PURPOSE: Urinary tract infection (UTI) is common in infant males who are uncircumcised and can lead to renal parenchymal disease of the still-growing pediatric kidney.
Although the rate of UTI is highest in the first year of life, the cumulative incidence over the rest of the lifetime is under-recognized, but is expected to be non-trivial. Thus any intervention that might prevent UTI would be expected to reduce suffering and medical costs.
MATERIALS AND METHODS: We conducted a meta-analysis of 22 studies examining the single risk factor of lack of circumcision, then determined the prevalence and relative risk (RR) of UTI in different age groups (0-1, 1-16 and >16 years of age). From these data we estimated lifetime prevalence.
RESULTS: For age 0-1 year RR was 9.91 (95% CI 7.49-13.1), for age 1-16 years RR was 6.56 (95% CI 3.26-13.2), and for >16 years was 3.41 (95% CI 0.916-12.7) fold higher in uncircumcised males. We then calculated that 32.1% (95% CI 15.6-49.8) of uncircumcised males experience a UTI over their lifetime compared with 8.8% (95% CI 4.15-13.2) of circumcised males (RR 3.65; 95% CI 1.15-11.8). Number needed to treat was 4.29 (95% CI 2.20-27.2).
CONCLUSIONS: The single risk factor of lack of circumcision confers a 23.3% chance of UTI over the lifetime. This greatly exceeds prevalence of circumcision complications (1.5%), which are mostly minor. The potential seriousness of UTI supports circumcision as a desirable preventive health intervention in infant males.
Written by:
Morris BJ, Wiswell TE. Are you the author?
School of Medical Sciences and Bosch Institute, University of Sydney, New South Wales 2006 Australia.
Reference: J Urol. 2012 Nov 27. pii: S0022-5347(12)05623-6.
doi: 10.1016/j.juro.2012.11.114
PubMed Abstract
PMID: 23201382
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