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Urinary tract infections and circumcision. A case-control study
1Division of Ambulatory Pediatrics, Children's Hospital, Boston, Mass. 02115.
Insights
Uncircumcised infant boys have a significantly higher risk of urinary tract infections (UTIs) compared to circumcised infants. This association holds true across different demographics and is linked to potential anatomical abnormalities.
Area of Science:
- Pediatrics
- Urology
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are common in infants.
- Previous studies suggest a higher UTI rate in uncircumcised infants.
Purpose of the Study:
- To investigate the association between noncircumcision and UTIs in infant boys.
- To determine if noncircumcision is a significant risk factor for infant UTIs.
Main Methods:
- A case-control study was conducted on infant boys with urine cultures.
- Cases had positive cultures ( > 10^5 organisms/mL); controls had negative cultures ( < 10^3 organisms/mL).
- Data were analyzed considering age, ethnicity, insurance, and culture method.
Main Results:
- All cases (100%) were uncircumcised, compared to 32% of controls.
- Noncircumcision was a significant risk factor for UTIs across all analyzed subgroups.
- Anatomic abnormalities were found in 26% of UTI cases.
Conclusions:
- Noncircumcision is a highly significant risk factor for UTIs in infants up to 12 months.
- The risk associated with noncircumcision is independent of race and socioeconomic status.
- A notable percentage of UTIs in uncircumcised infants are associated with underlying anatomic abnormalities.
Abstract:
It has been shown that uncircumcised infants have a higher rate of urinary tract infections in the first few months of life. To investigate further the association between noncircumcision and urinary tract infections, a case-control study was performed of infant boys who had a catheterized or suprapubic urine culture done as part of an acute illness visit. Cases (n = 36) were those infants who had a positive culture (greater than 105 organisms per milliliter); controls (n = 76) had a negative culture (less than 103 organisms per milliliter). There were no significant differences found in the two groups in age, ethnic group, and type of medical insurance. All of the cases were uncircumcised, vs 32% of controls. The data were analyzed separately by age, ethnic group, type of insurance, and method of culture, and in all groups the cases were significantly more likely to be uncircumcised. Of the 31 cases who underwent roentgenographic investigations, 8 had abnormal findings. Noncircumcision seems to be a highly significant risk factor for urinary tract infection in infants up to 12 months of age, affects infants regardless of race and socioeconomic status, and is associated with anatomic abnormalities in 26% of cases.