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Sir,

The most recent paper on male circumcision and its impact on sexual satisfaction [1] provided no details on the type of circumcision used in the volunteers. Correspondence with one of the authors, Dr. Stephen Watya, who is in charge of supervising and training medical personnel to do the operations, revealed that the sleeve technique was used, with the incision 0.5–1 cm from the frenulum. Further clarification with Dr. Watya confirmed that the entire frenular area, including the frenulum, was left completely intact in all of these volunteers.

It is known from previous research that the frenular area houses erogenous tissue [2,3] and comprises the most sensitive areas on the penis [4]. A key argument used in support of the idea that human genital cutting has a negative effect on sexuality is that the removal of sexual ‘hardware’ reduces the range and complexity of available sensation. It follows that any study which purports to assess such effects should consider the quantity and quality of tissue removed. This is the case with much of the research in female genital cutting, where different styles of cutting are discussed and their differential effects examined [5].

The current study is unique as all the volunteers had the same type of circumcision, and all were spared their most sensitive areas. As the study failed to discuss this important detail, many might generalize these results to circumcisions that are carried out for cultural or religious reasons in other parts of the world, yet which might involve the removal of some or all of the frenular tissue, due to different techniques and type.