- by Dr Gowher Yusuf
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- Sep 29 2017
Urinary Tract Infections Higher in Uncircumcised vs Circumcised Boys
(Source: July 9 in the Canadian Medical Association Journal)
According to the current study by Dubrovsky and colleagues, uncircumcised boys are at higher risk for urinary tract infections than circumcised boys, most likely as a result of heavier colonization under the foreskin with pathogenic bacteria, which leads to ascending infections. However, whether all uncircumcised boys are at equal risk for infection, or whether the risk varies with the visibility of the urethral opening, is not known.
All uncircumcised boys have a higher risk for acquiring a urinary tract infection, regardless of the degree of urethral meatus visibility (phimosis), according to a recent prospective cross-sectional study in the Canadian Medical Association Journal.
Alexander Sasha Dubrovsky, MDCM, a physician in the Division of Pediatric Emergency Medicine at Montreal Children's Hospital, McGill University Health Centre, Quebec, Canada, and colleagues explain that urinary tract infections are much more common in uncircumcised boys than in circumcised boys, and that some believe that the visibility of the urethral meatus (phimosis) plays a role, with the highest risk being in boys whose meatus is partially visible or non-visible.
"Although we cannot exclude the possibility that [boys with a completely visible meatus are] truly at higher risk (contrary to our hypothesis), this result should be interpreted with caution given the small number of participants in the completely visible group," the authors write. "Furthermore, no previous studies suggest such an association, nor is there an apparent physiologic mechanism to explain this finding."
All Uncircumcised Boys at Higher Risk: "Our results suggest that uncircumcised boys presenting with clinical symptoms or signs suggesting urinary tract infection are at equal risk for urinary tract infection irrespective of the visibility of the urethra. Clinicians should continue to use circumcision status alone, not the degree of phimosis, to decide which boys should undergo investigation for urinary tract infection," the authors conclude.
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