Circumcision, Adolescents
Conditions
Keywords
PrePex, Male Circumcision, HIV Prevention, Adolescents
Brief summary
A new Male Circumcision (MC) device, PrePex, has shown great promise as a way to radically shift the MC landscape. PrePex is an innovative circumcision device requiring no injected anesthesia, sutures, or sterile settings. Moreover, it is designed for use by minimally skilled healthcare professionals rather than surgeons. Two initial studies conducted in Rwanda in 2010 and 2011 demonstrated an excellent safety profile when the procedure was performed by skilled physicians
Detailed description
Rwanda Has also completed a third study to assess the safety and efficacy of MC when performed by nurses using PrePex in both rural and urban hospitals, Device safety was assessed by the rate of clinical adverse events and device-related incidents attributed to the PrePex device and its procedures, the study report was shared with the WHO Male Circumcision Technical Advisory Group. On February 2011 the WHO provided Rwanda with recommendation to phase in MC scale up with the PrePex device on adults. Moreover the WHO recommended Rwanda to study the PrePex for use on adolescent population, starting on ages 15-17 and thereafter on ages 12-14 and 10-12.
Interventions
DEVICEPrePex Device
The PrePex device is designed to enable conducting male circumcision procedure that is bloodless with no anesthesia and no sutures. For contraindicated subjects, a preparation procedure will take place.
Sponsors
Ministry of Health, Rwanda
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
10 Years to 17 Years
Healthy volunteers
Yes
Inclusion criteria
* Adolescent Males in ages - 10 to 17 years * Uncircumcised * Subject wants to be circumcised * Subject assent to the procedure * Legal guardian consent to the procedure * Subject with or without the following conditions: Preputial adhesions and /or narrow foreskin/Phimosis * Able to understand the study procedures and requirements * Agrees to abstain from sexual intercourse for 8 weeks after circumcision * Agrees to abstain from masturbation for at least 2 weeks after Removal * Agrees to return to the health care facility for follow-up visits (or as instructed) after his circumcision for a period of 7 weeks post removal (8 weeks total) * Subject able to comprehend and freely give informed consent for participation in this study and is considered by the investigator to have good compliance for the study * Subject agrees to anonymous video and photographs of the procedure and follow up visits.
Exclusion criteria
* Legal guardian withholds consent * Active genital infection, anatomic abnormality or other condition, which in the opinion of the investigator prevents the subject from undergoing a circumcision * Subject with the following diseases/conditions: paraphimosis, warts under the prepuce, torn or tight frenulum, hypospadias, epispadias * Known bleeding / coagulation abnormality, uncontrolled diabetes * Subject that to the opinion of the investigator is not a good candidate * Subject does not agree to anonymous video and photographs of the procedure and follow up visits.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of Serious Adverse Events on adolescent male population including contraindicated subjects in ages 10 to 17 | up to 7 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Glans fully exposed | Up to 7 weeks |
| The pain at key time points | Up to 7 weeks |
| Time to complete healing | Up to 7 weeks |
| Time to numb the foreskin using topical Lidocaine 5% cream - for contraindicated subjects only | Up to 7 weeks |
| Rate of side effects | Up to 7 weeks |
Countries
Rwanda
Outcome results
None listed