Does circumcision alter the periurethral bacterial flora?
A prospective study of 25 boys who underwent circumcision for medical reason was performed. Specimens of periurethral bacterial flora were taken before operation as well as 3 weeks after surgery, so that each boy acted as his own control. Before circumcision, 13 (52%) harboured uropathogenic organisms (Escherichia coli and other coliforms, Enterococcus spp, Proteus spp, Pseudomonas spp, and Klebsiella spp); after circumcision, none of the boys had uropathogens, the only organisms cultured from the periurethral region being skin commensals. We postulate that circumcision converts a 'cul-de-sac' that is a reservoir of organisms capable of causing ascending urinary tract infection into a surface colonised by natural skin organisms. This study provides circumstantial evidence supporting the idea that circumcision in well-selected patients may confer protection from urine infection.
Wijesinha
S S
SS
Department of Pediatric Surgery, John Radcliffe Hospital, Oxford, UK.
Atkins
B L
BL
Dudley
N E
NE
Tam
P K
PK
D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male; D006801:Humans; D008297:Male; D010413:Penis / Q000382:microbiology*; D011446:Prospective Studies; D012307:Risk Factors; D014521:Urethra / Q000382:microbiology*; D014552:Urinary Tract Infections