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Abstract：
BACKGROUND: Active debate concerns whether male circumcision (MC) affects sexual function, penile sensation, or sexual pleasure.
OBJECTIVE: To perform a systematic review examining the effect of MC on these parameters.
METHODS: PRISMA-compliant searches of PubMed, EMBASE, the Cochrane Library, and Google Scholar were performed, with \"circumcision\" used together with appropriate search terms. Articles meeting the inclusion criteria were rated for quality by the Scottish Intercollegiate Guidelines Network system.
METHODS: Evidence rated by quality.
RESULTS: Searches identified 46 publications containing original data, as well as 4 systematic reviews (2 with meta-analyses), plus 29 critiques of various studies and 15 author replies, which together comprised a total of 94 publications. There was overall consistency in conclusions arising from high- and moderate-quality survey data in randomized clinical trials, systematic reviews and meta-analyses, physiological studies, large longitudinal studies, and cohort studies in diverse populations. Those studies found MC has no or minimal adverse effect on sexual function, sensation, or pleasure, with some finding improvements. A consensus from physiological and histological studies was that the glans and underside of the shaft, not the foreskin, are involved in neurological pathways mediating erogenous sensation. In contrast to the higher quality evidence, data supporting adverse effects of MC on function, sensation, or pleasure were found to be of low quality, as explained in critiques of those studies.
CONCLUSIONS: The consensus of the highest quality literature is that MC has minimal or no adverse effect, and in some studies, it has benefits on sexual functions, sensation, satisfaction, and pleasure for males circumcised neonatally or in adulthood. Morris BJ, Krieger JN. The Contrasting Evidence Concerning the Effect of Male Circumcision on Sexual Function, Sensation, and Pleasure: A Systematic Review. Sex Med 2020;8:577-598.
OBJECTIVE: To perform a systematic review examining the effect of MC on these parameters.
METHODS: PRISMA-compliant searches of PubMed, EMBASE, the Cochrane Library, and Google Scholar were performed, with \"circumcision\" used together with appropriate search terms. Articles meeting the inclusion criteria were rated for quality by the Scottish Intercollegiate Guidelines Network system.
METHODS: Evidence rated by quality.
RESULTS: Searches identified 46 publications containing original data, as well as 4 systematic reviews (2 with meta-analyses), plus 29 critiques of various studies and 15 author replies, which together comprised a total of 94 publications. There was overall consistency in conclusions arising from high- and moderate-quality survey data in randomized clinical trials, systematic reviews and meta-analyses, physiological studies, large longitudinal studies, and cohort studies in diverse populations. Those studies found MC has no or minimal adverse effect on sexual function, sensation, or pleasure, with some finding improvements. A consensus from physiological and histological studies was that the glans and underside of the shaft, not the foreskin, are involved in neurological pathways mediating erogenous sensation. In contrast to the higher quality evidence, data supporting adverse effects of MC on function, sensation, or pleasure were found to be of low quality, as explained in critiques of those studies.
CONCLUSIONS: The consensus of the highest quality literature is that MC has minimal or no adverse effect, and in some studies, it has benefits on sexual functions, sensation, satisfaction, and pleasure for males circumcised neonatally or in adulthood. Morris BJ, Krieger JN. The Contrasting Evidence Concerning the Effect of Male Circumcision on Sexual Function, Sensation, and Pleasure: A Systematic Review. Sex Med 2020;8:577-598.
摘要：
背景：关于男性包皮环切术（MC）是否会影响性功能的争论很活跃，阴茎感觉,或者性快感。
目的：进行系统评价，检查MC对这些参数的影响。
方法：符合PRISMA标准的PubMed搜索，EMBASE,Cochrane图书馆,谷歌学者被表演了，“包皮环切术”与适当的搜索条件一起使用。苏格兰大学间指南网络系统对符合入选标准的文章进行了质量评级。
方法：按质量评定的证据。
结果：搜索确定了46种包含原始数据的出版物，以及4个系统评价(2个有荟萃分析)，加上29个对各种研究的批评和15个作者的回复，共包括94种出版物。随机临床试验中高质量和中等质量调查数据得出的结论总体上是一致的，系统评价和荟萃分析，生理研究,大型纵向研究，和不同人群的队列研究。这些研究发现MC对性功能没有或有最小的不良影响，感觉，或快乐，有一些改进。生理和组织学研究的共识是，龟头和轴的下侧，不是包皮,参与介导性感感觉的神经通路。与更高质量的证据相比，支持MC对功能的不利影响的数据，感觉，或者快乐被发现是低质量的，正如对这些研究的批评所解释的那样。
结论：最高质量文献的共识是MC具有最小或没有副作用，在一些研究中，它对性功能有好处，感觉，满意,和快乐的男性割礼新生儿或成年。MorrisBJ,KriegerJN.男性包皮环切术对性功能影响的对比证据,感觉，和快乐：系统回顾。性医学2020；8：577-598。
目的：进行系统评价，检查MC对这些参数的影响。
方法：符合PRISMA标准的PubMed搜索，EMBASE,Cochrane图书馆,谷歌学者被表演了，“包皮环切术”与适当的搜索条件一起使用。苏格兰大学间指南网络系统对符合入选标准的文章进行了质量评级。
方法：按质量评定的证据。
结果：搜索确定了46种包含原始数据的出版物，以及4个系统评价(2个有荟萃分析)，加上29个对各种研究的批评和15个作者的回复，共包括94种出版物。随机临床试验中高质量和中等质量调查数据得出的结论总体上是一致的，系统评价和荟萃分析，生理研究,大型纵向研究，和不同人群的队列研究。这些研究发现MC对性功能没有或有最小的不良影响，感觉，或快乐，有一些改进。生理和组织学研究的共识是，龟头和轴的下侧，不是包皮,参与介导性感感觉的神经通路。与更高质量的证据相比，支持MC对功能的不利影响的数据，感觉，或者快乐被发现是低质量的，正如对这些研究的批评所解释的那样。
结论：最高质量文献的共识是MC具有最小或没有副作用，在一些研究中，它对性功能有好处，感觉，满意,和快乐的男性割礼新生儿或成年。MorrisBJ,KriegerJN.男性包皮环切术对性功能影响的对比证据,感觉，和快乐：系统回顾。性医学2020；8：577-598。
