COMPARATIVE PERIURETHRAL BACTERIOLOGY OF UNCIRCUMCISED AND CIRCUMCISED MALES

Background: It has been established that lack of circumcision increase s the risk of urinary tract infection in infants. During the first six months, the presence of foreskin is associated with a greater quantit y and a higher concentration of uropathogens in the periurethral area. Very little is known about this association in older males. Objective : To compare the periurethral bacteriology of uncircumcised healthy ma les of more than one year of age. Methods: The periurethral area of 12 5 uncircumcised and 46 circumcised healthy males (mean age, 26.5 and 2 8.3 years, respectively) was swabbed and cultured for facultative and anaerobic bacteria, genital mycoplasmas and Chlamydia trachomatis. Res ults: Facultative Gram positive cocci predominated in both groups (62% and 80%, respectively). Pure culture of facultative Gram negative rod s was more common in uncircumcised males (17% v 4% in circumcised male s, p = 0.01). Streptococci, strict anaerobes and genital mycoplasmas w ere found almost exclusively in uncircumcised males of more than 15 ye ars of age. No case of C trachomatis was identified. Conclusions: The higher prevalence of potential uropathogens in the subpreputial space is in accordance with a previous finding of increased risk of urinary tract infection in uncircumcised young men. Our results also support t he role of the prepuce as a reservoir for sexually transmitted organis ms.