EPIDIDYMITIS IN CHILDREN - THE CIRCUMCISION FACTOR

Purpose: Recommendations for circumcision have significantly altered i n the last several years. Studies have objectively established an incr eased risk of urinary tract infection in uncircumcised boys. We evalua ted the relationship between epididymitis and circumcision status. Mat erials and Methods: We studied the relationships among the circumcisio n status of 36 consecutive boys with epididymitis in a review of 128 w ith acute scrotal inflammation (group 1), circumcision status of 43 in whom the diagnosis of epididymitis at discharge home had been made el sewhere (group 2), New York State hospital discharge figures for circu mcision in newborns (group 3) and the regional prevalence of circumcis ion in 200 consecutive pediatric emergency department patients at the same institution with nonurological diagnoses (group 4). Results: New York State Department figures indicate that 70% of male newborns are d ischarged home with a hospital code for circumcision. Similarly an eva luation of 200 consecutive male patients without urological diagnoses younger than 18 years in the emergency department revealed that 131 (6 5%) were circumcised. Comparatively in groups 1 and 2 only 25 and 26% of patients, respectively, were circumcised. The statistical differenc e in circumcision status among the 4 groups was significant (p > 0.000 4). Conclusions: These data demonstrate with highly statistical signif icance that a relationship exists between epididymitis and the presenc e of a foreskin. We found that an intact foreskin is an important etio logical factor in boys with epididymitis.