The Shang Ring procedure is an innovative technique used for adolescent and adult male circumcision. Utilizing the Shang Ring device offers numerous medical benefits, such as a 50 to 60 percent reduced risk of HIV transmission and lower chances of contracting HPV, HSV, and other sexually transmitted diseases. Additionally, male circumcision has been linked to decreased genital cancers, including cervical and penile cancer.
To facilitate the expansion of male circumcision use of devices like the Shang Ring has become essential for simplifying the procedure. Here we will be taught you step by step about the procedure. Let’s get started.
In 2016, the World Health Organization and UN AIDS established an ambitious target of 27 million male circumcisions in priority African countries, aiming for over 90% coverage among males aged 10 to 29. Device-assisted circumcision, such as the Shang Ring, is vital in achieving these goals.
The Shang Ring, a novel circumcision device, has been in China since 2005. It has an inner and outer ring, providing a safe and straightforward method for circumcision. Studies have shown that the Shang Ring is practical, well-accepted by individuals undergoing the procedure, and approved by the FDA and WHO for use in adults and adolescents.
ShangRing Safety Data
Ring, a medical device used for male circumcision, has shown promising safety data according to clinical studies. The World Health Organization (WHO) reports no serious adverse events and a low 1% rate of moderate adverse events, highlighting its potential as a safe procedure.
ShangRing Clinical Studies
ShangRing clinical studies have demonstrated numerous advantages over conventional circumcision procedures. The ShangRing offers minimal invasiveness and significantly reduces the procedure time, usually taking only 3 to 5 minutes.
It is easy to teach and learn, resulting in lower rates of pain, bleeding, and other adverse events. Additionally, satisfaction rates among both providers and patients are higher with ShangRing circumcision compared to conventional techniques.
ShangRing Step-by-Step Procedure
Choosing the Appropriate ShangRing Size
Proper measurement and sizing are crucial to ensure a successful ShangRing procedure. An undersized device can lead to post-operative pain, while an oversized device can cause increased penile edema and poor hemostasis. If the correct size is uncertain, it is recommended to use a smaller-sized Schoen ring. Studies have shown that providers can safely use one size smaller than the measured size, simplifying the supply chain.
Administering Local Anesthetic
Local anesthesia is essential to ensure patient comfort during the procedure. There are two options: traditional injectable anesthesia or topical anesthesia.
Before the procedure, proper skin preparation is necessary. A 2.5% povidone-iodine solution is used to scrub the penile area from the umbilicus to the upper mid-thigh. Alcohol-based scrubs should be avoided due to the potential for irritation. The foreskin should be retracted if possible to ensure thorough preparation.
Placing the ShangRing and Removing the Foreskin
The ShangRing procedure involves several steps:
- Testing Anesthetic Effect: The effect of the local anesthesia should be tested by pinching the foreskin with a hemostat clamp. This ensures that adhesions between the glans and foreskin can be freed without discomfort.
- Inserting the Inner Ring: The inner ring is inserted at a 45-degree angle, with adjustments made to its position near the frenulum if necessary.
- Confirming Ring Position: The outer ring is clamped over the inner ring, but only the first ratchet is engaged to allow confirmation of its position.
- Excising the Foreskin: Once the ring position is confirmed, the outer ring is locked, and the foreskin is carefully trimmed using curved iris scissors to protect the glans.
Postoperative Wound Care
After the procedure, the wound should be cleaned with povidone-iodine to ensure hemostasis. The penis and device can be wrapped with sterile gauze or left as is. Antibiotics are not required, and the rate of infection is low. Patients should be properly instructed to keep the wound clean and dry, abstain from sexual activity, and seek medical attention if they experience bleeding or partial detachment of the device.
The ShangRing is designed to detach spontaneously in 10 to 14 days. However, clients may schedule a visit for ring removal if it does not detach within 21 days or if there is partial detachment or bleeding. The outer ring is removed first by breaking the ratchet closure using a removal key opener. Then, the inner ring is gently freed from the wound using tissue forceps.
Post-procedure, the wound should be cleaned regularly with antiseptic, and a ShangRing bandage or suitable dressings should be applied. Patients must abstain from sexual activity, including masturbation until the wound is fully healed, which usually takes around seven weeks. Condoms should be used during sexual intercourse for at least six months after circumcision to protect the healing wound and prevent HIV transmission.
The ShangRing procedure requires careful sizing, proper anesthesia, meticulous skin preparation, accurate placement of the rings, and postoperative wound care. These steps ensure a successful circumcision with minimal complications and promote optimal wound healing. However, ensure you have chosen an expert medical professional who knows the complexities of the procedure. What is the plastibell procedure?