Feldblum Paul J, Okech Jairus, Ochieng Rolex, Hart Catherine, Kiyuka Grace, Lai Jaim Jou, Veena Valentine
FHI 360, Durham, North Carolina, United States of America.
Homa Bay District Hospital, Homa Bay, Kenya.
PLoS One. 2015 Sep 14;10(9):e0137510. doi: 10.1371/journal.pone.0137510. eCollection 2015.
To ascertain clinical sequelae, client satisfaction and sexual behavior 2+ years after male circumcision using the ShangRing device.
We enrolled 199 men from the Kenya sites (Homa Bay district) participating in a 2012 study of the ShangRing device used in routine male circumcision services (N = 552). We enrolled men who had had the ShangRing placed successfully, and over-sampled men who had had an adverse event and/or were HIV-positive during the field study. In the present study, each participant was examined and interviewed by a study clinician, and penile photographs were taken to document longer-term cosmetic results and any abnormal findings.
194 men were included in the analysis. The mean and median times between circumcision and the longer-term follow-up visit in this study were 31.8 and 32 months, respectively. Four men (2.1%) had signs/symptoms of a sexually transmitted infection (STI). Virtually all (99.5%) of the men were very satisfied with the appearance of their circumcised penis, and all would recommend a ShangRing circumcision to friends or family members. The most prevalent reported advantage of the circumcision was the ease of bathing and enhanced cleanliness of the penis (75.8%). 94.3% of the men did not cite a single negative feature of their circumcision. 87.5% of men reported more sexual pleasure post-MC, the most common reason being more prolonged intercourse. The majority of men (52.6%) reported one sexual partner post-MC, but more than a quarter of the men (28.1%) reported an increased number of partners post-MC. Less than half of the men (44.3%) reported using condoms half of the time or more, but the great majority of condom users stated that condom use was much easier post-MC, and 76.9% of users said they used condoms more after circumcision than before.
This study supports the safety and acceptability of ShangRing male circumcision during 2-3 years of follow-up. It should allay worries that the ShangRing procedure could lead to delayed complications later than the observation period of most clinical studies.
ClinicalTrials.gov NCT01567436.
确定使用商环进行男性包皮环切术后2年以上的临床后遗症、客户满意度和性行为情况。
我们从肯尼亚的研究地点（霍马湾地区）招募了199名男性，这些男性参与了2012年一项关于在常规男性包皮环切服务中使用商环的研究（N = 552）。我们招募了成功放置商环的男性，并对在现场研究期间发生不良事件和/或感染艾滋病毒的男性进行了过度抽样。在本研究中，每位参与者由一名研究临床医生进行检查和访谈，并拍摄阴茎照片以记录长期的外观效果和任何异常发现。
194名男性纳入分析。本研究中包皮环切术与长期随访之间的平均和中位时间分别为31.8个月和32个月。4名男性（2.1%）有性传播感染（STI）的体征/症状。几乎所有男性（99.5%）对其包皮环切后的阴茎外观非常满意，并且所有人都愿意向朋友或家人推荐商环包皮环切术。包皮环切术最普遍报道的优点是洗澡方便且阴茎清洁度提高（75.8%）。94.3%的男性没有提及包皮环切术的任何负面特征。87.5%的男性报告包皮环切术后性快感增强，最常见的原因是性交时间延长。大多数男性（52.6%）报告包皮环切术后有一个性伴侣，但超过四分之一的男性（28.1%）报告包皮环切术后性伴侣数量增加。不到一半的男性（44.3%）报告一半或更多时间使用避孕套，但绝大多数避孕套使用者表示包皮环切术后使用避孕套更容易，76.9%的使用者表示他们包皮环切术后比以前更多地使用避孕套。
本研究支持商环男性包皮环切术在2至3年随访期间的安全性和可接受性。它应消除人们对商环手术可能导致比大多数临床研究观察期更晚出现延迟并发症的担忧。
ClinicalTrials.gov NCT01567436。
