Monday, July 9, 2012

And the Circumcision Debate Continues - More UTIs in Uncircumcised Boys?

It's difficult to think of many things more polarizing in the parenting world as breast feeding versus bottle feeding, cloth diapers versus disposable diapers, and stay-at-home moms versus work-outside-the-home moms, but there is: circumcision. Parents who aren't sure what to do are bombarded with "It's horrible!" and "You must do it!" - messages from both sides of the circumcision spectrum. What are parents to do? Well, if they decide to research medical issues involved in circumcision, they may not come out any further ahead because the debate is raging on over there too.

The latest study to enter the fray of to circumcise or not to circumcise is one just published today in the CMAJ (Canadian Medical Association Journal) regarding urinary tract infections (UTIs) and circumcisions. Researchers from the Montreal Children's Hospital looked at boys who developed UTIs, whether they were circumcised and if uncircumcised, if the meatus (where the urethra opens to the outside of the penis) was visible. It has been thought that uncircumcised boys with clearly visible urethras may not be as vulnerable to developing a UTI as those whose urethras could not be seen. Therefore, going along that train of thought, if the boy was not circumcised but had a visible urethra, his risk of developing a UTI was lower.

To see if this was true, the researchers assessed 393 boys who had visited the MCH emergency department with symptoms of a possible UTI. Eighty-four of the boys were circumcised. Of the remaining who were uncircumcised, 40 had a visible urethral meatus and 269 had only partial visible or nonvisible meatus. In other words, it didn't matter if the urethra was visible or not - more boys who had not been circumcised had infections than those who were not.

The researchers concluded, "We suggest that clinicians should consider circumcision status alone, not the degree of urethral visibility when stratifying risk for boys presenting to the emergency department with symptoms or signs suggesting a urinary tract infection."

UTIs are serious infections that should be treated. Untreated, the infection may go up into the kidneys. UTIs can also develop into a life-threatening illness called sepsis (Sepsis and Urinary Tract Infections).