Comparative periurethral bacteriology of uncircumcised and circumcised males.

F. Serour, Z. Samra, Z. Kushel, A. Gorenstein, M. Dan

Genitourin Med 1997: 730(4); 288-290

BACKGROUND: It has been established that lack of circumcision increases the risk of urinary tract infection in infants; During the first six months; the presence of foreskin is associated with a greater quantity and a higher concentration of uropathogens in the periurethral area; Very little is known about this association in older males;

OBJECTIVE: To compare the periurethral bacteriology of uncircumcised healthy males of more than one year of age

METHODS: The periurethral area of 125 uncircumcised and 46 circumcised healthy males mean age 26 and 28 years respectively1; was swabbed and cultured for facultative and anaerobic bacteria, genital mycoplasmas and Chlamydia trachomatis

RESULTS: Facultative Gram positive cocci predominated in both groups (62% and 80%, respectively). Pure culture of facultative Gram negative rods was more common in uncircumcised males (17% v 4% in circumcised males, p = 0.01). Streptococci, strict anaerobes and genital mycoplasmas were found almost exclusively in uncircumcised males of more than 15 years of age. No case of C trachomatis was identified.

CONCLUSIONS: The higher prevalence of potential uropathogens in the subpreputial space is in accordance with a previous finding of increased risk of urinary tract infection in uncircumcised young men. Our results also support the role of the prepuce as a reservoir for sexually transmitted organisms.