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Old 03-16-2012, 01:03 PM   #21
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Re: A Question about Circumcision (yes, a real question!)

My understanding of the UTI study most often quoted (the one claiming a 1% reduction for circ) is that it's skewed because most of the circ'ed boys were full term and most of the intact boys were premature. Premature babies are more prone to UTI's simply because of their prematurity. If ALL the babies had been full-term, I personally believe they would have found the opposite results. It's still really uncommon in boys no matter what "kind" of penis they have, but I'm sorry it makes NO sense to me that a penis with a protective covering would have MORE infections. And as one person pointed out, if the "intact" group were given improper cleaning instructions....well...you can just throw the whole thing out the window. Premature retraction can cause a UTI in the blink of an eye.

If the condition you are concerned about has the faulty goings-on up inside his body, it won't have anything to do with his foreskin anyway.

FTR, DS is 7, intact, and has never had a UTI or other infection, DD is 4 1/2 and has had 2 UTI's and several vaginal infections. Even IF you could possibly have a 1% reduction, is that worth the risks of circ, plus taking the choice away from him and changing how his penis functions sexually? If he needs surgery like your DD did, so be it...but that surgery will be similar to hers and nowhere near his genitals and would likely correct the problem the same way it did for her.

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Old 03-16-2012, 03:43 PM   #22
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Hi mama! I just wanted to show you a study link that I think may be beneficial to your situation, as it specifically addresses VUR and the indication for circumcision.

http://adc.bmj.com/content/90/8/853.full.pdf

In a nutshell, this was the conclusion of the study:

- Meta-analysis of existing research shows that circumcision substantially reduces the risk of urinary tract infection (UTI)
- The data do not support the routine circumcision of normal boys to prevent UTI
- Circumcision should be considered in boys with a past history of recurrent UTI or high grade (grade 3 and above) vesicoureteric reflux, as the benefit outweighs the risk of complications in these case

Also a helpful note:

In conclusion, the data we present do not support the
routine circumcision of normal boys with standard risk in
order to prevent UTI. However, our data suggest that
circumcision of boys with higher than normal risk of UTI
should be considered.

Good luck to you!

Last edited by Stamina; 03-16-2012 at 03:47 PM.
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Old 03-16-2012, 03:46 PM   #23
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Re: A Question about Circumcision (yes, a real question!)

Quote:
Originally Posted by bigmamakelsey View Post
Urinary tract infections
Circumcision is associated with a reduced risk of urinary tract infections (UTIs) however the magnitude of this benefit is likely to outweigh the risk only in those at high risk of UTIs.
Some UTI studies have been criticized for not taking into account a high rate of UTI's among premature infants, who are usually not circumcised because of their fragile health status. The AMA stated that "depending on the model employed, approximately 100 to 200 circumcisions would need to be performed to prevent 1 UTI," and noted one decision analysis model that concluded that circumcision was not justified as a preventative measure against UTI.
Boys are not as prone to UTIs are girls are, and the slightly higher chance of them getting one is before the age of 1. The best preventative care for a UTI is frequent diaper changes and baths, and not retracting the foreskin.
This. also, because of the disorder you're talking about, I do not believe circ would help decrease the risk of UTIs at all because it is caused by recycled urine, which would happen regardless of circ if your son has the condition.
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Old 03-16-2012, 03:50 PM   #24
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Re: A Question about Circumcision (yes, a real question!)

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Originally Posted by linzbear View Post
The rate of UTIs looks like this for age under 1 year:

More Common
Girls
Intact Boys
Circ Boys
Less Common

Additionally, it is not known if the UTI risks are related to the old instruction to pull back the foreskin to clean.

I would not circ for this reason. Really, you don't know that it will help, and girls are far more likely to get UTIs anyway, so if the baby is a girl, you will still have to deal with this issue.

I'd also make sure if baby is a boy and you decide to keep him intact, and he does need a cath, make sure you ask the person placing the cath if they have experience on intact penises without retracting them before you let them near him. I've heard one too many stories of boys who were retracted (which likely causes infections) because the nurse had no idea how to place a catheter without retracting.
this as well. also, bubble baths are linked to UTIs in both sexes, so that could also be a factor in the UTI stats, on top of the old instructions to retract a baby's penis.

ETA: although the chances are high, you still do not know that if the baby is a boy, that he will have VR. i would at least wait to see if he does before circing, though I personally would not circ because of this. IF you do circ because of this, have as little foreskin as possible removed.

Last edited by JustSomeChickVee; 03-16-2012 at 03:52 PM.
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Old 03-16-2012, 04:37 PM   #25
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Re: A Question about Circumcision (yes, a real question!)

It would probably be best to talk to different doctors in the specialities who do this type of situation and see what they recommend. The advice you are getting here is non-medical and some very personalized responses based on their personal beliefs that may or may not be best in your family situation.
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Old 03-16-2012, 05:32 PM   #26
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Quote:
Originally Posted by Stamina
Hi mama! I just wanted to show you a study link that I think may be beneficial to your situation, as it specifically addresses VUR and the indication for circumcision.

http://adc.bmj.com/content/90/8/853.full.pdf

In a nutshell, this was the conclusion of the study:

- Meta-analysis of existing research shows that circumcision substantially reduces the risk of urinary tract infection (UTI)
- The data do not support the routine circumcision of normal boys to prevent UTI
- Circumcision should be considered in boys with a past history of recurrent UTI or high grade (grade 3 and above) vesicoureteric reflux, as the benefit outweighs the risk of complications in these case

Also a helpful note:

In conclusion, the data we present do not support the
routine circumcision of normal boys with standard risk in
order to prevent UTI. However, our data suggest that
circumcision of boys with higher than normal risk of UTI
should be considered.

Good luck to you!
This is great info!! I hope it helps you OP, when will you be able to find out what his level of VR is?
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Old 03-16-2012, 05:34 PM   #27
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Re: A Question about Circumcision (yes, a real question!)

Have you thought about trying to seek some medical information about managing VU reflux from countries where circ isn't routinely done? I.e., is circumcision considered a good preventive in such cases in any other country but the US? Or do they have ways of managing the infections properly that don't require circing? IMO, therein lies your answer.

Re: which countries to seek medical info from, I think either the Dutch or Finnish medical association welcomes email queries, even from citizens of other countries. I tried it once myself years ago. The person who responded was fluent in English, and the reply was very thorough and helpful. I want to say it was Finland -- which, incidentally, has a markedly healthier population in these areas than the States, in spite of the fact that circumcision is very rare there. Good luck!
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Old 03-16-2012, 05:34 PM   #28
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Re: A Question about Circumcision (yes, a real question!)

Dbl post, sorry.
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Old 03-16-2012, 06:21 PM   #29
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Re: A Question about Circumcision (yes, a real question!)

Quote:
Originally Posted by sarchamar View Post
Have you thought about trying to seek some medical information about managing VU reflux from countries where circ isn't routinely done? I.e., is circumcision considered a good preventive in such cases in any other country but the US? Or do they have ways of managing the infections properly that don't require circing? IMO, therein lies your answer.

Re: which countries to seek medical info from, I think either the Dutch or Finnish medical association welcomes email queries, even from citizens of other countries. I tried it once myself years ago. The person who responded was fluent in English, and the reply was very thorough and helpful. I want to say it was Finland -- which, incidentally, has a markedly healthier population in these areas than the States, in spite of the fact that circumcision is very rare there. Good luck!
wow this is such a good idea!
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Old 03-16-2012, 07:08 PM   #30
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Re: A Question about Circumcision (yes, a real question!)

Quote:
Originally Posted by sarchamar View Post
Have you thought about trying to seek some medical information about managing VU reflux from countries where circ isn't routinely done? I.e., is circumcision considered a good preventive in such cases in any other country but the US? Or do they have ways of managing the infections properly that don't require circing? IMO, therein lies your answer.

Re: which countries to seek medical info from, I think either the Dutch or Finnish medical association welcomes email queries, even from citizens of other countries. I tried it once myself years ago. The person who responded was fluent in English, and the reply was very thorough and helpful. I want to say it was Finland -- which, incidentally, has a markedly healthier population in these areas than the States, in spite of the fact that circumcision is very rare there. Good luck!
I have a DR who I love for the boys because he's very "intact is normal" I believe it's because he's from Brazil. Hes seen more intact boys than circed from working in a country with such a low circ rate.

So I think it's great advice to contact a doc who's not used to circ if you are interested in keeping him intact.

I don't know 2 things about your DDs condition, but don't let it worry you too much until you know one way or the other!
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