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Urinary tract infections and the uncircumcised state: an update

T E Wiswell1, W E Hachey

  • 1Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC 20307-5001.

Clinical Pediatrics
|March 1, 1993
PubMed

Insights

Male infants who are not circumcised have a significantly higher risk of urinary tract infections (UTIs). This study found uncircumcised boys had a 10-fold greater incidence of UTIs compared to circumcised boys.

Area of Science:

  • Pediatrics
  • Urology
  • Infectious Disease Epidemiology

Background:

  • Urinary tract infections (UTIs) are common in infants.
  • The role of circumcision in UTI prevention is a subject of ongoing research.
  • Understanding risk factors for infant UTIs is crucial for public health.

Purpose of the Study:

  • To investigate the association between circumcision status and the occurrence of UTIs in male infants.
  • To analyze the incidence of UTIs in relation to circumcision rates over time.
  • To synthesize existing evidence on circumcision and UTI risk through meta-analysis.

Main Methods:

  • Retrospective review of UTI hospitalizations in 209,399 infants born in US Army hospitals (1985-1990).
  • Analysis of UTI incidence in circumcised versus uncircumcised male infants.
  • Meta-analysis of nine previous studies on circumcision and pediatric UTIs.

Main Results:

  • Uncircumcised male infants had a 10-fold higher incidence of UTIs than circumcised infants.
  • Circumcision rates increased from 70.3% to 80.2% during the study period.
  • Meta-analysis revealed a combined 12-fold increased risk of UTIs in uncircumcised boys, with individual studies showing a 5- to 89-fold increase.

Conclusions:

  • Male infant circumcision is associated with a significantly lower risk of urinary tract infections.
  • Informed consent counseling should include information on the reduced UTI risk for circumcised boys.
  • The findings support the protective effect of circumcision against UTIs in male infants.

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