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July 1, 1992

Circumcision and Urinary Tract Infection

Author Affiliations

Nashville, Tenn

JAMA. 1992;268(1):54. doi:10.1001/jama.1992.03490010056025

To the Editor.  —I enjoyed reading the article by Spach et al1 in the February 5 issue of The Journal. Their findings add support to the once routine practice of circumcision. Even though the odds ratio for not being circumcised when comparing men with and without UTI was not significant (the 95% confidence interval includes 1.0), it is significant in infections with aerobic gram-negative bacilli.Two nonbacteriuric subjects were selected for each bacteriuric subject, but it is not clear how these controls were selected, or how many there were from which to choose. I also have some difficulty in understanding how the authors were able to determine the circumcision status of each of the subjects. The article does not mention whether such information is included in the clinic records. Each of these aspects could have influenced the study's results in addition to those mentioned by the authors.