title: Male circumcision does not result in inferior perceived male sexual function - a systematic review.
abstract: BACKGROUND
  The debate on non-medical male circumcision has gaining momentum during the past few years. The objective of this systematic review was to determine if circumcision, medical indication or age at circumcision had an impact on perceived sexual function in males.
  
  
  METHODS
  Systematic searches were performed in MEDLINE and Embase. The included studies compared long-term sexual function in circumcised and non-circumcised males, before and after circumcision, or compared different ages at circumcision. The quality of the studies was assessed according to the level of evidence (Grade A-D).
  
  
  RESULTS
  Database and hand searches yielded 3,677 records. Inclusion criteria were fulfilled in 38 studies including two randomised trials. Overall, the only identified differences in sexual function in circumcised males were decreased premature ejaculation and increased penile sensitivity (Grade A-B). Following non-medical circumcision, no inferior sexual function was reported (A-B). Following medical circumcision, most outcomes were comparable (B); however, problems in obtaining an orgasm were increased (C) and erectile dysfunction was reported with inconsistency (D). A younger age at circumcision seemed to cause less sexual dysfunction than circumcision later in life.
  
  
  CONCLUSIONS
  The hypothesis of inferior male sexual function following circumcision could not be supported by the findings of this systematic review. However, further studies on medical circumcision and age at circumcision are required.
authors.affiliation: daniel.moensted.shabanzadeh.01@regionh.dk.
authors.forename: Daniel Mønsted
authors.initials: DM
authors.lastname: Shabanzadeh
authors.forename: Signe
authors.initials: S
authors.lastname: Düring
authors.forename: Cai
authors.initials: C
authors.lastname: Frimodt-Møller
mesh_terms: D002944:Circumcision, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D010465:Perception; D012725:Sexual Behavior / Q000502:physiology*