The debate on the benefits and necessity of circumcision is ongoing. Male circumcision decreases penile sensitivity as measured. Sleeve technique for male circumcision christopher suiye lukong department of surgery, usmanu danfodiyo university abstract teaching hospital sokoto, nigeria male circumcision is a commonly performed surgical introduction procedure. In 2007, the american academy of pediatrics aap convened a multidisciplinary workgroup of aap members and other stakeholders to evaluate the. Mar 31, 2020 the american academy of pediatrics aap says the benefits of circumcision outweigh the risks. Manual for early infant male circumcision under local anaesthesia 3 chapter 1.
There are, however, clear surgical indications of this procedure. Circumcision is generally a safe procedure but there are risks of minor complications. The linkage between male circumcision and hiv infection acquisition has also recently been explored. The open methods are therefore still commonly used in this setting. There is little information concerning prevalence of gomco use outside of the usa. Learning from safe male circumcision project in kayunga. We term this method, the dorsal slitsleeve technique. It is one of the most common procedures in the world.
The merits and demerits of this technique are described, based on our experience. In this study, we aimed to determine the complications and complication rate of circumcisions occurring in. Male circumcision is a highly effective medical procedure that is protective against various medical conditions including urinary tract infections, inflammatory conditions of the penis, sexually. For adult circumcision, i use the sleeve resection technique in which the foreskin is removed as a single ring of tissue utilizing a scalpel. Derived from the latin word circumcido, circumcision means, cutting around. Different other clamps smart klamp, tara klamp, etc. Sample checklist for early infant male circumcision procedure 115. Male circumcision decreases penile sensitivity as measured in. Circumcision is the surgical removal of the foreskin, the tissue covering the head glans of the penis. Voluntary medical male circumcisionsouthern and eastern africa, 20102012.
In the united states, the procedure is most frequently performed during the newborn period. A 1998 survey found that the gomco clamp was the preferred technique by 67% of american physicians, whereas plastibell was used by 19% and the mogen clamp. Circumcision is the surgical removal of the foreskin of the penis. Similar effects on sti risk may exist for females, although this may result from an indirect. Scientific studies show some medical benefits of circumcision. Circumcision is the oldest and most frequently used surgical procedure. Circumcision patient education handout what is circumcision. In my opinion, this gives a symmetrical, fine incision line. Techniques of male circumcision abdullahi abdulwahabahmed, ismaila a.
The infant does experience some pain during the operation, but a simple nerve block can minimize this pain. Male circumcision became a common medical practice in the 19th century, with improved anesthetic, surgical, and antiseptic techniques. This is a technique used by the jewish during their bris ceremony for newborn babies. Topical or locally injected anesthesia is used to reduce pain and physiologic stress. However, there are few published reports of health policy analysis in subsaharan africa in this field. Discussions of the risks and benefits of neonatal circumcision, including the controversy. Consequently, tanzania is striving to scaleup safe medical male circumcision to reduce hiv transmission.
Pdf male circumcision is a controversial subject in surgical practice. The gomco clamp is the leading instrument used to perform nonritual male circumcision in the united states. Jun 20, 2014 in east africa, prepex circumcision was first tested in neighboring rwanda and it is hoped more men will take advantage of it. The clearinghouses resource library contains hundreds of resources on voluntary medical male circumcision for hiv prevention. However, every clinician performing circumcision occasionally has concerns or. I teach circumcision here and am struggling to find the simplest technique. Adult circumcision can be performed under local or regional anesthesia. Various methods of circumcision including several devices are in use for male circumcision.
Traditional circumcision during manhood initiation rituals. Male circumcision under local anaesthesia version 3. This attentiongetting assertion quickly resulted in action by who and the united nations aids advo cacy organization, unaids, both of which recommended expanding programs of male circumcision in subsaharan africa, where hiv rates. Backgroundsurgical male circumcision techniques prior to 2014 in tanzania, the forcepsguided fg technique was the main conventional surgical method used in scaling up the voluntary medical male circumcision vmmc program.
The american academy of pediatrics aap recommends newborn male circumcision for its preventive and public health benefits that has been shown to outweigh the risks. A 25year longitudinal study of a birth cohort of new zealand children concluded that male circumcision may reduce the risk of sexually transmitted infection acquisition and transmission by up. Male circumcision performed with 8figure nonabsorbable. In the most common procedure, the foreskin is opened, adhesions are removed, and the foreskin is separated from the glans. The devices for circumcision may not be readily available or may be expensive. However, the aap doesnt recommend routine circumcision for all male newborns. Male circumcision consists of the surgical removal of some, or all, of the foreskin or prepuce from the penis. Introduction of male circumcision for hiv prevention in. In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing hiv transmission from infected women to uninfected men. Male circumcision abstract male circumcision consists of the surgical removal of some, or all, of the foreskin or prepuce from the penis. In the first stage, skill acquisition, the participant sees others perform the procedure and acquires a mental picture of the required steps. Circumcision is generally a safe surgical procedure if the following conditions are met. Graphic before and after photos of patients receiving a traditional circumcision procedure. Medical indications for this procedure include phimosis, paraphimosis, recurrent balanitis and posthitis inflammation of.
The plastibell causes a lot of swelling in boys older than 2 years, and the glans occasionally becomes entrapped. Learning guide for dorsal slit male circumcision procedure. Adult circumcision is one of the specialties of gentle procedures clinic. Scaleup of voluntary medical male circumcision services. Circumcision can be a simple and safe procedure to remove the foreskin from the penis. The adult procedure is a little longer than circumcision for babies about five minutes of surgery under local anesthesia followed by several hours of observation and recuperation time onsite in our clinics recovery room. In the united states, circumcision is the fourth most common surgical procedurebehind cataract removal, cesarean delivery, and joint replacement. Nevertheless, only few studies address the effects of this procedure on sexual penile sensitivity, and the.
Male circumcision is the removal of some or all of the foreskin prepuce from the penis. New parents often follow family tradition and have their newborn sons circumcised. In addition to a refined scar line, this technique allows the final result to be customized to the patients specifications if he has a. Health policy analysis is important for all health policies especially in fields with ever changing evidencebased interventions such as hiv prevention. Learning from safe male circumcision project in kayunga district. The device methods are thought to have lower complication.
Techniques of male circumcision journal of surgical. Based on three large randomized controlled trials rcts conducted in africa, it can clearly be stated that circumcision lowers the risk of infection with the human immunodeficiency virus hiv and some sexually transmitted infections stis among males in settings of high hiv and sti endemicity. The following educational video will highlight the standardized surgical technique of male adult circumcision by dr. The circumcision is performed by a trained, experienced practitioner. Circumcison 1 circumscision the sign of the abrahamic promise introduction.
Circumcision might have various health benefits, including. Manual for early infant male circumcision under local. However, there is a need to investigate the perceptions of male circumcision in tanzania. Graphic before and after photos of patients receiving a cosmetic circumcision surgery by dr. It is performed on 77% of males born in the united states and on 42% of those born elsewhere who are living in this country. Uganda adopted safe male circumcision smc as part of the broader strategies for hiv prevention in the national safe male circumcision policy 2010, following results from three randomized trials in south africa, kenya, and uganda that showed that male circumcision reduces the sexual transmission of hiv from women to men by at least 60%1. Pdf techniques of male circumcision semantic scholar. Sexually transmitted infections and male circumcision. May 31, 2019 adult circumcision is a relatively simple procedure, but that doesnt mean it is without risks. Apr 27, 2019 circumcision is the oldest and most frequently used surgical procedure. Circumcision performed using the gomco clamp is usually quick and effective, and results in very little bleeding. You may search the entire site, including these resources, by adding key words in the search box located in the upper right corner of the website.
After that, a circumcision device may be placed, and then the foreskin is cut off. Though circumcision is typically associated with infants, boys, teens and men routinely receive the procedure. Scaleup of voluntary medical male circumcision services for. Rakai health sciences program formerly the rakai project has unveiled a new method of male circumcision in which one does not shed a single drop of blood. In the united states, the procedure is commonly performed during the newborn period.
The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. This study explored the policy process of the introduction of male circumcision mc for hiv prevention in uganda in order to inform the. Before and after circumcision surgery images circumcision. Traditional surgeons and nurses registered with the health department were trained over five days on. It is an ancient practice that has its origin in religious rites. Male circumcision is an elective procedure performed on a healthy. This policy relates to the implications of and indications for infant male circumcision. The aim of this study was to test an intervention for safe traditional circumcision in the context of initiation into manhood among the xhosa, eastern cape, south africa. Fg technique was efficient compared to other male circumcision mc techniques. Circumcision using bipolar scissors can be a safe and simple operation.
The american academy of pediatrics aap recommends newborn male circumcision for its preventive and public health benefits that has been shown to outweigh the risks of newborn male circumcision. A combination of the dorsal slit and the sleeve technique is possible and was consistently used in our center. Having a trained assistant helps to keep the surgery safe for the client, reduces the chance of the sterile area becoming contaminated and reduces stress if there is any difficulty with the procedure. Nevertheless, only few studies address the effects of this procedure on sexual penile sensitivity, and the results of these studies are contradictory. Hutcheson, md departments of urology and pediatrics, wake forest university, baptist medical center, 5th floor, watlington hall, medical center boulevard, winstonsalem, nc 27157, usa circumcision is one of the oldest surgical procedures performed today. Learning guide for screening of patients and preparation for male circumcision. Some adult circumcisions using guided forceps technique also use this principle. Resource library clearinghouse on male circumcision. Newborn circumcision is a cosmetic, elective procedure. The circumcision is performed only on a healthy, stable infant. Pdf dorsal slitsleeve technique for male circumcision. Techniques of male circumcision 2 journal of surgical technique and case report janjun 20 vol5 issue1 ventral aspect, initially only the dorsum of the glans penis is covered by this fold.
Methods and techniques of circumcision sciencedirect. The skin is pulled beyond the tip of the glans, a small clamp used to both reduce blood flow and provide a guide for the scalpel, and the tube of skin distal to the clamp is cut. The circumcision is performed carefully, using strict aseptic sterile technique. For many, circumcision is a decision related to faith or culture. Male circumcision is the oldest known human surgical procedure. The most common risks associated with adult circumcision include. Male circumcision is an elective procedure performed on a healthy adolescent boy or man for partial protection from hiv.
Male circumcision is a controversial subject in surgical practice. Research shows that male medical circumcision reduces the possibility. Male circumcision presents a different situation from performing a medically. The perceptions on male circumcision as a preventive. The aap leaves the circumcision decision up to parents and supports use of anesthetics for infants who have the procedure. Mungadi introduction c ircumcision is the surgical removal of the prepuce. Its common in the united states and parts of africa and the middle east but less common in europe and some countries.
Circumcision is the removal of the foreskin from the human penis. It does not relate to cases where there is a clear clinical need for intervention, nor directly to adult male circumcision. Manual for male circumcision under local anaesthesia. Switching from the forcepsguided to the dorsal slit. Circumcisions undertaken in nonclinical settings can have significant risks of serious adverse events, including death. One important advantage of infant male circumcision is that the procedure is simpler. Techniques for circumcision in boys connecting our. The practice of circumcision in the male refers to the surgical removal of the foreskin of the penis. The earliest evidence of male circumcision was discovered in egyptian tombs aged more than 4000 years israelistes, 1993. Mar 01, 2014 male circumcision is the oldest known human surgical procedure. Africa, indicated that circumcision of heterosexual men could reduce the risk of hiv infection by to 60 percent.
In this study, we aimed to determine the complications and complication rate of. Circumcision is the surgical removal of the portion of the foreskin that normally covers the tip of the penis. This article describes the dorsal slitsleeve method of male circumcision. Manual for early infant male circumcision under local anaesthesia. Circumcision is the surgical removal of all or part of the distal penile foreskin prepuce.
Male circumcision introduction summary male circumcision is the surgical removal of all or part of the foreskin tissue prepuce that typically covers the tip or head of the penis. Freehand is timeconsuming and requires skillful use 50 sutures for hemostasis and suturing mucosa to skin. Adult circumcision is a relatively simple procedure, but that doesnt mean it is without risks. Circumcision, technique, complications, and history. Variations in technique for minor abnormalities of the foreskin. Variations in technique for minor abnormalities of the foreskin 533 6. Male circumcision is a commonly performed surgical procedure. Circumcision video pollock technique male circumcision. Topical or locally injected anesthesia is used to reduce pain and. Objective this article provides an overview and interpretation of the performance of the us presidents emergency plan for aids reliefs pepfars male circumcision programme which has supported the majority of voluntary medical male circumcisions vmmcs performed for hiv prevention, from its 2007 inception to 2017, and client characteristics in 2017. The device methods are thought to have lower complication rates when compared to the open methods.
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