{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:52:58Z","timestamp":1777949578186,"version":"3.51.4"},"reference-count":44,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Adult circumcision is an effective surgical treatment for symptomatic phimosis, but its effects on sexual function and psychosocial outcomes remain incompletely characterized. This study aimed to assess patient-reported motivations for circumcision due to phimosis and to evaluate changes in sexual function, genital self-image, and depressive symptoms after surgery. Methods: We performed a prospective, single-center observational pre\u2013post cohort study of adult men who underwent circumcision for symptomatic phimosis at a tertiary academic center in Poland between January 2023 and April 2025. Participants completed an author-designed questionnaire and validated patient-reported outcome measures before surgery and at six months after circumcision. The primary endpoint was the change in sexual function measured by the International Index of Erectile Function (IIEF-15). Secondary endpoints included changes in genital self-image assessed using the Male Genital Self-Image Scale (MGSIS-7), depressive symptoms measured with the Beck Depression Inventory (BDI-II), and patient-reported motivations for surgery. Paired comparisons were performed using the Wilcoxon signed-rank test. Results: A total of 148 men were included in the study. The most common reasons for surgery were pain\/discomfort (58\/148, 39.2%) and impaired sexual activity (51\/148, 34.5%). The total IIEF-15 score increased from 46.4 \u00b1 20.4 to 57.5 \u00b1 21.0 (p &lt; 0.001), with significant improvements across all domains (all p &lt; 0.001). The total MGSIS-7 score improved from 19.9 \u00b1 4.5 to 23.1 \u00b1 4.0 (p &lt; 0.001). Paired BDI-II data were available for 77 men; the total BDI-II score decreased from 1.2 \u00b1 3.8 to 0.3 \u00b1 1.6 (p = 0.004). Most men reported improved sexual life (127\/148, 85.8%) and cosmetic satisfaction (124\/148, 83.8%), and 119\/148 (80.4%) reported no complications. Conclusions: Circumcision for symptomatic phimosis was associated with improved sexual function and genital self-image, alongside a statistically significant but clinically negligible decrease in subclinical depressive symptoms.<\/jats:p>","DOI":"10.3390\/jcm15093499","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:12:09Z","timestamp":1777857129000},"page":"3499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adult Circumcision for Symptomatic Phimosis in Poland: Six-Month Patient-Reported Sexual Function and Psychosocial Outcomes from a Central European Low-Circumcision Setting"],"prefix":"10.3390","volume":"15","author":[{"given":"Micha\u0142","family":"Falis","sequence":"first","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0687-3089","authenticated-orcid":false,"given":"Michalina","family":"Grudzi\u0144ska","sequence":"additional","affiliation":[{"name":"Student Scientific Circle at the Department of Urology, Faculty of Medicine, Medical University of Gda\u0144sk, Marii Sk\u0142odowskiej-Curie 3a, 80-210 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weronika","family":"Micha\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Wr\u00f3bel","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6492-6863","authenticated-orcid":false,"given":"Julia","family":"\u015awiechowska","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1238-3342","authenticated-orcid":false,"given":"Hubert","family":"Dyrszka","sequence":"additional","affiliation":[{"name":"Student Scientific Circle at the Department of Urology, Faculty of Medicine, Medical University of Gda\u0144sk, Marii Sk\u0142odowskiej-Curie 3a, 80-210 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7973-0718","authenticated-orcid":false,"given":"Micha\u0142","family":"Ba\u0142enkowski","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcin","family":"Matuszewski","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2017-5417","authenticated-orcid":false,"given":"Mateusz","family":"Czajkowski","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"},{"name":"Penile Disease Center, University Clinical Center of Gda\u0144sk, Mariana Smoluchowskiego 17 Street, 80-214 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.3390\/clinpract14010028","article-title":"Phimosis in Adults: Narrative Review of the New Available Devices and the Standard Treatments","volume":"14","author":"Rosato","year":"2024","journal-title":"Clin. 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