male circumcision


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male circumcision

Surgical removal of the end of the foreskin of the penis. Circumcision usually is performed at the request of the parents, in some cases for religious reasons. Considerable controversy exists whether the procedure has medical benefits: some authorities suggest that circumcision is associated with a reduced risk of HIV infection, urinary tract infections, sexually transmitted diseases, and penile carcinoma. Other authorities dispute these findings, suggesting that the procedure may have adverse effects on sexual, emotional, or psychological health. If the procedure is performed, anesthesia should always be used.

Patient care

Preoperative: The procedure and expected sensations are explained to the patient or his parents. Adult patients should be reassured that the procedure will not interfere with urinary, sexual, or reproductive function. Necessary equipment, including a restraining board for the newborn, and appropriate anesthetics are assembled. The newborn should not receive food within 1 hr before the procedure.

Postoperative: Vital signs are monitored, and the incision is inspected for bleeding every 15 min for the first hour, then hourly for 12 to 24 hr, as protocol directs. Bleeding is controlled by applying gentle pressure with sterile gauze sponges; any heavy or persistent bleeding should be reported, and preparations made for blood vessel ligation. A sterile petroleum gauze dressing is applied after circumcision, remains in place for 24 hr, and is replaced if it becomes dislodged during that time. The penis is gently washed at diaper change, and fresh sterile petroleum gauze is reapplied. The dressing, glans penis, and sutures, if present, are periodically examined for swelling, redness, or purulent exudate; any signs of infection are reported, and a specimen of the exudate is obtained. A plastic bell instead of petroleum gauze may be used to cover the glans and to prevent hemorrhage and contamination. The newborn is diapered loosely to avoid irritation and should not be positioned on the abdomen for the first few hours after the procedure.

For the adult patient, analgesics are provided, and a topical anesthetic ointment or spray is applied as needed. If prescribed, a sedative is given to help prevent nocturnal penile tumescence and resulting pressure on the suture line. The patient is encouraged to void within 6 hr after the procedure. Either the patient or his family is instructed how to keep the area clean and how to change and apply dressings. They are also instructed to watch for and report renewed bleeding or signs of infection. Adult patients can resume normal sexual activity as soon as healing is complete, usually within a week or so. Use of prescribed analgesics is recommended to relieve discomfort during intercourse.

See also: circumcision
References in periodicals archive ?
'In the period in which ARVs and male circumcision coverage increased we observed a decline in new HIV infections by half in those aged 15-64 years,' the study says.
Progress Brief: Voluntary medical male circumcision for HIV prevention, July 2018.
* However, it's unclear whether male circumcision can help prevent other sexually transmitted infections (STIs)
Puren, "Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS1265 trial," PLoS Medicine, vol.
In March 2007, the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended that Voluntary Medical Male Circumcision (VMMC) should be considered an effective tool for HTV prevention in countries with high HIV prevalence, a low male circumcision rate, and predominantly heterosexual transmission, listing a number of sub-Saharan African countries including Malawi (5).
The study's findings suggest that the safe male circumcision program in Uganda is reaching men who have an overall higher risk of acquiring HIV, according to the investigators, who also note that the differences documented at baseline were present before the men had received any circumcision-related health education that could have influenced behavior.
Male circumcision for the prevention of heterosexually acquired HIV infection: A meta-analysis of randomized trials involving 11,050 men.
The draft recommendations urge clinicians to review the health benefits and risks of elective male circumcision at any age while also taking into account other factors including "religion, societal norms and social customs, hygiene, aesthetic preference, and ethical considerations."
* Informing uncircumcised men and adolescents engaged in vaginal sexual intercourse about the partial protection against HIV afforded by male circumcision.
Key Words: Cost, Rwanda, male circumcision, nurses, HIV prevention, PrePex.
Clinical studies have shown that voluntary medical male circumcision reduces female-to male sexual HIV transmission by 60% and therefore by reducing new HIV infections in men reduces their female partners exposure to HIV.
Rapid, minimally invasive adult voluntary male circumcision: A randomized trial of Unicirc, a novel disposable device.