Preputial condition and urinary tract infections

Area of Science:

• Pediatric Urology
• Infectious Diseases

Background:

• Urinary tract infections (UTIs) are increasingly reported in uncircumcised male infants.
• Optimal foreskin management in newborns and infants remains an unresolved clinical question.

Purpose of the Study:

• To prospectively assess foreskin retractability with age.
• To investigate the correlation between foreskin retractability and UTIs in male children.

Main Methods:

• Prospective study of 122 male children under 15 years of age.
• Evaluation of foreskin retractability and incidence of bacteriuria.
• Correlation analysis between foreskin status and UTI development.

Main Results:

• Foreskins were largely unretractable under 6 months, becoming retractable over 3 years of age.
• Bacteriuria incidence was 11.4% in uncircumcised males; none in circumcised or hypospadias cases.
• UTI patients with poor foreskin retraction (<25%) showed varied clinical presentations, including systemic infection with E. coli and local symptoms with Proteus mirabilis.

Conclusions:

• Foreskin retractability naturally increases with age in male children.
• Uncircumcised status and poor foreskin retraction are associated with increased UTI risk.
• Specific bacterial pathogens (E. coli, Proteus mirabilis) in UTIs correlate with distinct clinical outcomes and potential renal involvement.