Abstract
In Reply.— Dr Williams asks, does this settle the debate regarding the "cause and effect" relationship of the intact prepuce and urinary tract infections?1,2 Perhaps not in and of itself; however, three other investigators3-5 recently confirmed our previous observations regarding this association. The risk for urinary tract infection during infancy appears to be at least 10- to 39-fold higher among uncircumcised boys. What are the reasons boys are not circumcised? I do not have a proportional breakdown, but the two broad categories are (1) parental choice for their healthy child following informed consent counseling and (2) one of several presupposed "medical" contraindications, including prematurity, neonatal illness (pneumonia, persistent pulmonary hypertension, etc), known family history of "bleeding disorders," and recognized genitourinary malformations (most commonly hypospadias).
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