This is largely a technical question but it has some bearing on the larger ethical and social issues of routine newborn circumcision. In order to discuss infant UTI intelligently, it is first necessary to understand that childhood UTI is in general a difficult and confusing diagnosis. If a careful physician and an adult patient have a telephone conversation that leads to the diagnosis of UTI the diagnosis will usually, though not always, be correct. This caveat applies both to individual clinical cases and to research projects. In all age groups except early infancy, females have a much higher rate of UTI than males.
Male infants are more likely to be born with abnormalities of the urinary tract.
Infant UTI is therefore a serious condition that often requires surgical correction of the underlying cause. Now enter Dr. Thomas Wiswell, Army pediatrician who did a prospective study of UTI in infants, targeting the role, if any, of circumcision. And perhaps more disturbing, the crucial connection between UTI and urinary birth defects is broken. Circumcision could conceivably prevent UTI but it cannot prevent birth defects without violating Einstein's Law of Relativity. Because of these concerns and others of a similar technical nature, a controversy erupted over Wiswell's result, and Wiswell responded with more data by doing an indirect review of all available hospitalized Army cases.