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PrePex circumcision surveillance: Adverse events and analgesia for device removal

Limakatso Lebina1, Minja Milovanovic1, Kennedy Otwombe1

  • 1Perinatal HIV Research Unit (PHRU), SA MRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Plos One
|March 27, 2018
PubMed
Abstract

Insights

Pain during PrePex device removal for male circumcision can be reduced with analgesia. This study found that providing pain medication before removal significantly decreased severe pain experienced by participants undergoing the procedure.

Area of Science:

  • Medical devices
  • Surgical procedures
  • Public health

Background:

  • The PrePex device offers a feasible and acceptable method for medical male circumcision (MMC).
  • Previous studies indicate that pain during PrePex device removal is a concern for participants.

Purpose of the Study:

  • To evaluate the safety of the PrePex device for male circumcision.
  • To determine if analgesia administered before PrePex removal can effectively reduce pain.

Main Methods:

  • A multi-site prospective cohort study involving 1023 adult males in South Africa.
  • Participants received analgesia prior to device removal, with regimens varying based on clinic availability.
  • Data on adverse events and pain experienced during removal were collected.

Main Results:

  • 98% of participants had the PrePex device removed successfully at a study clinic.
  • Adverse events were infrequent (2.4%), with most requiring no surgical intervention.
  • Participants receiving analgesia (except lidocaine) reported significantly less severe pain during removal compared to those who received none (16.6% vs. 29%).

Conclusions:

  • The PrePex device demonstrates a safety profile comparable to surgical circumcision.
  • Pre-emptive analgesia is effective in mitigating severe pain associated with PrePex device removal.

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