Newborn Circumcision and Urinary Tract Infections

Abstract

To the Editor. I commend Drs Schoen, Colby, and Ray for their recent article that once again shows the vast majority (98%) of uncircumcised males do not develop urinary tract infections (UTIs) in the first year of life.1 Their data verifies that 52 circumcisions need to be performed to prevent 1 UTI, and therefore 51 out of 52 circumcised males do not benefit from their circumcision but instead only suffer pain and permanent disfigurement of their genitalia. I also applaud them for showing that the cost of a UTI in an uncircumcised male averages $1179. Because the charge for a circumcision in our hospital is $382 (a reasonable amount given physician time for the circumcision including getting consent and checking for bleeding later, nursing time, lidocaine and EMLA, sterilization of equipment, and use of nursery space), the cost to perform 52 circumcisions is $19 864, making routine circumcision to prevent UTIs 17 times more expensive than treating the exceedingly rare UTI and its sequelae. Once again, looking at the data with logic and an unbiased eye confirms that routine neonatal circumcisions should not be performed. 1. 1. Schoen E, 2. Colby CJ, 3. Ray GT (2000) Newborn circumcision decreases incidence and costs of urinary tract infections during the first year of life. Pediatrics. 105:789–793. [OpenUrl][1][Abstract/FREE Full Text][2] # {#article-title-3} To the Editor. The article by Schoen et al1 discusses the need to present the benefits of newborn circumcision. It is essential that parents be fully informed before making a decision whether or not to circumcise their sons, and providing them with all the pertinent information is the responsibility of all health care providers.2 In discussing with parents the risks associated with circumcision, the focus is heavily weighted on the problems and complications in the immediate postoperative period, with some reference to the benefits of reduced UTIs and penile cancer. I would like to expand the discussion, beyond infancy and adulthood, to the complications of noncircumcision for the elderly dependent male and his … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft.stitle%253DPediatrics%26rft.issn%253D0031-4005%26rft.aulast%253DSchoen%26rft.auinit1%253DE.%2BJ.%26rft.volume%253D105%26rft.issue%253D4%26rft.spage%253D789%26rft.epage%253D793%26rft.atitle%253DNewborn%2BCircumcision%2BDecreases%2BIncidence%2Band%2BCosts%2Bof%2BUrinary%2BTract%2BInfections%2BDuring%2Bthe%2BFirst%2BYear%2Bof%2BLife%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.105.4.789%26rft_id%253Dinfo%253Apmid%252F10742321%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=105/4/789&atom=%2Fpediatrics%2F107%2F1%2F210.2.atom