Discussions By Condition: Kidney conditions

Kidney issues and circumcision

Posted In: Kidney conditions 3 Replies
  • Posted By: Anonymous
  • June 25, 2010
  • 09:14 PM

My 3 month old son has been diagnosed by one of the top pediatric urologists in the region with severe (grade 5) hydronephrosis, severe reflux (grade 4) and a partial blockage of his left kidney. His right has some reflux, but no blockage and no hydronephrosis. He has been on antibiotics since he was born (amoxicillian and now bactrim). My concern is that both the Urologist and my pediatrician have told me that we will HAVE to get him circumcised if he gets even one UTI. My husband (who is European) and I (American) don't believe in circumcision and didn't have either of our boys circumcised. I can't imagine that this disfiguring procedure is absolutely necessary just because of a UTI. Nor, do I believe, does having an intact foreskin cause UTI, especially when he is having all of these kidney problems that would be the obvious reasons for a UTI. He luckily seems to be having little trouble with his kidney issues right now and is slated for follow up tests when he is 6 months old. Has anyone here run into this situation? Is it just "normal" for Doctors to insist on this for a UTI in an otherwise normal child? My husband and I are just broken up over the possibility of an unnecessary circumcision and don't know how to argue our case against it with both of our son's doctors.

Thanks for any insight!


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  • In normal conditions, UTI's are rarely an indication for circumcision, and are usually treated just with antibiotics. Circumcised boys get UTI's too, and girls get four times as many as boys. http://kidney.niddk.nih.gov/kudiseases/pubs/utichildren/"Urinary tract infections (UTIs) affect about 3 percent of children in the United States every year. Throughout childhood, the risk of a UTI is 2 percent for boys and 8 percent for girls." http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=303&id=1626"Uncircumcised boy babies seem a little more likely to get urine infections because germs may grow under the foreskin in drops of urine, but infections that are caused by this are rare and most doctors will not advise circumcision for this reason alone. (About 1000 newborn boys would need to be circumcised to protect 10 boys from infection, and it is not possible to tell which boys would benefit from circumcision. Sometimes circumcision is done at an older age if an uncircumcised boy gets several urine infections.)" This may be relevant for later on: http://www.merck.com/mmhe/sec23/ch272/ch272i.html"Avoiding frequent bubble baths, which may irritate the skin around the urethral opening of both boys and girls, may help lessen the risk of UTIs." Also of interest:Circumcision is not effective in preventing recurrences of UTIs, Ref:Kwak C, Oh SJ, Lee A, Choi H. Effect of circumcision on urinary tract infection after successful antireflux surgery. BJU Int. 2004; 94(4):627-9."CONCLUSIONThese findings suggest that circumcision during antireflux surgery has no effect on the incidence of postoperative UTI."The hydronephrosis makes a big difference though, and the evidence is conflicting. In your position, I'd definitely get a second opinion from a pediatric urologist who is against routine infant circumcision. Let's face it, if they think all baby boys should be circumcised, they're not only disagreeing with most national medical organizations, they're not going to be interested in keeping your son intact. On the other hand, if you find a pediatric urologist who is against routine circumcision, but says it would be in your son's best interests, then you can rule out pro-circumcision bias. At least you tried. It might be worth trying to find a Hispanic or European specialist.http://www.jurology.com/article/S0022-5347(01)68134-5/abstract"Early circumcision may decrease the incidence of breakthrough urinary tract infection in this subpopulation."http://www.goldjournal.net/article/S0090-4295(08)00652-3/abstract"A total of 92 patients met the study criteria. The rate of UTI in all patients was 4.3% (95% confidence interval 0.2%-8.6%). No statistically significant difference in the infection rate was noted according to sex, obstruction level, hydronephrosis grade, or circumcision status"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477524/"In addition, circumcision should be considered in patients with significant perinatal hydronephrosis or reflux."
    ml66uk 4 Replies Flag this Response
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    ml66uk 4 Replies Flag this Response
  • Wow, thank you VERY much for that veritable FONT of information. When we go back in a couple of months, I am now armed. And I will follow your advice and go for a second opinion if the doctor still disagrees. Update, he seems to be doing VERY well and is hitting all of his developmental marks right on the nose or early. He is a strong kid and we have the highest hopes for him. I will keep you posted!~C
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