The impact of mucosal cuff length on premature ejaculation in circumcised men: a comprehensive systematic review and meta-analysis

Premature ejaculation (PE) is the most prevalent sexual dysfunction among men with unclear etiologies.There are differing medical theories about how circumcision affects ejaculation.One specific concern is about leaving too much mucosal tissue during the circumcision procedure.This study aims to comprehensively discuss the relationship between mucosal cuff length (MCL) and PE in circumcised men.A systematic search was conducted in November 2024, in the electronic database to find articles investigating the relationship between longer MCL and PE.Both intravaginal ejaculatory latency time and MCL were investigated.This review includes eight studies with 1451 participants.The cumulative data from these studies suggest that longer mucosal cuff in circumcised men were associated with PE, although with a significant amount of heterogeneity between studies.This review found that male patients with PE tend to have longer MCL.Furthermore, there is barely any harm in leaving the mucosa shorter to reduce the risk of PE.However, large-scale studies should be conducted to evaluate the positive and negative effects of circumcision on PE syndrome.