Shabanzadeh Daniel Mønsted, Düring Signe, Frimodt-Møller Cai
Dan Med J. 2016 Jul;63(7).
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.
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).
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.
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.
在过去几年中，关于男性非医疗性包皮环切术的争论愈演愈烈。本系统评价的目的是确定包皮环切术、医学指征或包皮环切术时的年龄是否会对男性的性功能认知产生影响。
在MEDLINE和Embase数据库中进行系统检索。纳入的研究比较了接受包皮环切术和未接受包皮环切术男性的长期性功能、包皮环切术前和术后的性功能，或比较了不同年龄进行包皮环切术的情况。根据证据水平（A-D级）对研究质量进行评估。
数据库检索和手工检索共获得3677条记录。38项研究符合纳入标准，其中包括两项随机试验。总体而言，接受包皮环切术的男性在性功能方面唯一确定的差异是早泄减少和阴茎敏感度增加（A级-B级）。非医疗性包皮环切术后，未报告性功能较差（A级-B级）。医疗性包皮环切术后，大多数结果相当（B级）；然而，性高潮困难增加（C级），勃起功能障碍的报告不一致（D级）。与成年后进行包皮环切术相比，幼年时进行包皮环切术似乎导致的性功能障碍更少。
本系统评价的结果无法支持包皮环切术后男性性功能较差的假设。然而，需要对医疗性包皮环切术和包皮环切术年龄进行进一步研究。
