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Circumcision prevents penile injuries

A new study finds that circumcised men appear less likely to sustain cuts, abrasions and other minor injuries to the penis during sex.

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A new study finds that circumcised men appear less likely to sustain cuts, abrasions and other minor injuries to the penis during sex - which may help explain why circumcision lowers the risk of HIV transmission from heterosexual sex.

Circumcision prevents infection and inflammation of the foreskin and it may decrease the risk of penile cancer. To study if circumcision helps preventing cuts and other injuries, researchers used data from an HIV clinical trial in Africa, where nearly 2,784, aged between 18 and 24 years were randomly assigned to undergo circumcision or remain uncircumcised.  This trial and two others in Uganda, South Africa and Kenya showed that circumcision can reduce a man's risk of HIV infection through heterosexual sex by up to 60 percent.
At the outset of the current trial, 65 percent of the men said they had sustained some form of penile injury during sex in the past six months - most often general soreness, scratches, cuts or abrasions. Seventeen percent said they had bleeding. Six months into the trial, that rate was on the decline. By year two, 30 percent of circumcised men said they'd had a sex-related penile injury in the past six months.

Men in the uncircumcised group also reported a reduction in injuries, though it was less significant - with 42 percent saying they'd sustained a penile injury in the past six months. That decline is likely due to the general improvements both study groups showed in their sexual health practices - including greater condom use and fewer sex partners.

Men who said they had had multiple sex partners in the past month were more likely to report sex-related penile injuries than those who had been monogamous. On the other hand, condom use and the habit of washing the penis within an hour of having sex were both linked to decreased risks of penile soreness and other injuries.

It was found that, over two years, circumcised men were almost 40 percent less likely than their uncircumcised counterparts to report any type of penile injuries during sex. This raises the possibility that lower injury risk is one reason that circumcision lowers the risks of HIV transmission.

Exactly why circumcision protects against HIV during sex is unknown. There are a few theories: One is that, by reducing the amount of mucosal tissue exposed during sex, circumcision limits the virus' access to the body cells it targets. Another theory is that the thickened skin that forms around the circumcision scar helps block HIV from gaining entry.

Further studies are required to look at the role penile injuries may play in the transmission of HIV or other sexually transmitted diseases.

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