Does circumcision alter the periurethral bacterial flora?

Pediatr Surg Int. 1998 Mar;13(2-3):146-8. doi: 10.1007/s003830050270.


A prospective study of 25 boys who underwent circumcision for medical reason was performed. Specimens of periurethral bacterial flora were taken before operation as well as 3 weeks after surgery, so that each boy acted as his own control. Before circumcision, 13 (52%) harboured uropathogenic organisms (Escherichia coli and other coliforms, Enterococcus spp, Proteus spp, Pseudomonas spp, and Klebsiella spp); after circumcision, none of the boys had uropathogens, the only organisms cultured from the periurethral region being skin commensals. We postulate that circumcision converts a 'cul-de-sac' that is a reservoir of organisms capable of causing ascending urinary tract infection into a surface colonised by natural skin organisms. This study provides circumstantial evidence supporting the idea that circumcision in well-selected patients may confer protection from urine infection.

MeSH terms

  • Bacteria / isolation & purification*
  • Bacterial Infections
  • Child
  • Child, Preschool
  • Circumcision, Male*
  • Humans
  • Male
  • Penis / microbiology*
  • Prospective Studies
  • Risk Factors
  • Urethra / microbiology*
  • Urinary Tract Infections