Paediatric Urology – Urinary Tract Infections in Children

U rinary tract infection (UTI) is a fairly common problem among children. Bacteria / germs that enter the bladder can cause UTI.

The majority of these bacteria come from the intestines – they are passed in the stools and may contaminate the child’s bladder pipe (urethra) and ascend into the bladder. UTI are more common in girls than boys because girls have a much shorter bladder pipe.

1What causes a UTI in children?

Most cases of UTI have no specific underlying problem and a child could just get an infection as a result of accidental contamination with bacteria.

If your child has repeated urinary tract infections, then your doctor will want to look for a specific cause or underlying problem. Some of the following conditions may cause recurrent UTI’s:

1. Constipation:
Prolonged constipation causes pressure on the bladder, which leads to poor drainage of urine. The retained urine in the bladder is prone to infection.

2. Abnormal urinary tract system:
This can also cause incomplete bladder emptying, which increases the risk of UTI. Some of the more common urinary tract abnormalities conditions:

  • Vesico-ureteric reflux: Abnormal back flow of urine towards the kidneys.
  • Spinal cord abnormalities: This can lead to a poorly functioning bladder, which fails to empty itself.
  • Urethral valves: An abnormal blockage is present in the bladder pipe, preventing the bladder from emptying properly

2What are the signs and symptoms of UTI in children?

A baby with a urinary tract infection may have the following symptoms:

  • Fever
  • Poor feeding
  • Failure to gain weight
  • Diarrhea and vomiting
  • Jaundice (yellow discoloration of skin and eyes)

Older children with urinary tract infection may complain of the following:

  • Abdominal pain
  • Burning urination
  • Blood in the urine
  • Fever
3What tests are done in children with UTI’s?

Some of the tests include:

  • Urine analysis to detect the presence of infection and to identify the specific bacteria causing the infection.
  • Ultrasound of the kidneys and bladder to detect any abnormalities.
  • Urinating cystogram is a special X-ray test which uses a dye to detect urine backflow back to the kidney.
  • Nuclear scans are performed to assess kidney damage or to detect blockage of urine flow.
4What is the treatment of UTI’s in children?

The treatment of a UTI depends on the severity of the infection and the number of previous episodes of infection.
Mild infections are treated with antibiotics and do not require overnight stay in hospital. Severe infections sometimes require admission to hospital for antibiotic treatment.

Children at risk of repeated UTI’s may require long-term antibiotic use to prevent new infections. In rare cases, a surgical procedure may be required to correct an abnormality in the urinary tract.