What is the effect of circumcision on risk of urinary tract infection in boys with posterior urethral valves?

Abridged version: CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

“…In patients with VUR, circumcision was more effective than antibiotic prophylaxis alone or surgical correction in preventing UTIs and the occurrence of new DMSA abnormalities [23][24][25] . Similar results were seen in boys with posterior urethral valves 26 and infants with significant antenatal hydronephrosis 27 . In this subset of boys, with a risk of recurrent UTI (assuming 10% UTI risk, the NNT is 11) and for boys with urological abnormalities (assuming 30% UTI risk high grade VUR, the NNT is 4), a circumcision should be considered 16 .…”

Work-up of Pediatric Urinary Tract Infection

“…About half of boys with UTI will be diagnosed within the first 12 months of life, however 80% of girls will be diagnosed at a later age 2 . Circumcision has been shown to have a protective effect on UTI, reducing the odds of infection by 87%, with an even greater effect for boys with recurrent infections or posterior urethral valves 5, 6 .…”

Urinomas protect renal function in posterior urethral valves—a population based study

“…Comparison of the initial nadir creatinine (defined as the minimum value to which the creatinine fell after decompression of the urinary tract and recovery of the boy from his postobstructive diuresis, at the time of PUV fulguration or definitive decompression by vesicostomy), current creatinine, and renal status score (RSS) was made between those who presented with urinomas at diagnosis of PUV and those boys who did not. The RSS was derived from independent nephrology assessment of the renal status of these patients (0 = normal, 1 = mild renal impairment, 2 = moderate renal impairment, 3 = severe renal impairment, and 4 = ESRF or transplantation; as previously described [9]). Data were reported as medians (range), except where stated otherwise.…”