Phimosis Treatment and Risk of Recurrent Urinary Tract Infection in Infant Males: A Systematic Review
Abstract
OBJECTIVE
To evaluate the effectiveness of phimosis treatment through circumcision or topical corticosteroids in preventing recurrent UTI (rUTI) in male infants.
METHODS
A systematic review of PubMed, Embase™, Cochrane Library, CINAHL, Scopus, Web of Science™ and ClinicalTrials.gov was conducted through September 2024 per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language articles with primary data on rUTI rates post-circumcision or topical corticosteroid treatment in infants were included. Articles were excluded if participants had not experienced a prior UTI. Two authors independently assessed abstracts and articles; a third resolved discrepancies. Joanna Briggs Institute Critical Appraisal Tools were applied for quality and risk of bias.
RESULTS
Of 3,283 abstracts, 69 full-text articles were reviewed and four met inclusion criteria (two on circumcision, two on topical corticosteroids). 11/35 (31%) uncircumcised premature infants and 6/53 (11%) uncircumcised boys developed a rUTI compared to none post-circumcision. Among 27 uncircumcised infants who received topical corticosteroids, none developed rUTI, vs. 27/165 (16%) untreated infants. Another study found phimosis resolution in 35/39 (90%) infants using topical corticosteroids vs. 8/39 (21%) using Vaseline. Infants were re-categorized by prepuce retractability, with rUTI in 2/28 (7%) infants with a retractile vs. 8/27 (30%) with a non-retractile prepuce.
CONCLUSIONS
This…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 27 participants or records.
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