| BackgroundRecurrent urinary tract infection（RUTI）is a urinary tract infection（UTI）caused by new bacteria or the same pathogen infected again after negative urine culture after anti infection treatment.It is a common infectious disease among adolescents in China.At present,researches at home and abroad pay more attention to the prevalence of RUTI in children,and there is a lack of research on RUTI in adolescents.Therefore,the purpose of this survey is to understand the correlation of redundant prepuce and phimosis with RUTI in Chinese adolescents,and to explore the prevalence of redundant prepuce and phimosis in urban and rural adolescents,so as to provide reference basis for the treatment of redundant prepuce and phimosis and the prevention and treatment of RUTI.ObjectiveTo investigate the correlation of redundant prepuce and phimosis with RUTI in adolescents in a university,and to understand the prevalence of redundant prepuce and phimosis in urban and rural adolescents in a university.Methods1.From September 2019 to October 2019,3 800 male college students aged 15-26 in a national university were selected as subjects and studied in the form of questionnaire and physical examination.2.The items to be filled in the questionnaire include:（1）basic information: date of birth,place of birth（urban or rural）,height and weight;（2）whether the prepuce has been treated by operation,the age of operation,and whether RUTI has occurred before and after operation;（3）whether the prepuce is often turned and washed;（4）past or present RUTI;（5）the cognition of redundant prepuce.Specialist examination includes whether there is phimosis,redundant prepuce,adhesion of prepuce,scaling of prepuce,and whether prepuce surgery has been performed.3.The diagnostic criterion of redundant prepuce is that the prepuce covers the urethral orifice,but can turn up to expose the urethral orifice and penis head.The diagnostic criterion of phimosis is that the foreskin completely covers the penis head,and the penis head cannot be exposed.The diagnostic criteria of RUTI is that bladder irritation symptoms such as frequent,urgency and pain have occurred in the past or now,and urinary tract infection has been diagnosed through urine test,and the number of bladder irritation symptoms has been ≥ 2 times in the past 6 months or ≥ 3 times in the past 12 months.4.To analyze the relationship between the prevalence of RUTI and age,redundant prepuce,phimosis,prepuce adhesion,prepuce washing,and cognition of the impact of redundant prepuce on the body.And to compare the prevalence of redundant prepuce and phimosis between urban and rural adolescents.Results1.A total of 3 800 questionnaires were distributed and 3 702 valid questionnaires were recovered,with an effective recovery rate of 97.42%.The results showed that there were 1 347 urban adolescents and 2 355 rural adolescents;51.08%（688/1347）of urban adolescents had redundant prepuce,and 50.19%（1182/2 355）of rural adolescents had redundant prepuce;2.00%（27/1 347）of urban adolescents had phimosis,and 5.82%（137/2 355）of rural adolescents had phimosis;8.54%（115/1 347）urban adolescents had RUTI,and 9.09%（214/2 355）rural adolescents had RUTI.2.Univariate analysis was conducted on the related factors of RUTI prevalence among urban and rural adolescents.The results showed that the prevalence of RUTI among adolescents with redundant prepuce,phimosis,prepuce adhesion and think redundant prepuce is good for health prepuce was higher（P < 0.05）.There was no significant correlation between age,prepuce operation history,prepuce washing（with or without prepuce scale）and RUTI（P>0.05）.3.Multivariate analysis of RUTI prevalence.With the presence or absence of RUTI as the dependent variable,statistically significant factors were included in the model as independent variables for logistic regression analysis The results showed that the cognition of the effects of redundant prepuce,phimosis,adhesion of prepuce and redundant prepuce on health was related to the risk of RUTI in adolescents,both in urban and rural areas.Among them,redundant prepuce（Urban: OR = 2.038,95% CI: 1.347 ～ 3.082;Rural: OR=1.690,95% CI: 1.219 ～ 2.342）,phimosis（Urban: OR = 4.583,95% CI: 1.696 ～ 12.383;Rural: OR = 3.406,95% CI: 2.124 ～ 5.463）prepuce adhesion（Urban: OR = 9.576,95% CI:3.151 ～ 29.106;Rural: OR = 0.219,95% CI: 13.592 ～ 32.115）,redundant prepuce is considered to be good for health（Urban: OR = 2.348,95% CI: 1.934 ～ 3.268;Rural: OR =2.689,95% CI: 2.352 ～ 5.634）,which is an independent risk factor for RUTI of adolescents in a university.Taking the belief that redundant prepuce is good for health as the control,It is considered that redundant prepuce is harmful to health（Urban: OR =0.568,95% CI: 0.382 ～ 0.845;Rural: OR = 0.723,95% CI: 0.536 ～ 0.975）is the protective factor of RUTI for adolescents in a university.ConclusionThe prevalence of RUTI in adolescents with redundant prepuce and phimosis was significantly higher in a university;redundant prepuce,phimosis,adhesion of prepuce and the belief that redundant prepuce is good for health are the risk factors of RUTI;The prevalence of redundant prepuce was higher in urban and rural adolescents,but the prevalence of phimosis in rural adolescents was significantly higher than that in urban adolescents. |
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