Malkoc Ercan, Ates Ferhat, Tekeli Hakan, Kurt Bulent, Turker Turker, Basal Seref
Department of Urology, Corlu Military Hospital, Corlu, Tekirdag, Turkey.
J Androl. 2012 Nov-Dec;33(6):1263-7. doi: 10.2164/jandrol.112.016709. Epub 2012 May 17.
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.
许多研究表明，包皮环切术切除的皮肤组织会导致性功能差异，尤其是在射精时。本文讨论了从早泄（PE）开始，包皮环切术引起的阴茎皮肤敏感性变化和性满意度。此外，这些研究大多依赖问卷调查。包皮上提取的游离神经末梢（FNE），可检测温度、机械刺激（触摸、压力、拉伸）或疼痛（伤害感受），尚未得到研究。我们的目的是确定包皮中的游离神经末梢及其对性功能，尤其是早泄的影响。这项前瞻性研究针对的是2010年9月至2011年10月期间自愿申请包皮环切术的成年人。评估了包皮环切术前的射精潜伏期（ELT），泌尿外科医生根据志愿者的回答填写早泄诊断工具（PEDT）表格。包皮环切术前标记包皮的近端和远端，将切除的包皮送至病理科以确定游离神经末梢。20名志愿者（平均年龄21.25±0.44岁）纳入研究。平均射精潜伏期为103.55±68.39秒，平均早泄评分为4.35±3.13。比较了近端、中间和远端的神经密度。近端与远端（P = 0.003）以及近端与中间（P = 0.011）节段相互不同，而中间与远端相似（P = 0.119）。PEDT评分与神经末梢总数之间无相关性（r = 0.018，P = 0.942）。平均射精潜伏期与PEDT评分之间也无相关性（r = 0.054，P = 0.822）。包皮环切术切除的组织有密集的游离神经末梢，但游离神经末梢强度与早泄无关。
