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November 1989

Circumcision and Urinary Tract Abnormalities-Reply

Author Affiliations

The Children's Hospital Boston, Mass 02115

Am J Dis Child. 1989;143(11):1262. doi:10.1001/archpedi.1989.02150230020011

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In Reply.—Dr Hopp and Drs Rockney and Caldamone discuss an important aspect of the relationship between UTI, noncircumcision, and anatomic abnormalities of the urinary tract. I did not mean to imply that the presence of a foreskin causes anatomic abnormalities—that seems highly improbable. Rather, I agree that noncircumcision is an additional risk factor that, by provoking UTI, can aid in detecting anatomic abnormalities that are already present. This may be of long-term benefit to the child, as Dr Hopp suggests. However, it is difficult to advocate catching one disease (UTI) to prevent another, albeit a more serious one (possible end-stage renal disease from reflux). Fortunately a safer screening test is being widely used—prenatal ultrasound. More and more congenital urologic abnormalities are being detected by prenatal ultrasound, which may someday render this whole discussion moot.

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