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The ShangRing device for simplified adult circumcision

Abstract

Adult male circumcision reduces HIV transmission through vaginal intercourse and is being promoted in areas where HIV is widespread. Conventional surgical circumcision involves suturing and thus requires practitioners with surgical skills. It is also associated with complications, including bleeding and infection, especially in resource-poor settings. The ShangRing (Wuhu Snnda Medical Treatment Appliance Technology Co. Ltd, Wuhu City, China) has been used to perform thousands of circumcisions in adult men, principally in China. It consists of two concentric plastic rings that sandwich the foreskin of the penis, allowing circumcision without stitches or notable bleeding. As well as substantially reduced operative times, ShangRing adult male circumcision is associated with a low complication rate, and the technique can easily be taught to both physician and nonphysician personnel. The simple technique and successful outcomes associated with the ShangRing procedure mean that the device could enable standardization of adult male circumcision, helping HIV prevention efforts throughout the developing world.

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Figure 1: The ShangRing is comprised of two concentric plastic rings: an inner ring and an outer ring.
Figure 2: Correct sizing of the ShangRing is done using a penile circumference measuring tape.
Figure 3: The ShangRing procedure.
Figure 4: Removal of the ShangRing.
Figure 5: Penile appearance following circumcision.
Figure 6: When the ShangRing is removed, healthy pink granulation tissue encircles the penis.

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Acknowledgements

The authors would like to thank Y. Peng and Y. Chang for their work using the ShangRing in China and for sharing their clinical experiences with us.

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All authors researched data for the article and were involved in discussion of content, as well as writing and reviewing and editing the manuscript before submission.

Corresponding author

Correspondence to Marc Goldstein.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Figure (JPG 31 kb)

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No–needle anesthesia for ShangRing circumcision (DOC 30 kb)

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Masson, P., Li, P., Barone, M. et al. The ShangRing device for simplified adult circumcision. Nat Rev Urol 7, 638–642 (2010). https://doi.org/10.1038/nrurol.2010.167

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