July 20th, 2012

Urinary Tract Infections More Common in Uncircumcised Boys


Uncircumcised boys are more likely than circumcised boys to develop a urinary tract infection (UTI), and UTI risk is elevated regardless of how tight or loose the foreskin is. These results were published in the Canadian Medical Association Journal.

The urinary tract includes the kidneys, the ureters, the bladder, and the urethra. Infections of the urinary tract are very common, and a majority are caused by bacteria that enter the urinary tract through the urethra and then travel upwards.

Circumcision is the removal of the foreskin (the skin that covers the tip of the penis). Uncircumcised boys are known to have a higher risk of UTI than circumcised boys, but it’s been uncertain whether the characteristics of the foreskin affect UTI risk among uncircumcised boys. It’s possible, for example, that tight foreskins could trap bacteria to a greater extent than looser foreskins.

To further explore the relationship between circumcision and UTI risk in young boys, researchers conducted a study among 393 boys who had a catheter urine culture performed in a pediatric emergency department because of a suspected UTI. Half of the boys were under four months of age, and none of the boys was toilet trained. Of the 393 boys, 309 were uncircumcised and 84 were circumcised.

For the uncircumcised boys, the nurses who inserted the catheters were asked to categorize how visible the opening of the urethra was: nonvisible, partially visible, or completely visible. A nonvisible urethral opening indicates a tighter foreskin.

  • Overall, 20% of the boys were found to have a UTI. A UTI was identified in 4.8% of the circumcised boys, 30% of the uncircumcised boys with a completely visible urethral opening, and 24% of the uncircumcised boys with a partially visible or nonvisible urethral opening.

The results confirm that uncircumcised boys are more likely than circumcised boys to develop a UTI. Furthermore, among uncircumcised boys, UTI risk appears to be elevated regardless of the tightness of the foreskin.

Reference: Dubrovsky AS, Foster BJ, Jednak R, Mok E, McGillivray D. Visibility of the urethral meatus and risk of urinary tract infections in boys. CMAJ. Early online publication July 9, 2012.

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Tags: News, Uncategorized, Urology