PMID- 21627752
OWN - NLM
STAT- MEDLINE
DCOM- 20120201
LR  - 20211020
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Print)
IS  - 1464-4096 (Linking)
VI  - 109
IP  - 1
DP  - 2012 Jan
TI  - Evaluation of the safety and efficiency of the dorsal slit and sleeve methods of 
      male circumcision provided by physicians and clinical officers in Rakai, Uganda.
PG  - 104-8
LID - 10.1111/j.1464-410X.2011.10259.x [doi]
AB  - OBJECTIVE: To assess the safety and efficiency of the dorsal slit and sleeve male 
      circumcision (MC) procedures performed by physicians and clinical officers (COs). 
      PATIENTS AND METHODS: We evaluated the time required for the MC procedure 
      (efficiency) and moderate/severe adverse events (AEs) for MC (safety) by trained 
      physicians and COs using the sleeve and dorsal slit MC methods in a service 
      programme. Univariate and multiple regressions with robust variance estimation 
      were used to assess factors associated with operative duration (linear) and AEs 
      (logistic). RESULTS: Six physicians and eight COs conducted 1934 and 3218 MCs, 
      respectively; there were 2471 dorsal slit and 2681 sleeve MC procedures. The 
      overall mean operative duration was 33 min for newly trained providers, which 
      decreased to  approximately 20 min after  approximately 100 MCs. The adjusted mean operative duration for 
      dorsal slit MC was significantly shorter than that for the sleeve MC method (Delta - 
      2.7 min, P < 0.001). The operative duration was longer for COs than physicians 
      for the sleeve procedure, but not the dorsal slit procedure; however this 
      difference reduced with increasing numbers of MCs completed. The unadjusted AE 
      rates were 0.6% for dorsal slit MC and 1.4% for the sleeve method (P = 0.006) and 
      1.5% for physicians and 0.68% for COs (P = 0.003); however, there were no 
      significant differences after multivariate adjustment. Use of bipolar cautery 
      significantly reduced operative duration (Delta - 4.0 min, P = 0.008), but was 
      associated with higher AE rates (adjusted odds ratio 2.13, 95% confidence 
      interval 1.26-3.61, P = 0.005). CONCLUSION: The dorsal slit MC method is faster 
      than sleeve resection, and can be safely performed by non-physicians; however, 
      use of bipolar cautery may be inadvisable in this setting.
CI  - (c) 2011 THE AUTHORS. BJU INTERNATIONAL (c) 2011 BJU INTERNATIONAL.
FAU - Buwembo, Dennis Rogers
AU  - Buwembo DR
AD  - Rakai Health Sciences Programme, Makerere University Kampala (MUK), School of 
      Public Health, Kampala, Uganda.
FAU - Musoke, Richard
AU  - Musoke R
FAU - Kigozi, Godfrey
AU  - Kigozi G
FAU - Ssempijja, Victor
AU  - Ssempijja V
FAU - Serwadda, David
AU  - Serwadda D
FAU - Makumbi, Fredrick
AU  - Makumbi F
FAU - Watya, Stephen
AU  - Watya S
FAU - Namuguzi, Dan
AU  - Namuguzi D
FAU - Nalugoda, Fredrick
AU  - Nalugoda F
FAU - Kiwanuka, Noah
AU  - Kiwanuka N
FAU - Sewankambo, Nelson K
AU  - Sewankambo NK
FAU - Wabwire-Mangen, Fredrick
AU  - Wabwire-Mangen F
FAU - Kiggundu, Valerian
AU  - Kiggundu V
FAU - Wawer, Maria J
AU  - Wawer MJ
FAU - Gray, Ronald H
AU  - Gray RH
LA  - eng
GR  - R24 HD042854/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20110531
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
SB  - IM
MH  - *Adaptation, Psychological
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Circumcision, Male/*methods
MH  - *Clinical Competence
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Patient Satisfaction
MH  - Physicians/*standards
MH  - Treatment Outcome
MH  - Uganda
MH  - Young Adult
PMC - PMC4326085
MID - NIHMS617026
EDAT- 2011/06/02 06:00
MHDA- 2012/02/02 06:00
PMCR- 2015/02/12
CRDT- 2011/06/02 06:00
PHST- 2011/06/02 06:00 [entrez]
PHST- 2011/06/02 06:00 [pubmed]
PHST- 2012/02/02 06:00 [medline]
PHST- 2015/02/12 00:00 [pmc-release]
AID - 10.1111/j.1464-410X.2011.10259.x [doi]
PST - ppublish
SO  - BJU Int. 2012 Jan;109(1):104-8. doi: 10.1111/j.1464-410X.2011.10259.x. Epub 2011 
      May 31.