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Risks from circumcision during the first month of life compared with those for uncircumcised boys
1Medical Research Fellowship, Walter Reed Army Institute of Research, Washington, DC.
Insights
Routine infant circumcision is rare and minor complications. Uncircumcised infants had higher rates of urinary tract infections and bacteremia, suggesting a potential benefit of circumcision.
Area of Science:
- Pediatric Medicine
- Urology
- Public Health
Background:
- Circumcision is a common procedure in the United States.
- The medical benefits and risks of infant circumcision are debated.
- Urinary tract infections (UTIs) are a significant concern in infants.
Purpose of the Study:
- To evaluate the complication rates associated with infant circumcision.
- To compare the incidence of urinary tract infections in circumcised and uncircumcised infants.
- To assess the association between circumcision status and serious infant infections.
Main Methods:
- Retrospective review of medical records from US Army hospitals (1980-1985).
- Analysis of 136,086 male infants based on circumcision status.
- Indexed complications were tracked during the first month of life.
Main Results:
- Circumcised infants (n=100,157) had a 0.19% complication rate (infections, hemorrhage, trauma).
- Uncircumcised infants (n=35,929) had a 0.24% complication rate, exclusively UTIs.
- UTIs and bacteremia were significantly more frequent in uncircumcised infants (P < .0001 and P < .0002, respectively).
- Two deaths occurred in the uncircumcised group due to UTI complications.
Conclusions:
- Serious complications from infant circumcision are rare and generally minor.
- Circumcision may reduce the risk of urinary tract infections and associated severe outcomes.
- The study supports a potential protective effect of circumcision against UTIs in male infants.
Abstract:
The records of 136,086 boys born in US Army hospitals from 1980 to 1985 were reviewed for indexed complications related to circumcision status during the first month of life. For 100,157 circumcised boys, there were 193 complications (0.19%). These included 62 local infections, eight cases of bacteremia, 83 incidences of hemorrhage (31 requiring ligature and three requiring transfusion), 25 instances of surgical trauma, and 20 urinary tract infections. There were no deaths or reported losses of the glans or entire penis. By contrast, the complications in the 35,929 uncircumcised infants were all related to urinary tract infections. Of the 88 boys with such infections (0.24%), 32 had concomitant bacteremia, three had meningitis, two had renal failure, and two died. The frequencies of urinary tract infection (P less than .0001) and bacteremia (P less than .0002) were significantly higher in the uncircumcised boys. Serious complications from routine prepuce removal are rare and relatively minor. Circumcision may be beneficial in reducing the occurrence of urinary tract infections and their associated sequelae.