The effect of male circumcision on sexual satisfaction and function, results from a randomized trial of male circumcision for human immunodeficiency virus prevention, Rakai, Uganda

OBJECTIVE: To investigate the relationship between adult male circumcision and sexual satisfaction and function in men, as observational studies on the effect of adult male circumcision on sexual satisfaction show conflicting results. SUBJECTS AND METHODS: We investigated self-reported sexual satisfaction and function among men enrolled in a randomized trial of male circumcision for human immunodeficiency virus (HIV) prevention conducted in Rakai, Uganda. In all, 4456 sexually experienced HIV-negative males aged 15-49 years were enrolled; 2210 were randomized to receive immediate circumcision (intervention arm) and 2246 to circumcision delayed for 24 months (control arm). Men were followed up at 6, 12 and 24 months, and information on sexual desire, satisfaction and erectile dysfunction was collected. These variables were compared between the study arms and over time within the study arms, using chi-square or Fisher's exact tests. The trial registration number is NCT00425984. RESULTS: There were no differences between the study arms at enrolment and problems with sexual satisfaction and function were reported by <2% of participants in both study arms at all time points. At 6 months, no difficulty with penetration was reported by 98.6% of circumcised men and 99.4% of controls (P = 0.02), and no pain on intercourse was reported by 99.4% circumcised and 98.8% of uncircumcised men (P = 0.05). There were no differences between the study arms in penetration or dyspareunia at later visits. Sexual satisfaction increased from 98.0% at enrolment to 99.9% at 2 years among the controls (P < 0.001), but there was no trend in satisfaction among circumcised men (enrolment 98.5%, 2 years 98.4%, P = 0.8). CONCLUSION: Adult male circumcision does not adversely affect sexual satisfaction or clinically significant function in men.