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Routine neonatal circumcision for the prevention of urinary tract infections in infancy
Vanitha A Jagannath1, Zbys Fedorowicz, Vikas Sud
1Department of Paediatrics, AmericanMission Hospital, Manama, Bahrain. zbysfedorowicz@gmail.com
Insights
Routine neonatal circumcision may prevent urinary tract infections (UTI) in male infants by reducing bacterial colonization. However, no randomized controlled trials were found to confirm its effectiveness or safety for UTI prevention.
Area of Science:
- Neonatal care
- Pediatric surgery
- Infectious disease prevention
Background:
- Neonatal circumcision is a common procedure sometimes performed to prevent urinary tract infections (UTI) in male infants.
- Periurethral bacterial colonization is a potential risk factor for UTI, and circumcision may reduce this risk.
- Evidence is needed to determine the benefits and harms of routine neonatal circumcision for UTI prevention.
Purpose of the Study:
- To evaluate the effectiveness and safety of routine neonatal circumcision in preventing UTIs in infants.
- To synthesize available evidence from randomized controlled trials on this topic.
Main Methods:
- A comprehensive literature search was conducted using the Cochrane Neonatal Review Group Trials Register.
- Searches included electronic databases, relevant journals, and conference proceedings up to June 30, 2011.
- The review planned to include randomized and quasi-randomized controlled trials.
Main Results:
- No relevant studies were identified for inclusion in this review.
- A thorough search of the literature did not yield any randomized controlled trials on routine neonatal circumcision for UTI prevention.
Conclusions:
- There is a lack of randomized controlled trials investigating the efficacy of routine neonatal circumcision for UTI prevention in male infants.
- Clinical decisions regarding neonatal circumcision for UTI prevention should be based on current guidelines and parental consultation in the absence of definitive evidence.
Background:
Neonatal circumcision is a fairly common surgical procedure that may be carried out for medical reasons, one of them being prevention of urinary tract infections (UTI) in male infants. Circumcision could help in reducing the incidence of UTI by reducing periurethral bacterial colonization, which is accepted as a potential risk factor in UTI. Evidence is needed to inform the benefits or harm for the routine use of this intervention.
Objectives:
To assess the effectiveness and safety of routine neonatal circumcision for the prevention of UTIs in infancy.
Search Methods:
We searched the Cochrane Neonatal Review Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We completed this search 30 June 2011.
Selection Criteria:
Randomised controlled trials and quasi-randomised controlled trials.
Data Collection And Analysis:
Two review authors had planned to independently screen studies, extract data and assess risk of bias using standard Cochrane Collaboration methodologies. We did not identify any studies for inclusion in this review.
Main Results:
We did not identify any relevant studies after a comprehensive search of the literature.
Authors' Conclusions:
We were unable to identify any randomised controlled trials on the use of routine neonatal circumcision for prevention of UTI in male infants. Until further evidence becomes available, clinicians should continue to base their decisions on position statements and recommendations and in conjunction with the opinions of the children's parents.
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