Urinary Tract Infections in Childhood

Definition

The urinary tract carries urine from the kidneys to the outside of the body. It includes the kidneys, bladder, and tubes that connect them. The tubes from the kidney to bladder are called ureters. The tube from the bladder to the outside of the body is called the urethra. A urinary tract infection (UTI) is an infection in any of these structures.

The Urinary Tract.

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Causes

UTIs are caused by bacteria. The bacteria may enter the bladder or the kidneys.

Risk Factors

Factors that may increase your child's chance of a urinary tract infection include:

• Abnormalities of the urinary tract, including:
  • Vesicoureteral reflux —urine flows backwards from the bladder up into the kidneys
  • Urinary obstruction—something is blocking or slowing the flow of urine
• Holding urine for long periods of time
• Not fully emptying the bladder
• Poor hygiene and toilet habits
• Clothing that is too tight, especially if it is not cotton
• Family history of UTIs
• Uncircumcised penis

Symptoms

Symptoms include:

• Feeling the need to urinate frequently
• Only producing a small amount of urine
• Burning or painful urination
• Fever
• Diarrhea
• Irritability
• Fatigue
• Stomachache
• Foul-smelling urine
• Blood in the urine
• Potty-trained children wetting themselves

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may also ask for a urine sample. Tests may include:

• Urinalysis—a laboratory examination of a urine sample
• Urine culture —to identify the specific bacteria involved
• Complete blood count and other blood tests if your child has a fever

Imaging tests may be ordered if UTIs recur. The test may include ultrasound or specialized scans and x-rays to look for problems in tract structure.

Treatment

Talk with your doctor about the best treatment plan for your child. Treatment options include:

Prevention

To help reduce your child's chances of a urinary tract infection:

• Talk to your child's doctor if your child has an abnormality of the urinary system. Your child may need surgery.
• Make sure that girls learn to wipe from front to back.
• Encourage your child to go to the bathroom often—at least several times a day.
• Retract the foreskin of the penis on a regular basis. This will help to keep the area clean.
• If your child has UTIs often, the doctor may prescribe antibiotics. This may help to prevent a new infection.