Talk:Bulbocavernosus reflex

Proposed removal of Journal of Urology citation and reversion of related edit

On June 26, 2023, editor @Man-Man122 added a citation to this article (a 1981 study published by the Journal of Urology). They also added text to the body of the article claiming that said study disagreed with the findings of a later study (a 2011 study published by BJU International).

Specifically, the 2011 study found that the bulbocavernosus reflex was substantially more likely to be clinically absent in circumcised individuals (as well as those with permanently retracted foreskins) than in those with neither condition. The editor in question claimed that the 1981 study found otherwise, stating, "...[A]lthough an earlier study found the reflex to be excitable in 98% of American men, who are predominantly circumcised."

I have read the entirety of the three-page 1981 paper cited, and it seems to provide no basis for the editor's claim. The only mention of those study participants' circumcision status appears to be on page 198 of that issue of the Journal of Urology (page 2 of the study), where it reads, "In uncircumcised male patients the foreskin was not retracted." Nowhere in the paper does it disclose exactly how many of the participants identified as male were circumcised.

The editor appears to be assuming that (because the 1981 study was conducted by a team based in the United States) the authors must have chosen a proportion of circumcised and uncircumcised participants equivalent to that of the general American population or simply that the participants identified as male were statistically likely to have been majority-circumcised if chosen without controlling for their circumcision status. The editor also appears to be assuming that this proves or suggests circumcision has (or may have) no statistically relevant impact on the presence of the bulbocavernosus reflex. None of these assumptions, however, is supported by the cited paper.

I propose deleting the citation and reverting the related edit, as, for the reasons stated above, the citation is irrelevant and the edit wholly unsupported. If I receive no response to this proposal within a reasonable amount of time, I will assume there are no objections and input the changes myself. DoItFastDoItUrgent (talk) 17:50, 8 July 2024 (UTC)

It should also be noted that the 1981 study did not find that 98 percent of its male-identified participants displayed a clinically "excitable" reflex. It found that 98 percent of "normal" male participants (those who were not found to have any of three specific types of neuron lesions) did. Again, nothing in this editor's edit accurately reflects the content of the 1981 study. DoItFastDoItUrgent (talk) 18:05, 8 July 2024 (UTC)

I object Man-Man122 (talk) 12:28, 9 July 2024 (UTC)

I'd say more, but it's quite early, but I will add that I think that this is a bit ridiculous Man-Man122 (talk) 12:28, 9 July 2024 (UTC)

Unless you're waiting for others to weigh in, you'll need to say more. Otherwise, I'd be happy to move right to a formal dispute, where I'd imagine "this is ridiculous" won't be seen as sufficient defense of the addition of the citation or the false claim that the cited paper found that the reflex is "excitable in 98% of American men." Remember, I've read the paper and can refer back to it, so be prepared to argue your position in more than just vague generalities. DoItFastDoItUrgent (talk) 17:27, 9 July 2024 (UTC)

Like I said, it was early, so I was going to reply later. I don't see where your wanton snarkiness comes from. The paper said that 98% of the neurologically normal men had a clinically "normal bulbocavernosus reflex". I don't believe there's too much of an issue. Man-Man122 (talk) 23:54, 9 July 2024 (UTC)

That's not what you stated in your edit. You stated the 1981 study found "98% of American men" displayed a normal reflex and followed that statement by offhandedly pointing out that the majority of American men are circumcised.

Surely you understand the difference between 98 percent of a subset of study participants and 98 percent of the entire male-identified population of the United States and why you can't just assume the 1981 study controlled for circumcision status when its only mention of circumcision status was to explain how they conducted the test on uncircumcised participants.

Unfortunately, this isn't something that could simply be corrected by rewording the edit, because, since you have no way of knowing how many of the 1981 study participants (including the subset of participants deemed "normal") were uncircumcised, the study, itself, can't be used to refute the findings of the 2011 study. Additionally, the bit about the majority of American men being circumcised is editorializing and not reflective of anything discussed in the study you cited.

I'd call all of the above a very big issue that compromises both the scientific/medical accuracy and neutrality of the article. DoItFastDoItUrgent (talk) 04:05, 10 July 2024 (UTC)

Is that really an issue you have? Obviously, there's a difference between study participants and the entire general populace it's supposed to represent. That's just a commonly used way to refer to the results of a study or a survey. Secondly, yes it can be used to counter the results of the 2011 study. The author of that study himself noted that this study differed significantly from the American one. I fundamentally disagree with your conclusion Man-Man122 (talk) 05:55, 10 July 2024 (UTC)

No, claiming the study said anything about the entirety of the United States' male populace was a wording choice you made, one that was a blatant misrepresentation of what the study found. The "98 percent" in question was the subset of male participants who were found to not have one of three specific neurological conditions, not 100 percent of all male participants. Thus, claiming that 98 percent subset is equivalent to 98 percent of the entire male population of the United States (including those with the neurological conditions in question) is factually wrong. And, you still haven't once addressed why you think you can just assume the majority of the 98 percent subset was circumcised when the study did not disclose how many participants were or why you thought it was appropriate to add your own analysis with the bit about Americans being majority-circumcised. If you're just going to waste my time with a Gish gallop, I'll be happy to wait another couple of days to see if anyone else would like to weigh in. If no one does, I'll proceed to a formal dispute. In the meantime, if you'd prefer to actually address the points I've made in a thorough and factually consistent manner, you're welcome to do so. DoItFastDoItUrgent (talk) 00:06, 11 July 2024 (UTC)

I mean this respectfully: there are less snarky ways to talk to people. Again, this wording is a non-issue. It's just a commonly used way to refer to the results of a study/survey. Although the study didn't disclose how many of the men were circumcised, it is an important piece of context to add. So much so that the author of the 2011 study noted as much. Man-Man122 (talk) 05:16, 11 July 2024 (UTC)

• the fact that most American men are is an important piece of context to add.

Man-Man122 (talk) 06:17, 11 July 2024 (UTC)

@Man-Man122 Since roughly 12 days have passed since I first opened this discussion and you and I are the only editors who have chosen to weigh in thus far, I have begun the dispute process by requesting a third opinion via Wikipedia:Third opinion. DoItFastDoItUrgent (talk) 07:28, 20 July 2024 (UTC)

What? No one else cares about the page for this random bodily reflex? Color me surprised! All kidding aside, best of luck with your third opinion thing. Man-Man122 (talk) 23:06, 20 July 2024 (UTC)

Response to third opinion request:

I have read the added text, the discussion above, and the papers by Podnar and Blaivas et al. My greatest concern is that both papers are primary sources. It is not the role of Wikipedia editors to evaluate, compare or contrast primary sources, especially for medical topics (WP:MEDRS). I would therefore suggest re-writing the whole section about the effect of circumcision to cite reviews. For example, this review from 2020 discusses the difference in results between the two studies, as well as discussing differences in technique for eliciting the reflex, questions/criticism of how results were presented, and further context around the possible effect of circumcision. Regarding the specific question about the phrase American men, who are predominantly circumcised, you could cite the review which states "In the United States, where circumcision is common", which I think should still convey the apparent contradiction between the two studies' results while addressing DoItFastDoItUrgent's concerns about introducing own analysis. I think this approach would improve the article and be in line with the MEDRS guideline. Would you both find that agreeable? Mgp28 (talk) 11:59, 27 July 2024 (UTC)

Thank you for providing your third-party perspective on the dispute per my request.

I still think the other party's blatant factual inaccuracy (conflating 98 percent of a subset of the study's participants with 98 percent of all participants) needs to be addressed. Any rewrite would have to remove the false claim that 98 percent of the male-identified American population has a manually elicitable reflex (or that 98 percent of study participants had one). The other party's response to this particular point has essentially been to claim that it is a factually accurate statement, which is not a defensible position based on the content of the study in question.

Additionally, I would be more willing to consider removing all discussion of circumcision's potential impact on the elicitation of the reflex, as the paper you cited was authored by B.J. Morris, a molecular biologist who could politely be described as a circumcision proponent (and less politely as a circumcision enthusiast) and has made wildly biased and scientifically unsupported statements, such as comparing parents who choose not to circumcise to parents who choose not to vaccinate and stating that he believes circumcision should be compulsory under the law.

Further, since Morris has no way of knowing how many participants in the older study were circumcised and how many were not (just as the other editor involved in this dispute has no way of knowing those things), I fail to see how any functional comparison of the two papers could be made in the first place.

What would your opinion be on removing all mention of both studies as an alternative to your initial suggestion of a rewrite? DoItFastDoItUrgent (talk) 14:07, 2 August 2024 (UTC)

I think we should avoid trying to compare these two articles, both to avoid WP:SYNTH, and because the studies seem so different. The study hypotheses, patient cohorts, and methods for eliciting and observing the reflex differ between the two studies. We certainly shouldn't compare the proportions with elicitable reflex across the two studies, as Blaivas separates the cohort on the basis of other neurological signs, and Podnar divides them on the basis of circumcision. Even Podnar's uncircumcised group does not get 98% elicited.

If the effect of circumcision on the reflex is discussed in secondary sources then we can use those. If it is not, I think it should be omitted. I have now looked up Brian Morris and there does seem to be a strong point of view which would make me very uneasy if his was the only source used. I haven't attempted a comprehensive search to see if there are other appropriate secondary sources. Mgp28 (talk) 07:04, 3 August 2024 (UTC)

It's a little early but, if I'm reading right, you believe that it would be best if circumcision was left out if it's not mentioned in reliable secondary sources? If so, I agree. I did do a little digging through sites like Pubmed and others when this little fiasco began and I couldn't find much other than the two studies mentioned in the article. Man-Man122 (talk) 12:11, 3 August 2024 (UTC)

Yes, I think that's best. Mgp28 (talk) 13:19, 3 August 2024 (UTC)

If the other party involved in the dispute agrees, I volunteer to remove both citations and all mention of circumcision from the article. I agree that the papers are not directly comparable and that, if the Morris paper is the only secondary source that weighs in, it's not worth trying to salvage via a rewrite. This would avoid biasing the article even further and turning it into a battleground over the topic of circumcision (which far too many articles with even a tangential relation to the topic have, unfortunately, become). DoItFastDoItUrgent (talk) 14:44, 3 August 2024 (UTC)

If that's so, then I'll do the honors. I'm glad we could come to an agreement Man-Man122 (talk) 20:27, 3 August 2024 (UTC)

References