The debate on comparative effects of circumcision in circumcised and uncircumcised men regarding their sexual functions intrigued me. After reading with interest the study published by Bronselaer et al. , we would like to add our comments.
Respondents in this study were poorly representative, as 47.1% of those recruited by means of leaflets held a Master's degree as their highest degree and 12.1% were homosexual (Table 1 ). More importantly, there is significantly fewer single men in the circumcised group than in the uncircumcised group (Fisher's exact probability P < 0.005). Married men are more likely to have regular sex lives, which could affect male penile sensitivity.
The authors also missed important information. As there is an improvement or recovery trend of sexual functions with time after circumcision, intervals between circumcision and the online survey of all participants should also be documented, which apparently, tend to be shorter in men circumcised at an older age. The authors claimed men circumcised during adolescence or later would experience less sexual pleasure, which could be explained by this.
We performed a meta-analysis of 10 studies with the aim of assessing men's sexual functions after recent adult male circumcision. The results suggest that circumcision is unlikely to adversely affect male sexual functions . The results of the present study  contrast with our findings, and the authors concluded that ‘before circumcision without medical indication, adult men, and parents considering circumcision of their sons, should be informed of the importance of the foreskin in male sexuality’. Considering the flaws of the retrospective study design, the demographic characteristics bias of the participants and the missed details, conclusions should not be addressed hastily. Well-designed prospective studies with large samples are needed for further understanding of this topic.