Clinical elicitation of the penilo-cavernosus reflex in circumcised men

BJU Int. 2012 Feb;109(4):582-5. doi: 10.1111/j.1464-410X.2011.10364.x. Epub 2011 Aug 23.


Objective: • To test clinical observations that the penilo-cavernosus reflex is much more difficult to elicit in circumcised men.

Patients and methods: • Men consecutively referred for uro-neurological or uro-neurophysiological examination were prospectively included. • Those with possible sacral neuropathic lesions were excluded. • A history was obtained, and a clinical neurological examination was performed. • The penilo-cavernosus reflex was tested clinically and neurophysiologically using electrical and mechanical stimulation. • Reflex elicitability scores in groups of circumcised men, men with foreskin retraction and a control group of uncircumcised men were compared using the Mann-Whitney U test.

Results: • The reflex was clinically non-elicitable in 73%, 64% and 8% of 30 circumcised men, 15 men with foreskin retraction, and 29 control men, respectively. • The scored reflex elicitability was significantly (P < 0.001) higher in control men than in the other two groups clinically, but not neurophysiologically.

Conclusion: • The study confirmed the lower clinical and similar neurophysiological elicitability of the penilo-cavernosus reflex in circumcised men and in men with foreskin retraction. This finding needs to be taken into account by urologists and other clinicians in daily clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Circumcision, Male*
  • Electric Stimulation
  • Humans
  • Male
  • Middle Aged
  • Penis / innervation
  • Penis / physiology*
  • Physical Stimulation / methods
  • Prospective Studies
  • Reflex / physiology*