Wellness & Fitness

Study: Circumcision reduces penile injuries

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A nurse carries out voluntary medical male circumcision in Nakuru last November. PHOTO | SULEIMAN MBATIAH | NMG

Circumcised men are less susceptible to injuries to their penile during intercourse, including abrasion, and cuts, a new study showed.

The research studied the prevalence in self-reported penile coital injuries among young newly circumcised and uncircumcised men in western Kenya aged between 18 and 24.

“Recent research in men participating in the Kenya randomised control trials has shown that penile coital injuries are more commonly reported among uncircumcised men and may be an important non-sexual transmitted illness (STIs) cause of genital ulcer disease and increase the risk of Neisseria gonorrhoea and HIV,” the researchers said in the study published last week in the scientific journal, PLOS ONE.

The researchers included Nelli Westercamp, Supriya D. Mehta, Walter Jaoko, Timothy A. Okeyo and Robert C. Bailey. To increase the understanding of the prevalence of penile coital injuries and the potential effect on sexual satisfaction in a more general population, the researchers picked on three types of self-reported penile coital injuries in a community-based cohort of newly circumcised and uncircumcised men in Nyanza Province.

These included men in urban areas of Kisumu East and two rural areas of Nyando and Kisumu West sub-counties.

Between November 2008 and April 2010, 3,186 participants were enrolled into a circumcision group involving 1,588 men and the rest as age-matched controls. Of the total, 66 per cent or 2,106 participants were sexually active at the beginning of the study.

Of this, 53 per cent reported penile injuries including scratches at 44 per cent, penile pain and soreness at 32 per cent, penile bleeding at 22 per cent while others reported cuts or abrasions.

These injuries, the researchers found, were “significantly associated with lower levels of sexual satisfaction in longitudinal analyses”.

“Other significant risk factors included increasing age, history of sexually transmitted illnesses and genital sores,” they said. “Multiple sex partners was also a factor for coital injuries while condom use was protective.” The researchers concluded that improving sexual experience through the removal of a potential source of sexual discomfort may resonate with many men targeted for circumcision services.

Compared to men not reporting sores, a higher proportion of men with genital sores who were seeking circumcision, had only primary education, were employed, married, had multiple partners in the past six months, had unprotected sex, preferred dry sex, and reported STIs in the past six months.

Following circumcision, men reporting genital sores declined from 11 per cent to two per cent at 24-months.

According to Mr Bailey, the study found that men reporting penile coital injuries were more likely to seek voluntary medical male circumcision services and observed a significant decline in coital injuries following circumcision.

“The role of penile coital injuries in sexual satisfaction, HIV, herpes simplex virus -2, and as a motivator for seeking circumcision services should be explored further.”

Mr Bailey said one possible foreskin-associated HIV risk factor that is often mentioned is the perception that the foreskin is comparatively fragile and prone to injury during intercourse.
“That has not received attention in empirical research,” he said.

Mr Bailey said one difficulty in determining the role of intercourse-associated mechanical injury to the penis in HIV infection is a lack of consistent terminology or operational assessment.

“When discussed, mechanical penile injuries are often referred to as minor epithelial disruptions, penile trauma, traumatic lesions, or most recently as penile coital injuries, clarifying an integral sexual component,” he said.

The study was funded by a Bill and Melinda Gates Foundation grant to support the Male Circumcision Consortium.

The researchers represent the US-based Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Department of Medical Microbiology, University of Nairobi, Nyanza Reproductive Health Society, Kisumu.