Circumcision reduces baby boy's risk of infection

By Cassie Nordenbrook

NEW YORK: Circumcising a newborn boy reduces the child's risk of suffering a urinary tract infection (UTI) in the first year of life by over nine times, according to results of a new study.

The study findings suggest that newborn circumcision is "a valuable preventive health measure, particularly in the first 3 months of life".

Dr. Edgar J. Schoen, an Oakland pediatrician and lead author of the report published in the April issue of Pediatrics, notes that since the 1980s over 45 studies have concluded that newborn circumcision offers health benefits.

"The circumcised infant at age 1 will have a lifetime health advantage over the uncircumcised one due to the (decreased) risks of HIV infection, cancer of the penis (in older men), genital hygiene, and UTI," said Schoen in an interview with Reuters Health.

Schoen hopes this current study will encourage parents to ask for circumcision before leaving the hospital after delivery or soon after birth because "these infections are most prevalent during the first 3 months of life when it most often leads to hospitalization."

"Severe UTIs in infancy are not benign," emphasized Schoen. These infections can lead to kidney infections, and may also spread in the bloodstream, leading to serious complications.

According to Schoen, kidney damage due to serious infection can lead to high blood pressure and chronic kidney problems. The current study analyzed the number of urinary tract infections in 14,893 male infants born in 1996 and treated by a large health maintenance organization.

Of those, a total of 5,225 (35.1%) babies were uncircumcised. During 1996, 154 UTI diagnoses were made in male babies less than 1 year old, and 132 (86%) of those were uncircumcised. The majority of the UTI cases (47%) occurred during the first 3 months of life.

Analysis of the study data shows that circumcised male babies were 9 times less likely to have a UTI than uncircumcised babies. "The uncircumcised boys with UTI up to 3 months old are much more likely to be admitted to the hospital with a 104-105 degree fever, or suffer additional kidney complications," added Schoen.

Due to the high number of hospitalizations, the cost of treating UTI was 10-fold higher in uncircumcised than in circumcised male babies, despite the fact the uncircumcised babies were only 35.1% of study patients.

The annual cost for UTI treatment averaged $1,111 per case. Newborn circumcision prevents bacterial colonization of the foreskin, and decreases the risk of UTI in infants less than 1 year old, when the risk of renal (kidney) scarring and kidney infection are greatest.

The research team, from Kaiser Permanente Medical Center in Oakland, California, concludes that newborn circumcision is a valuable preventative health measure against UTI in the first year of life, when such infections are more severe and more likely to lead to hospital admissions.

In a commentary on the study, Dr. Thomas E. Wiswell of the department of pediatrics at Thomas Jefferson University in Philadelphia, Pennsylvania, notes that the researchers did not examine longer-term expenses caused by complications of UTIs early in life.

He believes that the true cost of UTI among uncircumcised male infants "is considerably higher than what is described in the current report." Wiswell concludes that "the prevention, recognition, proper treatment, and adequate follow-up of UTIs are important measures in preventing renal scarring (and complications)." (Reuters)