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Expert Q&A

	By Dr. Vincent J. Kopp Pediatrician Pediatric Anesthesiologist

My 15-month-old son has suffered with three urinary tract infections. He is not circumcised. The doctor says the foreskin is too tight and is causing the infections. Have you ever heard of this?

This simple question belies a very complex question. The short answer is that uncircumcised male children are slightly more likely to have urinary tract infections than circumcised males. However, any male -- circumcised or uncircumcised -- who gets a urinary tract infection should have an entire urinary tract evaluation to detect possible anatomic reasons for a urinary tract infection. This is especially true if a child has had recurrent infections. Lack of circumcision cannot be definitively implicated until other possible reasons are ruled out. This child needs specialist evaluation.

Balanitis, or inflammation and swelling of the uncircumcised penis, is another common problem which must be considered when the decision not to circumcise is considered. Most recently it has been concluded that uncircumcised males are more likely to carry a type of human papaloma virus and that the partners of uncircumcised males are at higher risk for developing cervical cancer caused by this virus. This new evidence will certainly reopen the circumcision debate again.

Vincent J. Kopp, MD

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