Prospective trial on the effect of circumcision in boys less than 2 years with primary vesicoureteral reflux and recurrent urinary tract infection: A university medical center experience

ABSTRACT

Rationale Vesicoureteral reflux (VUR) occurs in 30-50 percent of children with urinary tract infection (UTI). Although it does not cause bacteriuria, it facilitates transport of bacteria from the bladder to the upper tract and increases risk both for UTI and scarring and its sequelae. Antibiotics remain as the mainstay of prevention, yet 40 percent breakthrough infections still occurObjectives: This study was done to determine whether circumcision prevents recurrent UTI in boys less than 2 years old diagnosed with primary vesicoureteral reflux who are on standard prophylactic antibiotic and likewise correlate age, laterality and severity of reflux with UTI recurrenceMethods: This is a prospective cohort of 57 subjects selected by non randomized purposive sampling allocated to either group A (circumcised) or group B (uncirResults: Of 57 males, 25 (44 percent) were circumcised and 32 (56 percent) were uncircumcised. The mean age was 16 months (1 month - 24 months). Twenty-nine had unilateral reflux and 28 had bilateral reflux. Recurrent UTI was observed in 12 subjects in group B (37 percent) while only 2 subjects in group A (8 percent). Chi square analysis showed a significant association between recurrence and circumcision status (x2Conclusion: The role of circumcision seems to protect boys with VUR for it decreases the recurrence of UTI. It maybe considered as part of UTI therapy. (Author)