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Comparative periurethral bacteriology of uncircumcised and circumcised males
Insights
Uncircumcised males over one year old harbor more potential uropathogens in the periurethral area. This finding supports increased urinary tract infection risk and the prepuce acting as a reservoir for sexually transmitted organisms.
Area of Science:
- Urology
- Microbiology
- Infectious Diseases
Background:
- Lack of circumcision is linked to increased urinary tract infection (UTI) risk in infants.
- The foreskin is associated with higher uropathogen levels in the periurethral area during early infancy.
- Limited data exists on this association in older males.
Purpose of the Study:
- To investigate and compare the periurethral bacterial flora in uncircumcised and circumcised healthy adult males.
- To assess the presence of specific bacteria, genital mycoplasmas, and Chlamydia trachomatis.
Main Methods:
- Swab cultures were performed on the periurethral areas of 125 uncircumcised and 46 circumcised males (mean ages 26.5 and 28.3 years).
- Cultures targeted facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis.
Main Results:
- Facultative Gram-positive cocci were predominant in both groups.
- Facultative Gram-negative rods were significantly more common in uncircumcised males (17% vs. 4%, p=0.01).
- Streptococci, strict anaerobes, and genital mycoplasmas were primarily found in uncircumcised males over 15 years old. Chlamydia trachomatis was not detected.
Conclusions:
- The subpreputial space in uncircumcised males harbors a higher prevalence of potential uropathogens.
- This finding aligns with previous research indicating an elevated UTI risk in uncircumcised young men.
- The prepuce may serve as a reservoir for sexually transmitted organisms.
Background:
It has been established that lack of circumcision increases the risk of urinary tract infection in infants. During the first six months, the presence of foreskin is associated with a greater quantity and a higher concentration of uropathogens in the periurethral area. Very little is known about this association in older males.
Objective:
To compare the periurethral bacteriology of uncircumcised healthy males of more than one year of age.
Methods:
The periurethral area of 125 uncircumcised and 46 circumcised healthy males (mean age, 26.5 and 28.3 years, respectively) was swabbed and cultured for facultative and anaerobic bacteria, genital mycoplasmas and Chlamydia trachomatis.
Results:
Facultative Gram positive cocci predominated in both groups (62% and 80%, respectively). Pure culture of facultative Gram negative rods was more common in uncircumcised males (17% v 4% in circumcised males, p = 0.01). Streptococci, strict anaerobes and genital mycoplasmas were found almost exclusively in uncircumcised males of more than 15 years of age. No case of C trachomatis was identified.
Conclusions:
The higher prevalence of potential uropathogens in the subpreputial space is in accordance with a previous finding of increased risk of urinary tract infection in uncircumcised young men. Our results also support the role of the prepuce as a reservoir for sexually transmitted organisms.