Stakeholders are engaged in a pilot study on a gadget touted to speed up male circumcision. The device known as the Shang Ring could help Kenya and other countries in sub-Saharan Africa meet the rising demand for Voluntary Medical Male Circumcision services and prevent the spread of HIV.
The provincial male circumcision taskforce said the device will revolutionize how male circumcision services are offered in areas hardest hit by the HIV epidemic since there will be no use of surgical.
One of the principal investigators of the Shang Ring David Sokal said the device reduces the time needed to perform surgery. The device, named after its inventor Jian-Zhong Shang, consists of two concentric plastic rings that sandwich the foreskin, allowing it to be cut away without suturing and with minimal bleeding. Performed in a clinic under local anesthesia, the procedure takes less than five minutes, compared with approximately 20 to 30 minutes for a traditional "free hands" circumcision that requires suturing. The patient returns in one week for device removal.
The piloting of Shang Ring started in Homa Bay District Hospital with hundreds of men enrolling for the studies this month. Thousands of men in communities most affected by HIV have been seeking VMMC services. In Kenya more than 230,000 men and boys have been circumcised in the past two and a half years. In Nyanza Province, circumcising 640,584 men by 2013 could avert about 900,000 HIV infections in men and women over 20 years.
Results from previous studies, including two conducted at Homa Bay hospital, suggest that the Shang Ring could help bring these ambitious goals within reach. "Using this device, rather than standard surgical procedures, could enable areas that have been devastated by the HIV epidemic to dramatically expand access to safe, high-quality male circumcision services," Sokal said.
Assessments of the Shang Ring in Africa began with a pilot study conducted at Homa Bay hospital by EngenderHealth in collaboration with Marc Goldstein and Philip Li.
Dr Mark Barone, a senior clinical adviser at EngenderHealth, said results of the studies are promising. "As a stitch-less procedure with little or no bleeding, it is faster to perform, less invasive, and-based on preliminary data-highly acceptable to men," he said.
The first study by the FHI group designed to address concerns on implication of no review after seven days was completed in February.
Like the Plastibell device that is widely used in the United States for infant male circumcision, the Shang Ring remains on the penis after the procedure. The Plastibell device falls off after several days. But the Shang Ring stays on longer because adults heal more slowly than infants.