بررسي تاثير ختنه در پيشگيري از عفونت ادراري در پسران كمتر از 6 سال

Circumcision for the prevention of urinary tract infection in preschool boys

Introduction: Urinary tract infection (UTI) is common in childhood with serious sequela. Among infants, boys are more likely to develop UTI. The aim of this study was to determine circumcision effects in decreasing UTI incidence. Material and Methods: During a 7.5 years period prospective study 166 boys less than 6 years old with UTI allocated into 2 groups. They had not any urinary tract abnormalities. In the first group 79 boys ranging in age from 2 months to 5.5 years (mean 11.3 ± 3.1 mo) were circumcised after UTI treatment and then observed for 6 month period with taking urinalysis (U/A) and urine culture (U/C) 1 -2 monthly. The second group as control subjects 87 boys aged 40 days to 5.5 years (mean 12.1 3.4) after treatment of UTI were followed for 6 month period with taking U/A and U/C then circumcised and followed for another 6 months period. Incidence of UTI in first group (circumcised) and second (uncircumcised period) was compared with use of Chi-square test. For comparing the incidence of UTI in second group (6 months before and 6 months after circumcision) we use Mc nemar method. Results: UTI is more common in boys aged 11.7±3.2mo. In the first 6 months follow-up period, UTI occurred in 2 cases of circumcised group whereas in 12 on uncircumcised group. In a 6 months period after circumcision in second group, UTI occurred only in one case. There was significant difference (P=0.009) in occurring of UTI between first and second group. There was also significant difference (P<0.001) in incidence of UTI in 6 month period before and after the circumcision in second group patients. Conclusions: The present study indicated that circumcision decreases the risk of UTI in boys, independent of the age. Therefore circumcision should be considered in newborn period and any patient with UTI or urinary tract abnormalities. Routinely performing ultrasonography and cystourethrography in boys with first attack of UTI is recommended. In this study there were not abnormal VCUG in the cases without urinary tract abnormalities (proven by history, physical examination and sonography).