John Dean's Clinical review of the Examination of patients with
sexual problems advises doctors that "The foreskin, if present, should be
retracted, and any pain, restriction, or scarring noted".[1] But why
should the foreskin be absent?
The absence of the foreskin due to circumcision is found in 21% of
British men.[2] It is surprising that Dean does not comment further on
the significance of this since at least three published case reports show
impotence secondary to male circumcision.[3-5]
If circumcision is not recorded as a significant feature in the
history of patients with sexual dysfunction, how could it's potential role
in the cause of disease ever be recognised?
References
1. Dean J. ABC of sexual health: Examination of patients with sexual
problems. BMJ 1998;317:1641-1643.
2. Johnson AM, Wadsworth J, Wellings K, Field J, Bradshaw S. Sexual
attitudes and lifestyles. Blackwell Scientific, Oxford, 1994.
3. Stinson JM. Impotence and adult circumcision. J Nat Med Assoc
1973; 65:161.
4. Palmer JM, Link D. Impotence following anesthesia for elective
circumcision. JAMA 1979; 241:2635-6.
5. Glover E. The `screening' function of traumatic memories. Int J
Psychoanal 1929; 10:90-93.
Rapid Response:
Absence of foreskin is significant too
John Dean's Clinical review of the Examination of patients with
sexual problems advises doctors that "The foreskin, if present, should be
retracted, and any pain, restriction, or scarring noted".[1] But why
should the foreskin be absent?
The absence of the foreskin due to circumcision is found in 21% of
British men.[2] It is surprising that Dean does not comment further on
the significance of this since at least three published case reports show
impotence secondary to male circumcision.[3-5]
If circumcision is not recorded as a significant feature in the
history of patients with sexual dysfunction, how could it's potential role
in the cause of disease ever be recognised?
References
1. Dean J. ABC of sexual health: Examination of patients with sexual
problems. BMJ 1998;317:1641-1643.
2. Johnson AM, Wadsworth J, Wellings K, Field J, Bradshaw S. Sexual
attitudes and lifestyles. Blackwell Scientific, Oxford, 1994.
3. Stinson JM. Impotence and adult circumcision. J Nat Med Assoc
1973; 65:161.
4. Palmer JM, Link D. Impotence following anesthesia for elective
circumcision. JAMA 1979; 241:2635-6.
5. Glover E. The `screening' function of traumatic memories. Int J
Psychoanal 1929; 10:90-93.
Competing interests: No competing interests