However, a positive urine culture alone is not necessarily indicative of symptomatic UTI requiring treatment. There is a significant false-positive rate in diagnosing UTI when urine cultures alone are used. This criticism was addressed to some extent in Wiswell's second review. No information on rooming-in or breastfeeding history for the infants before they were hospitalized was recorded. The hospital chart data used in the retrospective studies are unreliable.
Hospitals frequently omit to record a circumcision on a baby's chart.
If the records used in the retrospective bacteriuria studies are similarly inaccurate, then a statistically significant number of the infants with bacteriuria that were claimed to be intact were, in fact, circumcised. This would naturally overstate the rate of infection in intact boys. This possibility was not accounted for in the studies. The Wiswell studies and all other studies in the literature fail to control for the effects of breastfeeding. A number of studies about post-circumcision UTIs, and the role of the surgery in possibly facilitating UTIs, were not able to recommend neonatal circumcision.