Prevalence of Preoperative Penile Abnormalities Among Voluntary Male Medical Circumcision Patients in Swaziland

Anthony R. Oddo; Elizabeth Ruedrich; Christopher Zust; Lindsey Marugg; Echo VanderWal; Harry VanderWal; Rebekah Sartori; Ronald J. Markert; Mary C. McCarthy

doi:10.1016/j.jpedsurg.2016.12.027

Prevalence of Preoperative Penile Abnormalities Among Voluntary Male Medical Circumcision Patients in Swaziland

Anthony R. Oddo, Elizabeth Ruedrich, Christopher Zust, Lindsey Marugg, Echo VanderWal, Harry VanderWal, Rebekah Sartori, Ronald J. Markert, Mary C. McCarthy

Research output: Contribution to journal › Article › peer-review

Abstract

<p> <h3 id="x-x-st0010"> Background </h3> <p id="x-x-sp0020"> <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/circumcision" title="Learn more about Circumcision"> Circumcision </a> has been found to be an effective strategy for lowering the transmission of <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/human-immunodeficiency-virus" title="Learn more about Human Immunodeficiency Virus"> HIV </a> in Africa. The Luke Commission, a mobile hospital outreach program, has used this information to decrease the rate of HIV in Swaziland by performing voluntary male medical circumcisions throughout the country. During many of these circumcisions, genital medical conditions and penile abnormalities are simultaneously discovered and corrected. <h3 id="x-x-st0015"> Purpose </h3> <p id="x-x-sp0025"> The goal of our study was to evaluate the prevalence of penile abnormalities discovered and treated during voluntary male medical circumcisions performed by The Luke Commission (TLC) throughout rural Swaziland. <h3 id="x-x-st0020"> Basic procedures </h3> <p id="x-x-sp0030"> We completed a retrospective analysis of all male patients who underwent voluntary male medical circumcision performed by TLC during a period from June–August, 2014. The penile abnormalities included: <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/phimosis" title="Learn more about Phimosis"> phimosis </a> , <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/paraphimosis" title="Learn more about Paraphimosis"> paraphimosis </a> , <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/epispadias" title="Learn more about Epispadias"> epispadias </a> , <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hypospadias" title="Learn more about Hypospadias"> hypospadias </a> , <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/ulcer" title="Learn more about Ulcer"> ulcers </a> , balanitis, <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/torsion" title="Learn more about Torsion"> torsion </a> , and foreskin adherent to the glans. <h3 id="x-x-st0025"> Main findings </h3> <p id="x-x-sp0035"> Of 929 total circumcisions, 771 (83%) patients had at least one pre-existing penile abnormality identified during their examinations and procedures, totaling 1110 abnormalities. Three specific abnormalities were detected – phimosis, adherent foreskin, and hypospadias. The 6–12 and 13–19 age groups had adequate sample sizes to yield precise estimates of prevalence (age group 6–12: 87% (95% confidence interval [CI] = 84–90%; age group 13–19: 79% (95% CI = 74–84%). <h3 id="x-x-st0030"> Principle conclusions </h3> <p id="x-x-sp0040"> The Luke Commission is improving the lives of children and adults with limited access to healthcare through regular preoperative evaluations during male circumcision, and the organization is setting an example for other international healthcare groups. <h3 id="x-x-st0035"> Level of evidence </h3> <p id="x-x-sp0045"> Type of Study: Prognostic Study, Level II. </p> </p> </p> </p> </p> </p></p>

Original language	American English
Journal	Journal of Pediatric Surgery
Volume	52
DOIs	https://doi.org/10.1016/j.jpedsurg.2016.12.027
State	Published - Aug 1 2017

Keywords

Circumcision
Penile abnormalities
Swaziland
HIV

Disciplines

Medical Specialties
Medicine and Health Sciences
Surgery

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10.1016/j.jpedsurg.2016.12.027License: CC BY

Cite this

@article{c89c03c12fe54b00935784ff75e7ff47,

title = "Prevalence of Preoperative Penile Abnormalities Among Voluntary Male Medical Circumcision Patients in Swaziland",

abstract = " Background Circumcision has been found to be an effective strategy for lowering the transmission of HIV in Africa. The Luke Commission, a mobile hospital outreach program, has used this information to decrease the rate of HIV in Swaziland by performing voluntary male medical circumcisions throughout the country. During many of these circumcisions, genital medical conditions and penile abnormalities are simultaneously discovered and corrected. Purpose The goal of our study was to evaluate the prevalence of penile abnormalities discovered and treated during voluntary male medical circumcisions performed by The Luke Commission (TLC) throughout rural Swaziland. Basic procedures We completed a retrospective analysis of all male patients who underwent voluntary male medical circumcision performed by TLC during a period from June–August, 2014. The penile abnormalities included: phimosis , paraphimosis , epispadias , hypospadias , ulcers , balanitis, torsion , and foreskin adherent to the glans. Main findings Of 929 total circumcisions, 771 (83%) patients had at least one pre-existing penile abnormality identified during their examinations and procedures, totaling 1110 abnormalities. Three specific abnormalities were detected – phimosis, adherent foreskin, and hypospadias. The 6–12 and 13–19 age groups had adequate sample sizes to yield precise estimates of prevalence (age group 6–12: 87% (95% confidence interval [CI] = 84–90%; age group 13–19: 79% (95% CI = 74–84%). Principle conclusions The Luke Commission is improving the lives of children and adults with limited access to healthcare through regular preoperative evaluations during male circumcision, and the organization is setting an example for other international healthcare groups. Level of evidence Type of Study: Prognostic Study, Level II. ",

keywords = "Circumcision, Penile abnormalities, Swaziland, HIV",

author = "Oddo, {Anthony R.} and Elizabeth Ruedrich and Christopher Zust and Lindsey Marugg and Echo VanderWal and Harry VanderWal and Rebekah Sartori and Markert, {Ronald J.} and McCarthy, {Mary C.}",

year = "2017",

month = aug,

day = "1",

doi = "10.1016/j.jpedsurg.2016.12.027",

language = "American English",

volume = "52",

journal = "Journal of Pediatric Surgery",

}

TY - JOUR

T1 - Prevalence of Preoperative Penile Abnormalities Among Voluntary Male Medical Circumcision Patients in Swaziland

AU - Oddo, Anthony R.

AU - Ruedrich, Elizabeth

AU - Zust, Christopher

AU - Marugg, Lindsey

AU - VanderWal, Echo

AU - VanderWal, Harry

AU - Sartori, Rebekah

AU - Markert, Ronald J.

AU - McCarthy, Mary C.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background Circumcision has been found to be an effective strategy for lowering the transmission of HIV in Africa. The Luke Commission, a mobile hospital outreach program, has used this information to decrease the rate of HIV in Swaziland by performing voluntary male medical circumcisions throughout the country. During many of these circumcisions, genital medical conditions and penile abnormalities are simultaneously discovered and corrected. Purpose The goal of our study was to evaluate the prevalence of penile abnormalities discovered and treated during voluntary male medical circumcisions performed by The Luke Commission (TLC) throughout rural Swaziland. Basic procedures We completed a retrospective analysis of all male patients who underwent voluntary male medical circumcision performed by TLC during a period from June–August, 2014. The penile abnormalities included: phimosis , paraphimosis , epispadias , hypospadias , ulcers , balanitis, torsion , and foreskin adherent to the glans. Main findings Of 929 total circumcisions, 771 (83%) patients had at least one pre-existing penile abnormality identified during their examinations and procedures, totaling 1110 abnormalities. Three specific abnormalities were detected – phimosis, adherent foreskin, and hypospadias. The 6–12 and 13–19 age groups had adequate sample sizes to yield precise estimates of prevalence (age group 6–12: 87% (95% confidence interval [CI] = 84–90%; age group 13–19: 79% (95% CI = 74–84%). Principle conclusions The Luke Commission is improving the lives of children and adults with limited access to healthcare through regular preoperative evaluations during male circumcision, and the organization is setting an example for other international healthcare groups. Level of evidence Type of Study: Prognostic Study, Level II.

AB - Background Circumcision has been found to be an effective strategy for lowering the transmission of HIV in Africa. The Luke Commission, a mobile hospital outreach program, has used this information to decrease the rate of HIV in Swaziland by performing voluntary male medical circumcisions throughout the country. During many of these circumcisions, genital medical conditions and penile abnormalities are simultaneously discovered and corrected. Purpose The goal of our study was to evaluate the prevalence of penile abnormalities discovered and treated during voluntary male medical circumcisions performed by The Luke Commission (TLC) throughout rural Swaziland. Basic procedures We completed a retrospective analysis of all male patients who underwent voluntary male medical circumcision performed by TLC during a period from June–August, 2014. The penile abnormalities included: phimosis , paraphimosis , epispadias , hypospadias , ulcers , balanitis, torsion , and foreskin adherent to the glans. Main findings Of 929 total circumcisions, 771 (83%) patients had at least one pre-existing penile abnormality identified during their examinations and procedures, totaling 1110 abnormalities. Three specific abnormalities were detected – phimosis, adherent foreskin, and hypospadias. The 6–12 and 13–19 age groups had adequate sample sizes to yield precise estimates of prevalence (age group 6–12: 87% (95% confidence interval [CI] = 84–90%; age group 13–19: 79% (95% CI = 74–84%). Principle conclusions The Luke Commission is improving the lives of children and adults with limited access to healthcare through regular preoperative evaluations during male circumcision, and the organization is setting an example for other international healthcare groups. Level of evidence Type of Study: Prognostic Study, Level II.

KW - Circumcision

KW - Penile abnormalities

KW - Swaziland

KW - HIV

UR - https://corescholar.libraries.wright.edu/surg/734

U2 - 10.1016/j.jpedsurg.2016.12.027

DO - 10.1016/j.jpedsurg.2016.12.027

M3 - Article

C2 - 28088311

VL - 52

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

ER -

Prevalence of Preoperative Penile Abnormalities Among Voluntary Male Medical Circumcision Patients in Swaziland

Abstract

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