin, which can detect temperature, mechanical  stimuli (touch, pressure, stretch) or pain (nociception), have not been  researched. Our aim is to determine FNEs in foreskin and the affects on sexual  function, especially PE. This prospective study was done on adults who  voluntarily applied to be circumcised between September 2010 and October 2011.  The ejaculation latency times (ELT) before circumcision have been assessed,  and a PE diagnostic tool (PEDT) form was filled out by the urologist according  to the answers given by the volunteers. The proximal and distal ends of the  foreskin were marked before circumcision, and the extracted foreskin was sent  to the pathology department to determine FNEs. Twenty volunteers (average age  21.25 ± 0.44 years) were included in the study. The average ELT was  103.55 ± 68.39 seconds, and the average PE score was 4.35 ±  3.13. Proximal, middle, and distal tip nerve densities were compared. Proximal  and distal (P = .003) and proximal and middle (P = .011)  segments differed from each other, whereas middle and distal were similar  (P = .119). There were not any correlations between PEDT scores and  total nerve endings number (r = .018, P = .942). Also there  were not any correlations between mean ELT and PEDT scores (r = .054,  P = .822). The tissue extracted by circumcision has intensive FNEs,  yet FNE intensity has no relation to PE.
authors.affiliation: Department of Urology, Corlu Military Hospital, Corlu, Tekirdag, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Malkoc
authors.forename: Ferhat
authors.initials: F
authors.lastname: Ates
authors.forename: Hakan
authors.initials: H
authors.lastname: Tekeli
authors.forename: Bulent
authors.initials: B
authors.lastname: Kurt
authors.forename: Turker
authors.initials: T
authors.lastname: Turker
authors.forename: Seref
authors.initials: S
authors.lastname: Basal
mesh_terms: D002944:Circumcision, Male; D003075:Coitus; D004542:Ejaculation / Q000502:physiology; D052816:Foreskin / Q000294:innervation*; D006801:Humans; D008297:Male; D009411:Nerve Endings; D010549:Personal Satisfaction; D061686:Premature Ejaculation / Q000503:physiopathology*; D011446:Prospective Studies; D055815:Young Adult