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Neonatal Circumcision and Urinary Tract Infections in Infants With Hydronephrosis. Pediatrics 2018 07;142(1) PMID: 29880703

Pubmed ID





BACKGROUND: Boys with urinary tract abnormalities may derive a greater benefit from newborn circumcision for prevention of urinary tract infection (UTI) than the general population. However, the effect of newborn circumcision on UTI is not well characterized across the etiological spectrum of hydronephrosis. We hypothesized that boys with an early diagnosis of hydronephrosis who undergo newborn circumcision will have reduced rates of UTI.

METHODS: The MarketScan data set, an employer-based claims database, was used to identify boys with hydronephrosis or hydronephrosis-related diagnoses within the first 30 days of life. The primary outcome was the rate of UTIs within the first year of life, comparing circumcised boys with uncircumcised boys and adjusting for region, insurance type, year of birth, and infant comorbidity.

RESULTS: A total of 5561 boys met inclusion criteria, including 2386 (42.9%) undergoing newborn circumcision and 3175 (57.1%) uncircumcised boys. On multivariate analysis, circumcision was associated with a decreased risk of UTI in both boys with hydronephrosis and healthy cohorts: odds ratio (OR) 0.36 (95% confidence interval [CI] 0.29-0.44) and OR 0.32 (95% CI 0.21-0.48), respectively. To prevent 1 UTI, 10 patients with hydronephrosis would have to undergo circumcision compared with 83 healthy boys. Among specific hydronephrosis diagnoses, circumcision was associated with a reduced risk of UTI for those with isolated hydronephrosis (OR 0.35 [95% CI 0.26-0.46]), vesicoureteral reflux (OR 0.35 [95% CI 0.23-0.54]), and ureteropelvic junction obstruction (OR 0.35 [95% CI 0.20-0.61]).

CONCLUSIONS: Newborn circumcision is associated with a significantly lower rate of UTI among infant boys with hydronephrosis.

Author List

Ellison JS, Dy GW, Fu BC, Holt SK, Gore JL, Merguerian PA


Jonathan Scott Ellison MD Assistant Professor in the Urologic Surgery department at Medical College of Wisconsin


2-s2.0-85049573909   1 Citations

MESH terms used to index this publication - Major topics in bold

Circumcision, Male
Databases, Factual
Infant, Newborn
Risk Factors
Urinary Tract Infections
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e