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Do antibiotic prophylaxis and/or circumcision change periurethral uropathogen colonization and urinary
Adnan Gücük1, Berk Burgu, İlker Gökçe
1Department of Urology, Abant Izzet Baysal University Faculty of Medicine, Gölköy Kampusu, Bolu, Turkey.
Insights
Circumcision significantly reduces periurethral bacterial colonization in boys. For boys with vesicoureteral reflux (VUR), circumcision combined with antibiotic prophylaxis effectively prevents recurrent urinary tract infections.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Surgical Interventions
Background:
- Investigating the impact of circumcision and antibiotic prophylaxis on periurethral flora and bacteriuria.
- Assessing these effects in male children with and without vesicoureteral reflux (VUR).
Purpose of the Study:
- To determine the influence of circumcision and antibiotic prophylaxis on periurethral bacterial colonization.
- To evaluate the prevention of urinary tract infections (UTIs) in boys with VUR.
Main Methods:
- A study involving 91 boys with low-grade VUR and 106 healthy controls.
- Randomization into groups receiving antibiotic prophylaxis alone, or with circumcision.
- Periurethral swabs and urine cultures collected over 12 months for comparative analysis.
Main Results:
- Circumcised boys exhibited significantly lower rates of positive periurethral cultures.
- Positive urine culture rates were lower in circumcised compared to uncircumcised boys.
- Age did not influence the observed statistical differences in bacterial colonization.
Conclusions:
- Circumcision effectively reduces colonization by pathogenic bacteria in the periurethral area.
- Combined circumcision and antibiotic prophylaxis are highly effective in preventing recurrent UTIs in boys with VUR.
Background:
To evaluate the effect of circumcision and/or antibiotic prophylaxis on periurethral flora and associated bacteriuria in male children with and without vesicoureteral reflux (VUR).
Patients And Methods:
The study included 91 boys with low-grade VUR and 106 healthy boys (control) without VUR. The boys with VUR were randomized as antibiotic prophylaxis only and antibiotic prophylaxis plus circumcision. The boys without VUR were randomized as circumcision group and followed-up group without circumcision. Periurethral swab and urine cultures were obtained from the participants at the beginning of the study, and at 1st, 3rd, 6th, 9th, and 12th month. The groups were compared in terms of positive periurethral and urine cultures.
Results:
The positive periurethral culture rate was significantly lower in the circumcised boys at all measurement times. The positive urine culture rate in the circumcised boys was lower than in the uncircumcised boys. Subgroup analysis based on age groups showed that age did not affect these statistical differences.
Conclusion:
Circumcision decreases colonization of periurethral bacterial pathogenic flora. In boys with low-grade VUR, circumcision plus antibiotic prophylaxis prevented recurrent and febrile urinary tract infections.
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