Newborn circumcision for the prevention of urinary tract infections in infancy

Routine neonatal circumcision is a fairly common surgical procedure that may be carried out for medical or religious reasons. The incidence of urinary tract infection (UTI) is greater in uncircumcised babies. Circumcision is a relatively simple procedure and is associated with minimal complications when carried out in neonates rather than in later life. We did not find any trials to support or refute the effectiveness of routine neonatal circumcision to prevent UTI in infancy. Although limited data from previous studies have shown that this intervention might be beneficial, questions regarding the safety and effectiveness of routine neonatal circumcision for the prevention of UTIs in infancy remain unanswered.

Authors' conclusions: 

We were unable to identify any randomised controlled trials on the use of routine neonatal circumcision for prevention of UTI in male infants. Until further evidence becomes available, clinicians should continue to base their decisions on position statements and recommendations and in conjunction with the opinions of the children's parents.

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Background: 

Neonatal circumcision is a fairly common surgical procedure that may be carried out for medical reasons, one of them being prevention of urinary tract infections (UTI) in male infants. Circumcision could help in reducing the incidence of UTI by reducing periurethral bacterial colonization, which is accepted as a potential risk factor in UTI. Evidence is needed to inform the benefits or harm for the routine use of this intervention.

Objectives: 

To assess the effectiveness and safety of routine neonatal circumcision for the prevention of UTIs in infancy.

Search strategy: 

We searched the Cochrane Neonatal Review Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We completed this search 30 June 2011.

Selection criteria: 

Randomised controlled trials and quasi-randomised controlled trials.

Data collection and analysis: 

Two review authors had planned to independently screen studies, extract data and assess risk of bias using standard Cochrane Collaboration methodologies. We did not identify any studies for inclusion in this review.

Main results: 

We did not identify any relevant studies after a comprehensive search of the literature.

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