Abstract General Information

Title

ANALYSIS OF RELATED FACTORS OF RECURRENT URINARY TRACT INFECTION IN CHILDREN WITH PHIMOSIS AND RECHUNDANT PREPACE

Introduction and objective

Phimosis and redundant prepuce are more common in male children, and complications such as balanitis, glans adhesions, and recurrent urinary tract infection (RUTI) can occur due to the lack of relevant knowledge and timely intervention by some parents,these complications seriously affect the physical and mental health development of the child. Most of the domestic and foreign studies focus on infants and adult patients, and there are few studies on male primary and secondary school students. This study intends to explore the relevant influencing factors of RUTI in children with phimosis and redundant prepuce, and provides a reference for the prevention of RUTI in children with phimosis and long foreskin.

Method

From June 2019 to November 2021,2000 children aged 8 - 17 years with redundant prepuce or phimosis treated at First Affiliated Hospital, Xinxiang Medical College were selected. Inclusion Criteria: (1) meet the diagnostic criteria for redundant prepuce or phimosis; (2) no RUTI before surgery; (3) The child's family give informed consent and voluntarily participated in this study. Exclusion criteria: (1) presence of neurological diseases of the urinary system (neurogenic bladder, occult spina bifida, sacral spinal hypoplasia, etc.) or anatomical malformations of the urinary system; (2) Have a history of urinary system surgery; (3) Have other diseases that may cause urinary tract infections (UTI), such as urinary tract stones, diabetes, etc.They were divided into two groups of RUTI(n =213)and non-RUTI(n =1801)according to the presence or absence of RUTI. A case-control study was performed for examining the correlations between age ,body mass index( BMI),smegma, prepuce adhesion,prination habit, circumcision and RUTI. Related definition: Holding urine usually means that the urine stored in the bladder exceeds the physiological capacity of the bladder, but consciously endures and does not drain, so that the bladder is overfilled for a long time. Habitual urination means that 1~2 times a day will be held in urine. RUTI refers to at least 2 symptoms of UTIs (dysuria, frequency, urgency, suprapubic pain, or haematuria) in the past 6 months, or at least 3 UTIs with pyuria or positive bacterial cultures in the past 12 months3. smegma refers to solid adhesion within the foreskin.In this study, age ≤ 13 years and hody mass index (BMI) ≤18.53 were used as variables, based on the median age and BMI of 2000 boys as cut-off values.

Results

There were 213 cases (213/2000, 10.7%) in the RUTI group and 1787 cases (1787/2000 89.4%) in the non RUTI group.Whether the BMI value exceeds 18.54 (OR=0.76.95% C1:0.53, 1.09) is not correlated with the occurrence of RUTI; younger age(OR =0. 74,95%e C1;0. 50,0. 99),non-circumcision(OR=0.31,95% C1:0.22,0. 45)and frequent holding urine(OR =5. 26,95% C1:3. 82,7. 26) are risk factors for overlength of prepuce and RUTI in phimosis children(all P < 0, 05).

Conclusion

Recurrent urinary tract infection in children with phimosis and redundant prepuce may be related to risk faetors such as uncircumcised prepuce, frequent urination,adhesion of prepuce, prepuce scale and so on. Gireumcision, frequent cleaning of prepuce aod infregpert wrine lower the risk of arinary tract infection in children with phimosis and redlundant