Male Medical Circumcision for the Control of Human Immunodeficiency Virus by Nurses using the Unicirc® Assist Device

Author(s): Norman D Goldstuck

Objective: To demonstrate that male medical circumcision can be performed and evaluated by nurse practitioners using the Unicirc circumcision assist device.

Methods; Thirty nurses were trained to carry out circumcisions by learning how to perform them on a Unicirc training module before performing them under supervision and finally independently. They were also taught to assess circumcision related complications and how to identify absolute contra-indications for performing the procedure. The no-needle, no-suture approach using topical anaesthesia was used wherever possible. The subjects were males aged from one week to 66 years who requested circumcision for hygiene purposes, disease prevention or religious reasons. Results: The nurses performed 221 circumcisions. The mean age of the subjects was 17.3 years and 74% were under 20. Those over 21 required the larger sized Unicircs. Circumcisions were performed mainly for religious reasons in the younger boys and for hygiene and disease protection in the older boys ang men. The boys under 10 required local anaesthetic in addition to topical. Some 21 subjects required dilatation of the prepuce, 28 required a dorsal slit procedure and 5 required a frenulectomy. There were 5 cases of wound dehiscence which were managed conservatively with complete resolution. The patients who attended for follow-up were all extremely satisfied with the procedure.

Conclusion: Nurses can rapidly be taught to perform circumcisions with the Unicirc assist device and consideration should be given to teaching medical surgical technicians as well.