UTI's & circ

[mamadelbosque]

Hi there, we just got home from the hospital with my 3 week old son. We were admittied late thursday/early friday morning for what turned out to be a urniary tract infection. My son is not circumsized, and the doctor we saw (NOT our usual ped, just the one that was/is 'on call') said somethough about it - I gave her a nasty look and she never brought it up again. But my impression from here was 'you should have him circ'd else he'll be back in here shortly' - I just got that vibe, yk? SO.. I'm wondering, what are the risks of uti in circ'd vs uncirc'd boys? (not that I have an intention of getting him circ'd!!)

[robertandenith]

the foreskin has nothing to do with UTI, in fact there are more chances to get UTI's when there is no foreskin since the foreskin is not there to protect the urethra from feces, bacteria and ammonia from urine. Are you breastfeeding? Keep breastfeeding and probably apply some breastmilk in his genitals. Keep him hydrated with breastmilk. I know someone else may have more advice for you...

[MCatLvrMom2A&X]

The only study linking foreskin and UTI is not accurate because they used intact premature boys and compared them to full term circed infants. Because premature infants both boys and girls are more prone to UTI the study is invalid. Here are some links for you:
UTI myth http://www.cirp.org/library/disease/UTI/
http://www.nocirc.org/statements/breastfeeding.php

In fact, UTI's are so rare in any case that, using Wiswell's data, 50 to 100 healthy boys would have to be circumcised in order to prevent a UTI from developing in only one patient. (Using more recent data from a better-controlled study, the number of unnecessary operations needed to prevent one hospital admission for UTI would jump to 195.

FORESKINS: Seek Elsewhere for Infants' Urinary Tract Infections
http://www.cirp.org/news/1997.12.22_PhysiciansWeekly/




UTI Neonatal circumcision revisited
http://www.cps.ca/english/statements/FN/fn96-01.htm#PREVENTION%20OF%20UTI


The incidence of Geniturinary abnormalities in circumcised and uncircumcised presenting with an initial urinary tract infection by 6 months of age
http://www.cirp.org/library/disease/UTI/mueller/

[glongley]

There is a very interesting new study out showing how, assuming UTIs to in fact occur at the same rate in intact and circed boys, that common confounding factors could account for 4X overdiagnosis of UTI in intact boys.

Van Howe RS.Effect of confounding in the association between circumcision status and urinary tract infection. J Infect. 2005 Jul;51(1):59-68.

OBJECTIVES: To estimate the impact of confounding in the association between circumcision status and urinary tract infection from epidemiological factors, sample collection, and health-seeking behaviors in the first year of life.

METHODS: Beginning with the assumption that true urinary tract infection occurred equally regardless of circumcision status, a Markov model incorporating the differences in the rates of prematurity, of urine collection, of false positive urine specimens, and of health-seeking behaviors in infant boys based on circumcision status was developed. Using this model, the rates of false-positive urine cultures, asymptomatic bacteriuria, and true urinary tract infection detected in the first year of life were estimated and contrasted. Error of the model was estimated using Monte Carlo simulations.

RESULTS: Keeping the incidence of true urinary tract infection constant between groups, the factors included in the model could account for urinary tract infection being diagnosed 4.27 times more frequently in non-circumcised males under a year of age.

CONCLUSIONS: Previously reported differences in the rate of urinary tract infection by circumcision status could be entirely due to sampling and selection bias. Until clinical studies adequately control for sources of bias, circumcision should not be recommended as a preventive for urinary tract infection.

[MommytoB]

Also, make sure your Do Not Ever Pull back the foreskin because all you do is wipe on the outside.

[Alyantavid]

Neither of my boys are circed and have never had a uti. My oldest is 7.

[eepster]

Since others have pointed out the flaws in the studies showing a link, I won't get into that, but simply talk about whether the studies suggest circumcision as curative for UTI.

If the studies are taken at face value, they only show a reduction in UTI's for the first 6 months of life. Does it make sense to permanently alter the body for a very temporary effect?

Circumcised boys have the same risk for congenital problem of the urinary tract, but are less likely to be dx with them till later in life, since the recurrent UTI are missed. Basically intact boys are more likely to be symptomatic facilitating early detection of urinary tract deformities. Obviously I hope you DS doesn't have this problem, but if he does it's better to leave him intact and catch it early instead making him go through painful surgery that will mask the symptoms.

Once again taking the studies at face value, there is only a 1% chance of UTI in intact boys. There is a 2% chance of surgical complication, a 10% chance of meatal stenosis, etc, etc.

[snangel]

I know I am a girl, but I am intact...I suffer and have since infancy from a disorder of my kidneys and urinary tract. I have had countless uti's. (Like normally 1 every other month or so, they also often go into my kidneys) I have had several surgeries to try and correct what is wrong (with my urinary tract, urethra, things like that), but they can only do so much...strange how no doctor has ever recommended circ to me...weird eh....

[just_lily]

I also had severe issues with reflux and nearly continuous UTIs as an infant and young child. I was on a daily dose of antibiotics for YEARS. I had several surgeries to correct the reflux, but nothing was ever done to alter my genitals. Good thing I wasn't a boy.