Higher risk of urinary tract infections for uncircumcised boys

Uncircumcised boys are at higher risk of urinary tract infection, regardless of whether the urethra is visible, found a new study published in CMAJ (Canadian Medical Association Journal).

Urinary tract infections are one of the most common serious bacterial infections in children and, if not treated, can cause an infection of the blood or scar the kidneys.

To determine whether the risk for infection is higher in boys with a visible urethral meatus, researchers looked at a cross-section of 393 boys who visited an emergency department with symptoms of a possible urinary tract infection. Of the 393 boys, 40 were uncircumcised and had a visible urethral meatus, 269 had a partially or nonvisible meatus, and 84 were circumcised.

"We thought that incomplete foreskin retractability with a poorly visible urethral meatus may be associated with increased risk of urinary tract infection," writes Dr. Sasha Dubrovsky, Montreal Children's Hospital, McGill University Health Centre, with coauthors. "However, we found no difference in risk with degree of visibility of the urethral opening."

The researchers did find that boys with a completely visible urethral meatus were at higher risk of infection, but recommended interpreting this result with caution given the small sample size of the group and that other studies have not found this association.

"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 suggestioning a urinary tract infection," they conclude.