MOPE681 - Poster Exhibition
Penile measurements in rural Tanzanian males: informing male circumcision device design
K. Chrouser1, E. Bazant1, L. Jin2,3, T. Adamu1, B. Kileo3, K. Curran1, H. Mahler3, S. Koshuma4, H. Sanghvi1
1Jhpiego - an affiliate of Johns Hopkins University, Baltimore, United States, 2Washington University in St. Louis School of Medicine, St Louis, United States, 3Jhpiego - an affiliate of Johns Hopkins University, Dar es Salaam, United Republic of Tanzania, 4Ministry of Health, United Republic of Tanzania, Dar es Salaam, United Republic of Tanzania
Background: Male circumcision has been shown to reduce female to male HIV transmission by about 60%, and WHO and UNAIDS have recommended rapid scale up of voluntary medical male circumcision (VMMC), for which several novel, cost-effective devices have been designed. By simplifying the circumcision procedure, devices can potentially accelerate the pace of VMMC scale up by allowing circumcisions to be done by non-physician clinicians in rural settings. Penile measurement data in a target African population is needed for device development and sizing, and is not available in the current literature.
Methods: Clients undergoing VMMC at health facilities in Tanzania's Iringa region between July and September 2011 were recruited after informed consent. After local anesthesia and prior to circumcision, measurements of the glans, shaft and foreskin were collected using calipers, rulers, and tape measures. Age, Tanner stage, height, and weight were also recorded.
Results: 252 males participated, ranging in age from 10 to 47. Table 1 reports penile measurements by age category. This rural population is non-obese with a median BMI in adults of 20.8. Glans and foreskin measurements are most critical to device fit. We found glans circumference was highly correlated with patient height (r=0.80, p< .001) and weight (r=0.81, p< .001). Stretched diameter of the distal foreskin was moderately correlated with patient height (r=0.68, p< .001) and weight (r=0.71, p< .001).
[Table 1. Penile measurement by age category]
|Measurement Variable||Age 10-13
(n=52) Median(IQR)||Age 14-18
|Stretched penile length in cm
(using ruler)||7.5 (6.4, 8.3)||10.0 (8.3, 11.2)||11.5 (10.7, 12.3)|
|Glans length in cm
(using ruler)||1.8 (1.5, 1.9)||2.5 (2.1, 2.8)||2.9 (2.6, 3.2)|
|Girth/circumference of shaft proximal to corona in cm (using tape measure)||5.5 (5.0, 6.0)||7.9 (7.0, 8.5)||8.5 (8.1, 9.0)|
|Girth/circumference at coronal ridge/margin in cm(using tape measure)||5.5 (5.0, 5.8)||7.9 (6.9, 8.7)||8.8 (8.2, 9.4)|
|Foreskin stretched diameter distally in cm (using calipers)||2.6 (2.3, 3.0)||4.0 (3.3, 4.5)||4.6 (4.2, 4.9)|
|Foreskin thickness under tension in mm (using calipers)||1.1 (1.0, 1.2)||1.3 (1.2, 2.0)||1.4 (1.2, 1.8)|
|Distance from coronal ridge to distal edge of foreskin in cm (using ruler)||2.5 (2.0, 2.8)||3.0 (2.6, 3.4)||3.3 (3.0, 3.6)|
Conclusions: This descriptive study provides critical baseline data to inform device development and sizing in a rural African population. Penile dimensions, including stretched penile length and shaft circumference, are slightly lower than previously reported in world literature, although notably this is the first study performed in an African population. These differences suggest potential influence of environmental, nutritional or genetic factors. Correlation between somatometric parameters (height and weight) and penile measurements in this population may simplify prediction of future device sizing and fit.
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