title: Does circumcision alter the periurethral uropathogenic bacterial flora.
abstract: BACKGROUND
  The aim of this study was to assess the pattern of periurethral bacterial flora in uncircumcised boys and to evaluate the effect of circumcision on alteration of periurethral uropathogenic bacterial flora.
  
  
  METHODS
  Pattern of periurethral bacterial flora before and after circumcision was studied prospectively in 124 boys. The results were analysed to compare change in bacterial colonisation before and after circumcision.
  
  
  RESULTS
  The age range was 6 weeks to 96 months. Most (94.3%) of the boys had religious indication and 5.7% had medical indication for circumcision. E. coli, Proteus and Klebsiella were most common periurethral bacterial flora in uncircumcised subjects. Coagulase-negative staphylococcus and Staphylococcus aureus was most common periurethral bacterial flora in circumcised subjects. In 66.1% of circumcised subjects, no bacteria were grown from periurethral region.
  
  
  CONCLUSIONS
  We conclude that presence of prepuce is associated with great quantity of periurethral bacteria, greater likelihood of the presence of high concentration of uropathogens and high incidence of urinary tract infection (UTI). This study provides circumstantial evidence supporting the idea that early circumcision may be beneficial for prevention of UTI.
authors.affiliation: Department of Paediatric Surgery, Sheri-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India.
authors.forename: Mushtaq Ahmad
authors.initials: MA
authors.lastname: Laway
authors.forename: Mohd Lateef
authors.initials: ML
authors.lastname: Wani
authors.forename: Rekha
authors.initials: R
authors.lastname: Patnaik
authors.forename: Dalip
authors.initials: D
authors.lastname: Kakru
authors.forename: Sumaira
authors.initials: S
authors.lastname: Ismail
authors.forename: Altaf Hussain
authors.initials: AH
authors.lastname: Shera
authors.forename: Khursheed Ahmad
authors.initials: KA
authors.lastname: Shiekh
mesh_terms: D002944:Circumcision, Male; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D014521:Urethra / Q000382:microbiology*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000517:prevention & control