Epididymitis in children: the circumcision factor?

Recommendations for circumcision have significantly altered in the last several years. Studies have objectively established an increased risk of urinary tract infection in uncircumcised boys. We evaluated the relationship between epididymitis and circumcision status.

We studied the relationships among the circumcision status of 36 consecutive boys with epididymitis in a review of 128 with acute scrotal inflammation (group 1), circumcision status of 43 in whom the diagnosis of epididymitis at discharge home had been made elsewhere (group 2), New York State hospital discharge figures for circumcision in newborns (group 3) and the regional prevalence of circumcision in 200 consecutive pediatric emergency department patients at the same institution with nonurological diagnoses (group 4).

New York State Department figures indicate that 70% of male newborns are discharged home with a hospital code for circumcision. Similarly an evaluation of 200 consecutive male patients without urological diagnoses younger than 18 years in the emergency department revealed that 131 (65%) were circumcised. Comparatively in groups 1 and 2 only 25 and 26% of patients, respectively, were circumcised. The statistical difference in circumcision status among the 4 groups was significant (p >0.0004).

These data demonstrate with highly statistical significance that a relationship exists between epididymitis and the presence of a foreskin. We found that an intact foreskin is an important etiological factor in boys with epididymitis.