Circumcision Doesn't Effectively Prevent Urinary Tract Infection

A US Army pediatrician, Wiswell, read a study done about UTI in a hospital where only 5% of the boys were circumcised. He began examining charts of the male births in military hospitals. He came to the conclusion that circumcision resulted in a 10-100x decrease in UTI, which is a gross exaggeration. Using his information, 50-100 circumcisions would need to be performed to prevent a single UTI. More recent information from a better study suggests that number would have to be closer to 195. Urinary tract infections are extremely rare. The AAP states an intact male's risk is only 1% at most. Is it worth a 2-10% rate of complication from circumcision to try to decrease a 1% likelihood of contracting UTI?

In 1972 a study found that UTI was associated with maternal infection, perinatal anoxia, and birth weight. It is far more likely that intact boys were more likely to have UTIs because of those factors and others, such as having their foreskins prematurely retracted. In the 1990s we learned that breastfeeding greatly reduced the chances of an infant having a UTI. We have also learned that rooming-in with mother lowers the UTI rate as well. Unfortunately, Wiswell focused focused on circumcision instead. His methods and information were faulty, yet the myths he created are still being perpetuated.

In 1989 the AAP stated that his studies were flawed and tainted by bias. All of the babies observed were hospitalized due to illness. It is likely that many of the intact babies studied were premature, hence the reason for their hospitalization. Preemies were often on catheters back then, which increase the risk of UTI. In the past circumcision wasn't always accurately documented on patient charts, so some children marked as intact may indeed have been circumcised. Furthermore, the studies considered a positive urine culture alone as indication of a UTI, and those tests carry a high false positive rate. They concluded that the information did not clearly represent the general population of male babies.