In the study, 571 males were enrolled in two study sites in Kenya. The circumcisions were completed by 6 healthcare providers, 5 non-physician and 1 physician. The circumcisions utilized the no-flip Shangring technique, which first involves determining the correct size of device by wrapping the Shangring tape around the penis. Afterwards, the inner plastic ring is inserted under the foreskin, which can be facilitated by a dorsal split of the foreskin if necessary. This is followed by securely clamping the outer ring onto the inner ring from outside of the foreskin to provide hemostatic occlusion. Finally, the foreskin is excised from the over side of the device. Adverse events, pain score, and operative time were all metrics collected from the participants of the study.
For the results, all participants were successfully circumcised with the no-flip Shangring technique. Five out of six providers showed significant improvement in pain scores and operative time in second half of cases when compared to the first half. Low rates of adverse events were maintained in the first and second half of the procedures performed. Majority of all participants achieved full wound healing by the last scheduled follow up visit (day 42) and were satisfied with penile cosmesis.
In conclusion, the Shangring device is a useful tool that can scaled up male circumcision globally. Specifically when used with the no-flip technique, it is shown to be a safe, quick and effective method of male circumcision in the hands of both physicians and non-physician healthcare providers for patients ranging from young adolescence to adult.
Presented by: Omar Al Hussein Alawamlh, MD
Written by: Whitney Zhang, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA