割除包皮并不会影响阴茎的敏感性


  2003 年4月30 日(芝加哥)- 根据一项新的研究结果,割除包皮和未割除包皮者的阴茎敏感性并不会受到影响。
  
  纽约Albert Einstein学院泌尿学科的Clifford B. Bleustein博士表示,关于割除包皮者的阴茎敏感性增加还是减少,仍有许多争论。我们设法利用科学方式回答这个问题。
  
  为了评估割除包皮后阴茎的作用,研究员测试了36名已割除包皮及43名未割除包皮的男性阴茎头部背中线的大小轴突神经纤维的振动(生物振动阈测量仪)、压力(Semmes-Weinstein 单纤维丝)及空间的感知能力(触觉的周围辨器),和温暖和冷的热量阈值(Physitemp NTE-2),在未割除包皮的男性中,将包皮缩回以进行测试。
  
  Bleustein博士于昨天在美国泌尿学协会的年会上提出这项研究结果。在测试之后,所有患者均完成了国际勃起功能指标(IIEF)的勃起功能调查表,利用不同的统计评估及年龄、糖尿病和高血压因素分析二者关系。
  
  最初,未割除包皮者的温暖热量阈值感觉(P = .048)和振动的感觉(P = 01)较差,但是,当进行年龄、高血压,和糖尿病因素的调整后,便失去了统计上的差异。
  
  研究员表示,我们证实了,已割除包皮和未割除包皮男性间的阴茎感觉并无差异,而且有无勃起不能的患者之振动、空间感受性、压力、温和冷的热量阈值,也无重大差异。
  
  他们也估计了割除包皮的流行率,并且发现白人男性比西班牙男性进行割礼的比例多出25倍,而黑人则较西班牙男性高了8倍。
  
  根据Bleustein表示,医疗机构通常采取较为中立的立场,不干涉个人是否进行包皮割除。他告诉Medscape,这是因为手术具有风险,但是在第一年内也有潜在的优点,虽然这些优点仍有所争议。
  
  人们利用许多理由反对或赞成割除包皮,但实际上,少有严谨的科学资料可以佐证。
  
  Bleustein表示,他并不确定割除包皮的优缺点为何,但是他表示对于有的民族将割礼视为一种风俗,却不清楚之间的差异而感到惊讶。
  
  根据美国Case Western Reserve 大学Mamdouh Mohamed博士的论点,男性不愿意割除包皮的主要论据是因为他们认为割除包皮可能会减少阴茎的敏感性-但这项论点与本研究结果背道而驰。赞成割除包皮的主要论据是,割除包皮可以防止阴茎癌。

Circumcision Does Not Influenc

By Emma Hitt, PhD
Medscape Medical News

April 30, 2003 (Chicago) — No significant quantitative differences in penile sensation exist between circumcised and uncircumcised men, according to the findings of a new study.

"There's been a lot of controversy about whether or not circumcised men have greater or lesser sensitivity," said Clifford B. Bleustein, MD, with the Department of Urology at Albert Einstein College of Medicine in the Bronx, New York, "and this is a scientific way of trying to answer that question," he told Medscape.

To evaluate the effects of circumcision, the researchers tested 36 circumcised and 43 uncircumcised men for level of vibration (Biothesiometer), pressure (Semmes-Weinstein monofilaments), spatial perception (Tactile Circumferential Discriminator), and warm and cold thermal thresholds (Physitemp NTE-2) in the large and small axon nerve fibers in the dorsal midline glans of the penis. In uncircumcised males, the foreskin was retracted for testing.

Dr. Bleustein presented the findings here yesterday at the annual meeting of the American Urological Association.

After testing, all patients completed the erectile function domain of the International Index of Erectile Function (IIEF) questionnaire. Bivariate relationships were assessed using various statistical assessments and the factors of age, diabetes, and hypertension were taken into account.

Initially, worse sensation was demonstrated in uncircumcised men for warm thermal thresholds (P = .048) and for vibration (P = .01). However, significance for these measures was lost when they controlled for age, hypertension, and diabetes.

"We demonstrated that there are no significant differences in penile sensation between circumcised and uncircumcised men with respect to vibration, spatial perception, pressure, warm and cold thermal thresholds in both patients with and without erectile dysfunction," the researchers conclude.

They also assessed prevalence of circumcision and found that white men are 25 times and African American men 8 times more likely to be circumcised than Hispanic men.

According to Dr. Bleustein, medical organizations generally take a relatively neutral stance on whether an individual should undergo circumcision or not. "That's because there are risks to the operation, but there are also some potential benefits within the first year, although these benefits are somewhat controversial," he told Medscape.

"People use many reasons for or against circumcision to try to justify doing the operation or to dissuade people from doing it," he added. "But in fact, there is a paucity of very rigorous scientific information on it," he said.

Dr. Bleustein noted that he was not sure what he would find when it came to the effects of circumcision, but he said he was surprised that there was such a race predilection for circumcision and was unclear about why such a difference might exist.

According to Mamdouh Mohamed, MD, a urologist at Case Western Reserve University in Cleveland, Ohio, the main argument he sees used among patients for not having a circumcision is that it may decrease sensitivity — contrary to these study findings — whereas the main argument used for having a circumcision is to prevent penile carcinoma.

AUA 98th Annual Meeting: Abstract 1260. Presented April 29, 2003.

Reviewed by Gary D. Vogin, MD

    
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