Circumcision Doesn't Effectively Prevent Urinary Tract Infection

A US Army pediatrician, Wiswell, read a study done about UTI in a hospital where only 5% of the boys were circumcised. He began examining charts of the male births in military hospitals. He came to the conclusion that circumcision resulted in a 10-100x decrease in UTI, which is a gross exaggeration. Using his information, 50-100 circumcisions would need to be performed to prevent a single UTI. More recent information from a better study suggests that number would have to be closer to 195. Urinary tract infections are extremely rare. The AAP states an intact male's risk is only 1% at most. Is it worth a 2-10% rate of complication from circumcision to try to decrease a 1% likelihood of contracting UTI?

In 1972 a study found that UTI was associated with maternal infection, perinatal anoxia, and birth weight. It is far more likely that intact boys were more likely to have UTIs because of those factors and others, such as having their foreskins prematurely retracted. In the 1990s we learned that breastfeeding greatly reduced the chances of an infant having a UTI. We have also learned that rooming-in with mother lowers the UTI rate as well. Unfortunately, Wiswell focused focused on circumcision instead. His methods and information were faulty, yet the myths he created are still being perpetuated.

In 1989 the AAP stated that his studies were flawed and tainted by bias. All of the babies observed were hospitalized due to illness. It is likely that many of the intact babies studied were premature, hence the reason for their hospitalization. Preemies were often on catheters back then, which increase the risk of UTI. In the past circumcision wasn't always accurately documented on patient charts, so some children marked as intact may indeed have been circumcised. Furthermore, the studies considered a positive urine culture alone as indication of a UTI, and those tests carry a high false positive rate. They concluded that the information did not clearly represent the general population of male babies.

Studies so far have been unable to prove a significant decrease in the rate of UTI. There is not enough evidence for pediatric organizations to recommend routine infant circumcision. There are studies from Israel and Canada that suggest circumcision may actually cause an increase in the rate of UTI. One study found no cases of UTI in 603 uncircumcised males of many ages. There is no reason to recommend circumcision to prevent potential or recurrent UTI, as there is no indicator that having a foreskin creates a greater incidence of urinary tract infection. Circumcision wouldn't do anything for those with abnormal urinary tracts anyway. The AAP agrees that the studies are not well-conducted enough for them to recommend circumcising.

The National Kidney and Urologic Diseases Clearinghouse lists the causes of urinary tract infections. They do not list circumcision as a prevention or cure. The American Academy of Pediatrics states that the studies on UTI are so flawed that the data is inconclusive. The AAP also does not consider circumcision to be useful in reducing the rate of UTI. It is becoming more widely known now that circumcision only decreases the risk of UTI by 1%. Breastfeeding and other techniques are much more effective preventions of Urinary Tract Infection, and this is becoming more widely acknowledged as well. The Canadian Pediatric Society recommends it as a more effective and less expensive means of preventing UTI.

In 1998, an AAP publication stated that intact males may be at a higher risk of UTI for only the first 3 months of life--not the entire first year, or their entire lives. With circumcision rate still being high, many of the males left intact are premature or afflicted by illness, which alone increases their risk of urinary tract infections. Most of the UTIs in the first 3 months were in boys, and in that study, 95% of the boys were intact. This led to the conclusion that intact boys were more likely to developed UTIs. For accurate data we would need to compare the incidence of UTI in these uncircumcised boys to an equal number of circumcised boys. We would also need to know the gestational age and health conditions of the children involved.

Urinary tract infections are painful, but they can usually be treated quite quickly with antibiotics. This is much less expensive, time-consuming, and painful than circumcising. The treatment comes with no life-long results, unlike circumcising. UTI is extremely rare and is more common in girls than boys, yet we do not circumcise girls for this. Usually UTI is cured within 1-2 days after treatment is started. There are also many drugs that can help alleviate the pain. Severe complications are extremely rare, especially if prompt treatment is given. Most sources of medical information, such as MayoClinic, do not list circumcision as prevention or cure.

My sources include three well-known anti-circumcision organizations. Some people, as I've stated before, like to challenge the data based solely on who is distributing it. This is a mistake, because while they may be biased, their sources are not. They are listed in black and white, so that you can read it straight from the horse's mouth--free of bias--if you don't believe it coming from the intactivists. My other sources are two AAP publications and information from the NKUDIC web page, which is an informative site about kidney problems. I have also used an excerpt from the Canadian Medical Association Journal. Please feel free check my sources and my sources' sources if you have any doubts. It is not worth a 2-10% rate of complication to lower risk of UTI by 1% at most.

Sources
Unknown, "Circumcision and Urinary Tract Infection." Circumcision Info & Resource Pages. URL: http://www.cirp.org/library/disease/UTI/
Unknown, "Circumcision and Urinary Tract Infection." Circumstitions. URL: http://www.circumstitions.com/Utis.html
Unknown, "Urinary Tract Infections in Children: Why They Occur and How to Prevent Them." AAP. URL: http://www.aafp.org/afp/980515ap/heller.html
Unknown, "Urinary Tract Infection and Circumcision." InfoCirc. URL: http://www.infocirc.org/uti2.htm
Unknown, "Urinary Tract Infections in Adults." NKUDIC. URL: http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/#treatment
Unknown, "Circumcision Policy Statement." AAP. URL: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686
Fetus and Newborn Committee, Canadian Paediatric Society. "Neonatal Circumcision Revisited." Canadian Medical Association Journal, March 15, 1996, pp. 769-780.