title: Effect of circumcision on prostatic bacterial colonization and subsequent bacterial seeding following transrectal ultrasound-guided prostate biopsies.
abstract: OBJECTIVE
  This study was designed to compare the prevalence of prostatic bacterial growth between circumcised and uncircumcised males and determine whether the lack of circumcision results in a change in the incidence of bacterial seeding following prostate needle biopsy.
  
  
  METHODS
  Forty-six men (21 circumcised and 25 uncircumcised) undergoing ultrasound and biopsy to rule out prostate cancer were evaluated with questionnaires regarding previous history of urinary tract infection (UTI), any symptoms suggestive of UTI, and obstructive voiding symptoms. None of the patients received preprocedure antibiotics. Preprocedure and postprocedure urine samples, prostate biopsy core, and postprocedure blood samples were obtained for culture. After the cultures were obtained, patients received oral antibiotics.
  
  
  RESULTS
  Patient characteristics between circumcised and uncircumcised patients were similar in terms of age, prostate-specific antigen level, voiding symptoms, history of UTI, prostate biopsy technique, and incidence of prostate cancer. The prevalence of preprocedure bacteriuria was slightly higher in the uncircumcised men (14 [56%] of 25 patients) vs. the circumcised men (8/21 [38%] patients), although this was not statistically significant (r = .2, p = .1). The prevalence of postprocedure bacteriuria was significantly higher (p = .04) in the uncircumcised men (12/25 [48%] patients) vs. the circumcised men (4/21 [19%] patients). No correlation was found between circumcision status and incidence of bacterial colonization in the prostate tissue. A statistically significant difference (p = .003) was found between the lack of circumcision and postprocedure bacteremia.
  
  
  CONCLUSIONS
  Circumcision status does not effect the prevalence of bacterial growth in the urine and the prostate tissue. Uncircumcised men have a higher incidence of bacteriuria and bacteremia following prostate needle biopsies.
authors.affiliation: Department of Urology, Stanford University Medical Center, Stanford, USA.
authors.forename: F C
authors.initials: FC
authors.lastname: Lai
authors.forename: W A
authors.initials: WA
authors.lastname: Kennedy
authors.forename: K A
authors.initials: KA
authors.lastname: Lindert
authors.forename: M K
authors.initials: MK
authors.lastname: Terris
mesh_terms: D000368:Aged; D001437:Bacteriuria / Q000453:epidemiology* / Q000209:etiology; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D002944:Circumcision, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology