Neonatal circumcision reduces the incidence of asymptomatic urinary tract infection: A large prospective study with long-term follow up using Plastibell

Simforoosh, Nasser; Tabibi, Ali; Khalili, Seyed Ali Reza; Soltani, Mohammad Hossein; Afjehi, Abolfazl; Aalami, Fatemeh; Bodoohi, Heshmat

doi:10.1016/j.jpurol.2010.10.008

Cited by 31 publications

(15 citation statements)

References 23 publications

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“…The reported overall complication rate of circumcision varies between 0.03% and 10%,29 and in our study was 0.75%, indicating that circumcision performed by qualified experts using conventional dissection surgery has the best outcomes 30. Hemorrhage, reported as one of the most common complications (0.1%–35%),31 was seen in 0.26% of the cases reported by Simforoosh et al32 and in 0.25% of our cases.…”

Section: Discussionsupporting

confidence: 50%

Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center

Moslemi

Abedinzadeh²,

Aghaali³

2011

OAJU

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BackgroundCircumcision can be performed for a variety of techniques, including conventional dissection surgery or a Plastibell device, and has religious, ritual, or medical roots. In countries like Iran, circumcision is done purely on religious grounds. In this study, we outline 390 cases in our practice and describe the epidemiology, indications, surgical technique used, and the early complications.Materials and methodsIn this retrospective study, the charts for 390 circumcision cases were analyzed for the period March 2005 to August 2010. We reviewed all cases, noting age, indication, type of anesthesia used, technique, cosmetic appearance, and any potential early complications. All cases were followed up 1–4 weeks postoperatively and their notes were evaluated.ResultsThe age of children who underwent circumcision ranged from 3 weeks to 14 years, with a mean age of 4.25 years. The most common age for circumcision was 4–5 years (14.6%), and the least common age was 11–12 years (1.5%). In 372 cases (95%), the parents had opted for the procedure for religious reasons, and in 18 cases (5%), there was a medical indication, including phimosis (11 cases, 3%), urinary tract infection (5 cases, 1.2%), and balanoposthitis (2 cases, 0.8%). No major early complications were found in our series. Cosmetic appearance was satisfactory in all cases by 4 weeks after the operation.ConclusionCircumcision was performed for religious reasons in our cases, although medical indications sometimes modified the timing of the procedure. Conventional dissection surgery for circumcision was safe, effective, and without any major complications.

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Section: Discussionsupporting

confidence: 50%

Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center

Moslemi

Abedinzadeh²,

Aghaali³

2011

OAJU

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“…They considered meatal stenosis to be “particularly worrying,” but misconstrue data on its prevalence, which, as noted earlier in this article, we argue will not affect “between 5% and 20% of boys undergoing non-therapeutic circumcision.” A recent study by Frisch and Simonsen found meatal stenosis incidence in Denmark to be very much lower than those figures and higher in uncircumcised than in circumcised elderly men, 123 possibly contributed by lichen sclerosus. A critical evaluation of the literature suggests prevalence is in the order of 0.01%–1%, with a similarly low frequency among both circumcised and uncircumcised boys 13 , 20 , 44 , 124 …”

Section: Complication Rates After Circumcisionmentioning

confidence: 99%

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

Morris

Krieger

Klausner³

2017

Glob Health Sci Pract

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“…25,26 Previous studies have demonstrated that circumcision status is the greatest risk factor in males at risk of UTIs. 3 Uncircumcised male infants are about 10 times more likely to develop UTIs than circumcised infants.…”

Section: Limitationsmentioning

confidence: 99%

Can a Simple Urinalysis Predict the Causative Agent and the Antibiotic Sensitivities?

Waseem

Paudel²,

Sharma³

et al. 2014

Pediatric Emergency Care

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Objectives The objective of this study was (1) to determine the reliability of urinalysis (UA) for predicting urinary tract infection (UTI) in febrile children, (2) to determine whether UA findings can predict Escherichia coli versus non–E. coli urinary tract infection, and (3) to determine if empiric antibiotics should be selected based on E. coli versus non–E. coli infection predictions. Methods This was a retrospective chart review of children from 2 months to 2 years of age who presented to the emergency department with fever (rectal temperature >100.4°F) and had a positive urine culture. This study was conducted between January 2004 and December 2007. Negative UA was defined as urine white blood cell count less than 5 per high-power field, negative leukocyte esterase, and negative nitrites. Urine cultures were classified into E. coli and non–E. coli groups. These groups were compared for sex, race, and UA findings. Multivariate forward logistic regression, using the Wald test, was performed to calculate the likelihood ratio (LR) of each variable (eg, sex, race, UA parameters) in predicting UTI. In addition, antibiotic sensitivities between both groups were compared. Results Of 749 medical records reviewed, 608 were included; negative UA(−) was present in 183 cases, and positive UA(+) was observed in 425 cases. Furthermore, 424 cases were caused by E. coli, and 184 were due to non–E. coli organisms. Among 425 UA(+) cases, E. coli was identified in 349 (82.1%), whereas non–E. coli organisms were present in 76 (17.9%); in contrast, in 183 UA(−) cases, 108 (59%) were due to non–E. coli organisms versus 75 (41%), which were caused by E. coli. Urinalysis results were shown to be associated with organism group (P < 0.001). Positive leukocytes esterase had an LR of 2.5 (95% confidence interval [CI], 1.5–4.2), positive nitrites had an LR of 2.8 (95% CI, 1.4–5.5), and urine white blood cell count had an LR of 1.8 (95% CI, 1.3–2.4) in predicting E. coli versus non–E. coli infections. Antibiotic sensitivity compared between UA groups demonstrated equivalent superiority of cefazolin (94.7% sensitive in UA(+) vs 84.0% in UA(−) group; P < 0.0001), cefuroxime (98.2% vs 91.7%; P < 0.001), and nitrofurantoin (96.1% vs 82.2%; P < 0.0001) in the UA(+) group. In contrast, the UA(−) group showed significant sensitivity to trimethoprim-sulfamethoxazole (82.2% vs 71.3% in UA(+); P = 0.008). Conclusions Urinalysis is not an accurate predictor of UTI. A positive urine culture in the presence of negative UA most likely grew non–E. coli organisms, whereas most UA(+) results were associated with E. coli. This study also highlighted local patterns of antibiotic resistance between E. coli and non–E. coli groups. Negative UA results in the presence of strong suspicion of a UTI suggest a non–E. coli organism, which may be best treated with trimethoprim-sulfamethoxazole. Conversely, UA(+) results suggest E. coli, which calls for treatment with cefazolin or cefuroxime.

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Neonatal circumcision reduces the incidence of asymptomatic urinary tract infection: A large prospective study with long-term follow up using Plastibell

Abstract: Neonatal circumcision has few complications and reduces the incidence of asymptomatic urinary infection. It may be considered as a preventative health measure.

Cited by 31 publications

References 23 publications

Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center

Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

Can a Simple Urinalysis Predict the Causative Agent and the Antibiotic Sensitivities?

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