PMID- 26684654
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20161230
IS  - 1423-0399 (Electronic)
IS  - 0042-1138 (Linking)
VI  - 96
IP  - 2
DP  - 2016
TI  - Unexpected Complications Following Adult Medical Male Circumcision Using the 
      PrePex Device.
PG  - 188-93
LID - 10.1159/000442753 [doi]
AB  - INTRODUCTION: In this study, we describe and depict unexpected sequelae of adult 
      medical male circumcision (MMC) using the PrePex device. MATERIALS AND METHODS: 
      The PrePex system is an elastic compression device for adult MMC. The device is 
      well studied, has been pre-qualified by the World Health Organization (WHO), and 
      its use is being scaled-up in African countries targeted by WHO. We conducted a 
      PrePex implementation study in routine service delivery among 427 men in the age 
      range of 18-49 in western Kenya. We captured penile photographs to create a 
      record of adverse events (AEs) and to monitor healing. Several unexpected AEs 
      ensued, including some that have not been reported in other PrePex studies. We 
      describe and depict those unexpected complications and resulting treatments to 
      alert circumcision providers in the relevant areas. RESULTS: We observed 5 device 
      displacements (1.2%); 3 cases of early sloughing of foreskin tissue (0.7%) among 
      men with long foreskins; 2 cases of a long foreskin obstructing urine flow, as it 
      became dry and necrotic (0.5%); and 2 cases of insufficient foreskin removal 
      caused by invagination for which surgical completion was necessary (0.5%). All of 
      the participants healed completely by day 42 post-circumcision or shortly 
      thereafter. CONCLUSION: The potential for these complications should be 
      incorporated into PrePex training programs. Integration of devices into MMC 
      programs in medically underserved areas requires the availability of prompt 
      surgical intervention for some sequelae, particularly displacement events.
CI  - (c) 2015 S. Karger AG, Basel.
FAU - Odoyo-June, Elijah
AU  - Odoyo-June E
AD  - Formerly at Nyanza Reproductive Health Society, Kisumu, Kenya.
FAU - Feldblum, Paul J
AU  - Feldblum PJ
FAU - Fischer, Shelly
AU  - Fischer S
FAU - Bailey, Robert C
AU  - Bailey RC
FAU - Obiero, Walter
AU  - Obiero W
FAU - Hart, Catherine
AU  - Hart C
FAU - Veena, Valentine
AU  - Veena V
FAU - Combes, Stephanie
AU  - Combes S
FAU - Cherutich, Peter
AU  - Cherutich P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20151219
PL  - Switzerland
TA  - Urol Int
JT  - Urologia internationalis
JID - 0417373
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Circumcision, Male/*adverse effects/*instrumentation
MH  - Equipment Design
MH  - Foreign-Body Migration/diagnosis/*etiology
MH  - Foreskin/*blood supply/pathology/surgery
MH  - Humans
MH  - Kenya
MH  - Male
MH  - Middle Aged
MH  - Necrosis
MH  - Pilot Projects
MH  - Time Factors
MH  - Treatment Outcome
MH  - Urination Disorders/diagnosis/*etiology
MH  - Wound Healing
MH  - Young Adult
EDAT- 2015/12/20 06:00
MHDA- 2016/12/15 06:00
CRDT- 2015/12/20 06:00
PHST- 2015/10/06 00:00 [received]
PHST- 2015/11/24 00:00 [accepted]
PHST- 2015/12/20 06:00 [entrez]
PHST- 2015/12/20 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - 000442753 [pii]
AID - 10.1159/000442753 [doi]
PST - ppublish
SO  - Urol Int. 2016;96(2):188-93. doi: 10.1159/000442753. Epub 2015 Dec 19.