Urinary tract infections (UTIs) pose a big burden for patients, as well as parents. Studies have shown eight in 100 girls and two in 100 boys will get UTIs, according to the Urology Care Foundation.

Causes

There are two types of urinary tract infections: lower (bladder) and upper (kidney) tract infections. Simply put, UTIs happen when bacteria travel up through the urethra and into the bladder. Urinary stasis from incomplete or infrequent bladder emptying also contributes to the development of a UTI. Constipation also increases the risks.

Bladder infections, often referred to as cystitis, often manifest with symptoms such as burning, frequency, urgency, enuresis (involuntary urination), and foul odor. These symptoms are bothersome but not as concerning.

Infections involving the kidney are associated with high fevers, and often other symptoms such as nausea/vomiting and lethargy. These types of infections are more worrisome since they can cause renal scarring or damage.

Uncircumcised boys are at a higher risk of UTIs in their first year of life. Those infants with concomitant urologic diagnoses or abnormalities may benefit from a circumcision or treatment of tight phimosis with a steroid cream to allow retraction of the foreskin for cleaning.

Abnormalities

Many children who get urinary tract infections have normal kidneys and bladders. However, if infections occur repeatedly or are severe, such as pyelonephritis, doctors may evaluate conditions that increase the risk of infection. Common ones are:

Vesicoureteral Reflux, where urine flows backward from the bladder towards the kidney. This alone does not cause UTIs but can propagate pyelonephritis.

Urinary Obstruction, where urine flow is partially or completely blocked anywhere along the urinary tract.

Diagnosis

The only way to confirm a UTI is with a urine test. It is important to check the urine for both the presence of white blood cells and cultured to see whether bacteria grow. Depending on the results and initial symptoms, your doctor may perform additional tests such as a kidney and bladder ultrasound and may refer you to specialists if there are recurrent infections and any other abnormalities.

Treatment

A physician prescribes antibiotics to treat UTIs, which help eliminate the bacteria causing the infection. Most children start to feel better after a few doses, but it is important to complete the full course of antibiotics as prescribed. Children who are sick or unable to drink fluids may need treatment in the hospital.

Prevention

Prevention is key and simple daily habits can help reduce the risk of UTIs. Encouraging your child to use the bathroom regularly and not hold urine for prolonged periods is key and often we recommend urinating on a timed schedule.

Taking additional time to urinate to ensure the bladder is completely emptied and having your child urinate first thing in the morning is important.

Promoting regular bowel movements daily to avoid constipation and drinking plenty of water is especially important.

Healthy bowel and bladder habits go a long way and play a key role in preventing future infections. Proper evaluation by your doctor is key and referral to a specialist when appropriate if there are anatomical concerns or recurrent infections.

Dr. Heidi Stephany is board certified in urology with a subspecialty in pediatric urology. She treats kids and teens at Rady Children’s Health, formerly called CHOC, in Orange County.