What are urinary tract infections?
Urinary Tract Infections or UTIs are bacterial infections of the bladder and the kidney. When the bladder alone is involved, it is called cystitis. When the kidneys are involved exclusively, it is called pyelonephritis.
Why do they occur?
UTIs are more common in girls because the opening to the urinary tract called the urethral opening (where the urine comes out) is in the middle of the vagina which is filled with many germs. Certain germs called fimbriated germs walk up the urethra into the bladder. In boys, where the urethral opening is at the tip of the penis, it is more difficult for germs to climb in.
What are the symptoms?
UTIs are almost always associated with painful urination and accidents. The reason is that when the bladder is infected, it goes into spasm more easily. The spasm is associated with pain as well as the unexpected emptying of the bladder (an accident). In addition, there is often urgency (the feeling that you have to constantly urinate) and frequency (actual frequent urination). In cases of pyelonephritis, symptoms of fever, abdominal pain and even vomiting can occur. Please schedule an appointment to see us if symptoms of a UTI occur. It is important to us to confirm the infection with a urine sample given at the office.
What can be done?
The treatment for a UTI is oral antibiotics. Typically, antibiotics such as Bactrim or Augmentin are used and recovery occurs in a few days. We will then schedule a follow-up appointment in a few weeks to ensure the infection is gone. Most commonly for females, a UTI is caused from improper wiping (remember, front to back) or not voiding in a timely manner. However, up to 5% of UTIs are associated with anatomical abnormalities of the urinary tract. It may be important to make sure your child’s UTI doesn’t mean there is a fixable problem of the urinary tract. Two tests that can be done in children with a suspected anatomical abnormality are a renal ultrasound (usually done first) which is a non-invasive picture of the bladder and kidneys (similar to the prenatal ultrasound that all women routinely get), and a VCUG or vesico-ureteragram where some dye is inserted in the urethra and we test for reflux or the passage of urine up to the kidneys as well as down outside the body. We will discuss with you if these tests are necessary after your child’s UTI.