MYTH: Circumcision & UTIs December 17, 2007

Circumcision and Urinary Tract Infection Urinary Tract Infections (UTIs) are rare, and mainly occur in the first year of life. They are several times commoner in girls than boys (but of course surgery is never considered for girls). They are painful, and women’s experience of them is a powerful inducement to have sons circumcised, if they imagine that this will protect them. In fact, a significant proportion of boys contract UTIs even though they are circumcised. A study in Israel found they mainly occured in girls at four months, but in boys soon after they were circumcised…. Now an Australian study suggests circumcision may cause urinary problems. The supposed correlation between intactness and UTIs was only discovered in 1982, long after the custom of circumcision was well-established in the US. (Yet today it is commonly presented as the first reason, illustrating how circumcision is a “solution” looking for a problem – constantly looking, as each new problem is disposed of.) Ironically, all the 1982 paper did was quite casually note that “95% of the [male] infants [with UTI] were uncircumcised.” without mentioning that virtually no babies born at that hospital (Parkland in Dallas, Texas) were circumcised. The paper went on: “All infants responded promptly to antimicrobial therapy.” Dr Thomas Wiswell It is Dr Thomas Wiswell who has made it his life’s work to establish the UTI-intact penis connection, and he is also a keen circumcisor. His many papers present statistics involving huge samples, tens of thousands of babies (which may convince those who mistakenly think large numbers guarantee accuracy). However, all the babies were born in military hospitals, where circumcision is very much the norm. It is very likely that the intact babies had their foreskinsforcibly retracted. It is also likely that a major reason for the babies to be left intact was that they were born prematurly, put in intensive care and catheterised for that reason: the catheterisation, not their intactness, caused their UTIs. There are also issues around the method of determining UTI infection. Some methods of collecting urine samples risk contamination. There is a more detailed rebuttal of Wiswell on the CIRP website. Another confounding factor is that in some studies, hospitalisiation is taken as the defining degree of seriousness of UTIs: but babies with UTIs are often hospitalised in order to be circumcised, so of course more intact babies appear in the statistics. One commonly quoted figure is that UTIs are ten times as common in intact boys (1.1%) as circumcised boys (0.1%). This means that circumcision offers an absolute reduction of 1% at best. Combining the rarity of UTIs, with the only partial prevention attributable to circumcision, To et al calculated that it would take 195 circumcisions to prevent one UTI. LINK    See also: http://www.cirp.org/library/disease/UTI/ and http://www.infocirc.org/uti2.htm.