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adjusted REFjournal
|last=Boyle
|first=Gregory J.
|init=GJ
|author-link=
|last2=Hill
|first2=George
|init2=G
|author2-link=George Hill
|title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns
As justification for circumcision, the Manual alleges that circumcision would reduce the incidence of [[urinary tract infection]] (UTI) in the first six months of life, however this is not a valid justification because UTI, if it should occur, is easily treated medically instead of with body-altering surgery.<ref name="McCracken 1989">{{REFjournal
|last=McCracken
|firstinit=G.H.GH
|url=http://www.cirp.org/library/disease/UTI/mccracken/
|title=Options in antimicrobial management of urinary tract infections in infants and children
Moreover, the foreskin protects the penis from infection, so the amputation of the foreskin makes UTI more likely. In infant boys, UTIs originate from the external environment, strongly suggesting that these infections are iatrogenically caused.<ref>{{REFjournal
|last=Maskell
|firstinit=R.
|etal=yes
|title=Urinary Pathogens in the Male
}}</ref> Two interventions that put the male infant at immediate risk for UTIs are [[circumcision]], and [[forced retraction]] of the foreskin. These interventions tear away the synechia which binds the foreskin to the glans in male infants, thereby creating entry points for ''E. coli'' bacteria,<ref name="Winberg 1989">{{REFjournal
|last=Winberg
|firstinit=J.
|etal=yes
|url=http://www.cirp.org/library/disease/UTI/winberg-bollgren/
}}</ref> which binds to the glans penis of the infant.<ref name="Cunningham 1986">{{REFjournal
|last=Cunningham
|firstinit=N.
|url=http://www.cirp.org/library/disease/UTI/cunningham/
|title=Circumcision and urinary tract infections (letter)
}}</ref> Urinary tract infections (UTI) are a complication of circumcision.<ref>{{REFjournal
|last=Smith
|firstinit=R.M.RM
|url=http://www.cirp.org/library/disease/UTI/smith1916/
|title=Recent contributions to the study of pyelitis in infancy
}}</ref><ref name="Cohen 1992">{{REFjournal
|last=Cohen
|firstinit=H.
|etal=yes
|url=http://www.cirp.org/library/disease/UTI/cohen/
}}</ref><ref name="Goldman 1996">{{REFjournal
|last=Goldman
|firstinit=M.
|last2=Barr
|first2init2=J.
|last3=Bistritzer
|first3init3=T.
|last4=Aladjem
|first4init4=M.
|url=http://www.cirp.org/library/disease/UTI/goldman/
|title=Urinary tract infection following ritual jewish circumcision
}}</ref><ref>{{REFjournal
|last=Prais
|firstinit=D.
|last2=Shoov-Furman
|first2init2=R.
|last3=Amir
|first3init3=J.
|title=Is circumcision a risk factor for neonatal urinary tract infections?
|journal=Arch Dis Child