Friday, June 4, 2010

Soreness, Injuries, Perspective, and Circumcision

The African circumcision trials have yielded new data and analysis; Remember those? Foreign researchers attracted African men who wanted to be circumcised and get free health care, counselling, and follow-ups. Circumcision was immediate or in a couple years, at random. Great deal if you want the surgery. Thousands did.

The researchers collected so much data they've been able to mine it over the course of half a decade--and there's no indication they're done--for subsets with which to publish a paper, make news, and give press interviews. Let's face it--The researches want circumcision to work as much as the participants want a free circumcision--or more. They designed the tests and questions, collected the results, and are probing the data for evidence of efficacy.

"Are you sore after sex?"

That's what they asked the African men. That's what they're publishing. This is not a joke. Self reported "general soreness" from sex--which probably happens from time to time to everybody who has much of it--is the subject of this study.

The men didn't need to have a sore penis to make the "penile coital injuries" group which netted 1775 of 2784 men initially. They could have reported any cut, abrasion, any scratch or bleeding or soreness of the penis in the past 6 months. 64% did.

Then, some of the men underwent circumcision.

Those who did not get circumcised later reported "penile coital injuries" at a rate of 42%. That's a big improvement over 64% and reflects aspects of participation unrelated to surgery. Men circumcised later reported a rate of 31%. That's an even bigger improvement over 64%.

Let's reflect a moment on self reporting, particularly of feelings like soreness. Person A's soreness may be Person B's great day may be Person C's awful pain. Worse, Person A's soreness now may be his own great day later. A person's standards change based on their experiences. We may not expect to feel as good as we age, so we report equal or less soreness even though more careful questions tell a different story. Aging isn't the only experience that can change perspective--so can surgery--like circumcision.

Experiencing an adult circumcision might make a man laugh off what he previously thought was "penile soreness"--or "cuts" for that matter--and use a more relaxed standard.

"Are you sore after sex? I used to think so, but boy was I wrong! I had no idea what sore was!" If you later re-questioned the men about soreness experienced prior to study enrollment, the circumcised ones might recall it in a rosier fashion than they did initially.

That's my hypothesis, but did these researchers take the initiative to collected such data? And if they did, will they bother to publish a paper about it? How much data did they collect which doesn't support their various pro-circumcision hypotheses?

Will we ever know?

Circumcision and Reduced Risk of Self-Reported Penile Coital Injuries: Results From a Randomized Controlled Trial in Kisumu, Kenya. (Abstract)

Circumcision may prevent sex-related penis injuries (REUTERS)