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Pediatric Urinary Tract Infections

By Philip E. Gleason, MD

Urinary tract infections (UTI) can occur in both boys and girls at any age. They are relatively uncommon in young boys, but may or may not be related to whether or not the boy is circumcised. They tend to occur more commonly in young girls. In both sexes, UTI's are considered abnormal and raise the possible concern of underlying abnormality of the urinary tract predisposing to the infection. We therefore attempt to evaluate the UTI and treat the bacteria to get rid of the infection. It is then recommended to pursue further evaluation to exclude possible abnormalities which would predispose to recurrent, persistent, or future UTI's and possible abnormality or damage to the kidneys.

Having completed antibiotic therapy, anatomic evaluation of the urinary system is performed. This is an attempt to identify any potential blockage or obstruction of the urinary system that may cause obstruction of the urine flow and cause UTI's. In addition, vesicoureteral reflux (VUR) or reflux of urine from the bladder back up to the kidneys can also cause difficulties with urinary drainage and predispose to UTI's. Therefore, evaluation of the urinary system including either renal ultrasound or VCUG or possibly an IVP is recommended. Other potential causes of UTI include dysfunctional voiding or essentially bad urinary voiding habits such as waiting too long to void or possibly voiding but not completely emptying the bladder.

I hope this will provide a brief introduction to the UTI's in children and serve as a guide for anticipated further management and evaluation of the urine infections to prevent future infections or difficulties.