G e o r g e H i l l 1323 North River Road Port Allen, Louisiana 70767-3303 E-mail: DYKS96A@prodigy.com Tel: 504-383-8067 Fax: 504-381-8200 16 February 1998 Carole Marie Lannon, MD, MPH Chair, Task Force on Circumcision c/o Mr. Edward P. Zimmerman, Director Division of Physician Payment Systems American Academy of Pediatrics P. O. Box 927 Elk Grove Village, IL 60009-0927 Re: UTI and Circumcision Dear Dr. Lannon: Further research has discovered a new abstract in a supplement of abstracts published by Paediatrics & Child Health, the official journal of the Canadian Paediatric Society. This abstract reports a prospective study on the incidence of UTI in circumcised and intact male children in Ontario. This study reports dramatically different results from those reported by Wiswell's retrospective studies a decade ago.[2,3] This report finds 625 circumcisions would be necessary to prevent one case of UTI. Unfortunately this new study does not indicate any efforts to control for confounding factors. In addition, it must be remembered that Mueller and colleagues found no significant difference in incidence of UTI in circumcised and intact children. I am also enclosing the Pisacane study on the value of breastfeeding in the reduction of the incidence of UTI. Cordially yours, George Hill References 1. To T, Agha M, Dick PT, et al. A cohort study on male neonatal circumcision and the subsequent risk of urinary tract infection. Paediatr Child Health, Vol 2 Supple A May/June 1997:55A 2. Wiswell TE, Smith FR, Bass JW. Decreased incidence of urinary tract infections in circumcised male infants. Pediatrics 1985; 75:901-3. 3. Wiswell TE, Roscelli JD. Corroborative evidence for decreased incidence of urinary tract infections in circumcised male infants. Pediatrics 1986; 78:96-9 4. Mueller ER, Steinhardt G, Naseer S. The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection. Pediatrics 1997; 100: 580 (supplement) 5. Pisacane A, Graziano L, Mazarella G, et al. Breastfeeding and urinary tract infection. J Pediatrics 1992; 120:87-9.
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