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Voluntary male medical circumcision of pre-school-aged boys in primary care.

Title: Voluntary male medical circumcision of pre-school-aged boys in primary care.
Authors: Goldstuck ND; Department of Obstetrics and Gynaecology, Faculty of Medicine, Stellenbosch University, Cape Town. joan@sprout.co.za.; Millard PS
Source: African journal of primary health care & family medicine [Afr J Prim Health Care Fam Med] 2025 Nov 04; Vol. 17 (1), pp. e1-e3. Date of Electronic Publication: 2025 Nov 04.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: OpenJournals Pub Country of Publication: South Africa NLM ID: 101520860 Publication Model: Electronic Cited Medium: Internet ISSN: 2071-2936 (Electronic) Linking ISSN: 20712928 NLM ISO Abbreviation: Afr J Prim Health Care Fam Med Subsets: MEDLINE
Imprint Name(s): Original Publication: Tygervalley, South Africa : OpenJournals Pub.
MeSH Terms: Circumcision, Male*/methods ; Circumcision, Male*/instrumentation ; Circumcision, Male*/adverse effects ; HIV Infections*/prevention & control ; Primary Health Care*; Humans ; Male ; Prospective Studies ; South Africa ; Child, Preschool ; Infant ; Child
Abstract: Voluntary medical male circumcision (VMMC) is a priority human immunodeficiency virus (HIV) preventive intervention. Challenges in funding national VMMC programmes mandate us to adopt new methods to provide circumcisions in a primary care setting. This study aims to test the practicality of instrument-assisted circumcision in primary care in pre-school-age boys. The study setting was one primary care centre in Western Cape, South Africa. The methodology adopted is prospective case series of minimally invasive voluntary circumcision using the Unicirc instrument in boys less than 6 years of age. We circumcised 221 healthy boys using the Unicirc instrument, using a combination of topical anaesthetic, subcutaneous local anaesthetic and intramuscular ketamine. There were 5 (2.3%) mild complications and 48 (21.7%) had mucosal swelling as a result of lysis of physiological phimosis. All boys were fully healed at 2 weeks and all caregivers were highly satisfied. Using a circumcision instrument in primary care simplifies circumcision in pre-school-age boys and has a low rate of adverse events. This study demonstrates that a new model of circumcision in primary care may enhance national VMMC programmes.
Contributed Indexing: Keywords: HIV prevention; Unicirc; VMMC; Voluntary Medical Male Circumcision; circumcision; instrument-assisted circumcision; minimally invasive surgery; paediatric surgery; primary care; surgical instruments
Entry Date(s): Date Created: 20251217 Date Completed: 20251217 Latest Revision: 20260509
Update Code: 20260509
PubMed Central ID: PMC13150383
DOI: 10.4102/phcfm.v17i1.5039
PMID: 41405118
Database: MEDLINE

Journal Article