In a two-part study of the circumcision status of boys with urinary tract infections (UTIs), we reviewed the occurrence of UTIs in 209,399 infants born in US Army hospitals worldwide from 1985 to 1990. During the first year of life, 1,046 (0.5%: 550 girls and 496 boys) were hospitalized for UTIs. Noncircumcised male infants had a 10-fold greater incidence of infection than did circumcised male infants. The frequency rate of circumcision rose significantly, from 70.3% to 80.2%, during the study period. Among uncircumcised boys younger than 3 months with UTIs, 23% had concomitant bacteremia involving the same organism. The second part of the study consisted of a meta-analysis of all nine previous reports on the circumcision status of boys with UTIs. These studies revealed a fivefold to 89-fold increased risk of infection in uncircumcised boys; the combined data yielded a 12-fold increase in UTIs in this population. Parents should be told of the lower risk of UTIs for circumcised boys during informed-consent counseling.

Wallerstein E. Circumcision: the uniquely American medical enigma. Urol Clin North Am. 1985;12:123-132. Google Scholar, Medline, ISI
Schoen EJ The status of circumcision of newborns. N Engl J Med. 1990;322:1308-1311. Google Scholar, Crossref, Medline, ISI
Poland RL The question of routine neonatal circumcision. N Engl J Med. 1990;322:1312-1315. Google Scholar, Crossref, Medline, ISI
American Academy of Pediatrics , Committee on Fetus and Newborn. Standards and Recommendations for Hospital Care of Newborn Infants. 5th ed. Evans-ton, IL : American Academy of Pediatrics ; 1971:110. Google Scholar
Thompson HC , King LR , Knox E. , et al. Report of the ad hoc task force on circumcision. Pediatrics. 1975;56:610-611. Google Scholar, Medline, ISI
Wiswell TE , Smith FR , Bass JW Decreased incidence of urinary tract infections in circumcised male infants . Pediatrics. 1985;75:901-903. Google Scholar, Medline, ISI
Wiswell TE , Roscelli JD Corroborative evidence for the decreased incidence of urinary tract infections in circumcised male infants. Pediatrics. 1986 ;78:96-99. Google Scholar, Medline, ISI
Wiswell TE , Enzenauer RW , Holton ME , et al. Declining frequency of circumcision: implications for changes in the absolute incidence and male-to-female sex ratio of urinary tract infections in early infancy. Pediatrics. 1987;79:338-342. Google Scholar, Medline, ISI
Wiswell TE , Geschke DW Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989;83:1011-1015. Google Scholar, Medline, ISI
Ginsburg CM , McCracken GH Jr. Urinary tract infections in young infants . Pediatrics. 1982;69:409-412. Google Scholar, Medline, ISI
Schoen EJ , Anderson G. , Bohon C. , et al. Report of the task force on circumcision. Pediatrics . 1989;84:388-391. Google Scholar, Medline, ISI
Rudolph AM , ed. Rudolph's Pediatrics. 19th ed. Norwalk, CT: Appleton and Lange; 1991:1288-1293. Google Scholar
Oski FA , ed. Principles and Practice of Pediatrics. Philadelphia, PA: JB Lippincott ; 1990:1968-1973. Google Scholar
Avery ME , First LR , eds. Pediatric Medicine. Baltimore, MD: Williams & Wilkins; 1989 :611-614. Google Scholar
Thompson RS Is routine circumcision indicated in the newborn? An opposing view. J Fam Pract. 1990;31:189-196. Google Scholar, Medline, ISI
Snyder HM To circumcise or not. Hosp Pract. 1991;26:201-207. Google Scholar, Crossref, ISI
Rushton HG , Majd M. Pyelonephritis in male infants: how important is the foreskin? J Urol. 1992;148:733-736. Google Scholar, Crossref, Medline, ISI
Nelson JW , McCracken GH Jr. Circumcision and UTI. Pediatr Infect Dis J. 1984;10:6. Google Scholar
Herzog LW Urinary tract infections and circumcision. A case-control study. Am J Dis Child. 1989;143:348-350. Google Scholar, Crossref, Medline
Kashani IA , Faraday R. The risk of urinary tract infection in uncircumcised male infants. Int Pediatr. 1989;4:44-45. Google Scholar
Crain EF , Gershel JC Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatrics. 1990 ;86:363-367. Google Scholar, Medline, ISI
Jenicek M. Meta-analysis in medicine: where we are and where we want to go. J Clin Epidemiol. 1989;42:35-44. Google Scholar, Crossref, Medline, ISI
Thacker SB Meta-analysis: a quantitative approach to research integration. JAMA. 1988;259:1685-1689. Google Scholar, Crossref, Medline, ISI
Oxman A. Science of reading. Pediatrics. 1989;83:617-619. Google Scholar, Medline, ISI
Mann C. Meta-analysis in the breech. Science. 1990 ;249:476-480. Google Scholar, Crossref, Medline, ISI
Walker AM , Martin-Moreno JM , Rodriguez Artalejo F. Odd man out: a graphical approach to meta-analysis. Am J Public Health. 1988;78:961-966. Google Scholar, Crossref, Medline, ISI
Sacks HS , Berrier J. , Reitman D. , et al. Meta-analyses of randomized controlled trials. N Engl J Med. 1987;316:450-455. Google Scholar, Crossref, Medline, ISI
Henry DA , Wilson A. Meta-analysis. Med J Aust. 1992;156:31-38,173-187. Google Scholar, Medline, ISI
Mantel N. , Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719-748. Google Scholar, Medline
Cochran WG The combination of estimates from different experiments. Biometrics. 1954;10:101-129. Google Scholar, Crossref, ISI
DerSimonian R. , Laird N. Meta-analysis in clinical trials. Controlled Clin Trials. 1986;7:177-188. Google Scholar, Crossref, Medline
Wiswell TE Larger numbers needed. Pediatrics. 1987;80:763-764. Google Scholar, Medline, ISI
Winberg J. The prepuce: a mistake of nature? Lancet. 1989;1:598-599. Google Scholar, Crossref, Medline, ISI
Wiswell TE The circumcision debate. Pediatrics. 1987;79:649-650. Google Scholar, Medline, ISI
Stang HJ Influence of circumcision status on urinary tract infections in pediatric males. Presented at the annual meeting of the Ambulatory Pediatric Association ; May 6, 1992; Baltimore, MD. Google Scholar
Spach DH , Stapleton AE , Stamm WE Lack of circumcision increases the risk of urinary tract infection in young men. JAMA. 1992;267:679-681. Google Scholar, Crossref, Medline, ISI
View access options

My Account

Welcome
You do not have access to this content.



Chinese Institutions / 中国用户

Click the button below for the full-text content

请点击以下获取该全文

Institutional Access

does not have access to this content.

Purchase Article

Your Access Options


Purchase

CPJ-article-ppv for $40.00

Article available in: