Background: As medical male circumcision services are scaled up in sub-Saharan Africa, assessment of circumcision's impact on sexual function and satisfaction is crucial.
Methods: We are conducting a longitudinal study to evaluate risk compensation following male circumcision among 18-35 year-old men in Western Kenya. Men were recruited from 8 clinics in Nyanza Province. Sexual function, satisfaction, and penile trauma were compared before and six months after circumcision using mixed effect models.
Results: The median age of the 1016 participants was 20 (IQR=18-23). 97% were satisfied with the procedure and the appearance of their penis after circumcision. 88% disclosed their circumcision status to partners and 95% reported their partners being pleased. At 6 months, men reported experiencing fewer problems with reproductive health in the last 6 months compared to baseline: painful urination (10% before vs. 7%, p=0.008), difficulty passing urine (7% vs. 4%, p=0.01), and sores around genitals (7% vs. 4%, p=0.002). Similar reductions were found in measures of penile trauma in the preceding 6 months: pain during intercourse (15% vs. 8%, p<0.0001); scratches, cuts, abrasions during sex (24% vs. 6%, p<0.0001); and bleeding during or after intercourse (10% vs. 3%, p<0.0001). Reported sexual dysfunction for a period of two weeks or more also decreased after circumcision: inability to climax (20% vs. 16%, p=0.007), finding sex not pleasurable (31% vs. 24%, p=0.0005), and lack of interest in sex (45% vs. 39%, p=0.008). Men reported a higher overall level of satisfaction with intercourse after circumcision (71% vs. 87%, p<0.0001). 54% of men reported their penis being much more sensitive and 36% reported reaching orgasm much more easily 6 months after circumcision.
Conclusion: Circumcision does not negatively affect and may improve reported sexual satisfaction, function, penile trauma, and reproductive health in a sample of recently circumcised Kenyan men.