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Preputial condition and urinary tract infections

¹Department of Urology, School of Medicine, Hallym University, Seoul, Korea.

Journal of Korean Medical Science

|August 1, 1996

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Urinary tract infections (UTIs) are more common in uncircumcised infants. Foreskin retraction increases with age, and poor retraction is linked to UTIs, particularly with E. coli 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.

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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.