TY - JOUR
T1 - Circumcision reduces urinary tract infection in children with antenatal hydronephrosis
T2 - Systematic review and meta-analysis
AU - Wahyudi, Irfan
AU - Raharja, Putu Angga Risky
AU - Situmorang, Gerhard Reinaldi
AU - Rodjani, Arry
N1 - Funding Information:
This study was supported by Universitas Indonesia with Publikasi Terindeks Internasional (PUTI) Q2 Grant [Grant Number NKB-1235/UN2.RST/HKP.05.00/2022].
Publisher Copyright:
© 2022 The Author(s)
PY - 2022
Y1 - 2022
N2 - Introduction: Urinary tract infection (UTI) is more prevalent in boys with antenatal hydronephrosis (ANH). Circumcision is known to lessen the risk of UTI. This study was performed to examine the associations between circumcision and UTI among patients with ANH. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed for conducting this systematic review and meta-analysis. PubMed, ScienceDirect, EMBASE, and Cochrane Library databases were searched through August 4th, 2022 to identify eligible studies. The risk of bias was measured using the Newcastle-Ottawa Scale (NOS). Review manager 5.4 was used for all analysis. Results: A total of 21 studies involving 8,968 patients with ANH were included in the meta-analysis. The incidences of UTI were 18.1% in the uncircumcised group and 4.9% in the circumcised group. From analysis, circumcision had significant protective effect against UTI with pooled OR of 0.28 (95% CI 0.23–0.32). The significant protective effects were also found in subgroup analysis of hydronephrosis etiology, including vesicoureteral reflux (pooled OR of 0.24; 95% CI 0.17–0.32), obstructive hydronephrosis (pooled OR of 0.34; 95% CI 0.21–0.53), and posterior urethral valve (pooled OR of 0.28; 95% CI 0.16–0.52). Conclusion: Our meta-analysis showed that circumcision was associated with a decreased incidence of UTI in children with ANH. This benefit was consistent irrespective of the underlying cause of hydronephrosis.
AB - Introduction: Urinary tract infection (UTI) is more prevalent in boys with antenatal hydronephrosis (ANH). Circumcision is known to lessen the risk of UTI. This study was performed to examine the associations between circumcision and UTI among patients with ANH. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed for conducting this systematic review and meta-analysis. PubMed, ScienceDirect, EMBASE, and Cochrane Library databases were searched through August 4th, 2022 to identify eligible studies. The risk of bias was measured using the Newcastle-Ottawa Scale (NOS). Review manager 5.4 was used for all analysis. Results: A total of 21 studies involving 8,968 patients with ANH were included in the meta-analysis. The incidences of UTI were 18.1% in the uncircumcised group and 4.9% in the circumcised group. From analysis, circumcision had significant protective effect against UTI with pooled OR of 0.28 (95% CI 0.23–0.32). The significant protective effects were also found in subgroup analysis of hydronephrosis etiology, including vesicoureteral reflux (pooled OR of 0.24; 95% CI 0.17–0.32), obstructive hydronephrosis (pooled OR of 0.34; 95% CI 0.21–0.53), and posterior urethral valve (pooled OR of 0.28; 95% CI 0.16–0.52). Conclusion: Our meta-analysis showed that circumcision was associated with a decreased incidence of UTI in children with ANH. This benefit was consistent irrespective of the underlying cause of hydronephrosis.
KW - Antenatal hydronephrosis
KW - Circumcision
KW - Obstructive hydronephrosis
KW - Posterior urethral valve
KW - Urinary tract infection
KW - Vesicoureteral reflux
UR - http://www.scopus.com/inward/record.url?scp=85142904382&partnerID=8YFLogxK
U2 - 10.1016/j.jpurol.2022.10.029
DO - 10.1016/j.jpurol.2022.10.029
M3 - Review article
C2 - 36371332
AN - SCOPUS:85142904382
SN - 1477-5131
VL - 19
SP - 66
EP - 74
JO - Journal of Pediatric Urology
JF - Journal of Pediatric Urology
IS - 1
ER -