The benefits of circumcision in boys with posterior urethral valves.

Abstract

Journal of Paediatrics and Child HealthVolume 58, Issue 10 p. 1908-1909 Heads UpFree Access The benefits of circumcision in boys with posterior urethral valves First published: 11 September 2022 https://doi.org/10.1111/jpc.16201 edited by Craig Mellis (craig.mellis@sydney.edu.au) AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Posterior urethral valves (PUVs) affect 1 in 4000 male births, with a life-time risk of end-stage renal disease of 28.5%. Despite post-natal management with valve ablation, PUVs still pose an increased risk of febrile urinary tract infections (fUTIs), and possible acquired renal injury. A collaboration between 13 French referral centres was recently published to determine the utility of circumcision in boys with PUVs.1 Neonates with a diagnosis of PUVs were recruited and randomised (93 in total) to either circumcision with prophylactic antibiotics, or prophylactic antibiotics alone. A fUTI was defined by a fever of >38.5°C with concomitant pyuria and culture-positive infection on urinalysis (obtained by suprapubic aspiration or catheterisation). Following two years of follow-up, the risk of febrile UTI was 3% among boys in the treatment arm, compared to 20% in the control group, translating to a tenfold risk reduction of fUTI, and a number needed to treat of six children to prevent one fUTI. This was a well-constructed study providing objective evidence for what has generally been considered a worthwhile procedure on an intuitive basis. The above French randomised trial provides valuable evidence to inform discussions of the benefits of medical circumcision in the context of PUV. Reference 1Harper L, Blanc T, Peycelon M et al. Circumcision and risk of febrile urinary tract infection in boys with posterior urethral valves: Result of the CIRCUP randomized trial. Eur. Urol. 2022; 81: 64– 72. CrossrefCASPubMedWeb of Science®Google Scholar Reviewers: Kiarash Taghavi, kiarash.taghavi@monashhealth.org and Chris Kimber, ckimber@bigpond.net.au, Department of Paediatric Urology, Monash Children's Hospital, Melbourne, Australia. Kai Zheong Lim, teddylimkz@outlook.com, Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Australia. Volume58, Issue10October 2022Pages 1908-1909 ReferencesRelatedInformation