title: Penile measurements in Tanzanian males: guiding circumcision device design and supply forecasting.
abstract: OBJECTIVE
  Voluntary medical male circumcision decreases the risk in males of HIV infection through heterosexual intercourse by about 60% in clinical trials and 73% at post-trial followup. In 2007 WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended that countries with a low circumcision rate and high HIV prevalence expand voluntary medical male circumcision programs as part of a national HIV prevention strategy. Devices for adult/adolescent male circumcision could accelerate the pace of scaling up voluntary medical male circumcision. Detailed penile measurements of African males are required for device development and supply size forecasting.
  
  
  METHODS
  Consenting males undergoing voluntary medical male circumcision at 3 health facilities in the Iringa region, Tanzania, underwent measurement of the penile glans, shaft and foreskin. Age, Tanner stage, height and weight were recorded. Measurements were analyzed by age categories. Correlations of penile parameters with height, weight and body mass index were calculated.
  
  
  RESULTS
  In 253 Tanzanian males 10 to 47 years old mean ± SD penile length in adults was 11.5 ± 1.6 cm, mean shaft circumference was 8.7 ± 0.9 cm and mean glans circumference was 8.8 ± 0.9 cm. As expected, given the variability of puberty, measurements in younger males varied significantly. Glans circumference highly correlated with height (r = 0.80) and weight (r = 0.81, each p <0.001). Stretched foreskin diameter moderately correlated with height (r = 0.68) and weight (r = 0.71, each p <0.001).
  
  
  CONCLUSIONS
  Our descriptive study provides penile measurements of males who sought voluntary medical male circumcision services in Iringa, Tanzania. To our knowledge this is the first study in a sub-Saharan African population that provides sufficiently detailed glans and foreskin dimensions to inform voluntary medical male circumcision device development and size forecasting.
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Chrouser
authors.forename: Eva
authors.initials: E
authors.lastname: Bazant
authors.forename: Linda
authors.initials: L
authors.lastname: Jin
authors.forename: Baldwin
authors.initials: B
authors.lastname: Kileo
authors.forename: Marya
authors.initials: M
authors.lastname: Plotkin
authors.forename: Tigistu
authors.initials: T
authors.lastname: Adamu
authors.forename: Kelly
authors.initials: K
authors.lastname: Curran
authors.forename: Sifuni
authors.initials: S
authors.lastname: Koshuma
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002944:Circumcision, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010413:Penis / Q000033:anatomy & histology* / Q000601:surgery*; D013636:Tanzania
keywords: Africa south of the Sahara; BMI; HIV; VMMC; body mass index; circumcision; male; organ size; penis; voluntary medical male circumcision