Adult male circumcision: results of a standardized procedure in Kisumu District, Kenya.

Authors: Krieger JN, Bailey RC, Opeya J, Ayieko B, Opiyo F, Agot K, Parker C, Ndinya-Achola JO,
Magoha GA, Moses S.
Abstract
OBJECTIVE:
To develop a standard procedure for male circumcision in a resource-poor medical setting and
prospectively evaluate the outcome in a randomized, controlled trial with the incidence of human
immunodeficiency virus (HIV) as the main outcome, as studies suggest that circumcision is
associated with a lower incidence of HIV and other sexually transmitted infections in high-risk
populations.
SUBJECTS AND METHODS:
Healthy, uncircumcised, HIV-seronegative men aged 18-24 years from Kisumu District, Kenya,
were offered participation in a clinical trial using a standard circumcision procedure based on
"usual" medical procedures in Western Kenya. The follow-up included visits at 3, 8 and 30 days
after circumcision, with additional visits if necessary. Healing, satisfaction and resumption of
activities were assessed at these visits and 3 months from randomization.
RESULTS:
Overall, 17 (3.5%) of the 479 circumcisions were associated with adverse events judged
definitely, probably or possibly related to the procedure. The most common adverse events were
wound infections (1.3%), bleeding (0.8%), and delayed wound healing or suture line disruption
(0.8%). After 30 days, 99% of participants reported being very satisfied with the procedure;
approximately 23% reported having had sex and 15% reported that their partners had expressed
an opinion, all of whom were very satisfied with the outcome. About 96% of the men resumed
normal general activities within the first week after the procedure.
CONCLUSION:
Safe and acceptable adult male circumcision services can be delivered in developing countries
should male circumcision ultimately be advocated as a public-health measure.
BJU Int. 2005 Nov; 96(7):1109-13. PubMed PMID: 16225538

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