Urinary Tract Infections in Boys

Urinary tract infections (UTI) in boys are the result of bacteria getting into the bladder and staying there. UTIs are common in kids, especially girls and uncircumcised boys. E. Coli, responsible for over 75% of UTIs, doubles every 20 minutes in the bladder. That means if there are 100 bacteria of E. Coli in the bladder and you wait three hours to go to the bathroom, you will have over 50,000 bacteria in your bladder. The more bacteria in the bladder and the longer it stays there, the more likely you are to get a UTI.

There are many things that can be done to both treat urinary tract infections in boys and prevent them in the future.

What are recurrent UTIs?

Some boys get UTIs again and again – these are called recurrent UTIs. If left untreated, recurrent UTIs can cause kidney damage, especially in kids younger than 6. It’s important to recognize signs of these infections and get help for your child.

What are the symptoms of UTIs in children?

Symptoms of a UTI can include:

• Pain when peeing
• Changes in frequency of urination
• Changes in appearance or smell of pee
• Fever
• Chills
• Loss of appetite
• Nausea
• Vomiting
• Lower abdominal pain
• Lower back pain or discomfort

Causes of Urinary Tract Infections in Boys

• Poor water intake
• Improper genital hygiene
• Infrequent voiding
• Constipation

Types of UTIs in Children

Common types of UTIs include:

• Cystitis: this bladder infection is the most common type of UTI. Cystitis occurs when bacteria move up the urethra (the tube-like structure that allows urine to exit the body from the bladder) and into the bladder
• Urethritis: when bacteria infect the urethra
• Pyelonephritis: a kidney infection caused by infected urine flowing backward from the bladder into the kidneys or an infection in the bloodstream reaching the kidneys

Preventing Urinary Tract Infections in Boys

Many UTIs can be prevented by changing infants’ diapers frequently, encouraging kids to practice good hygiene, and instructing kids not to “hold it” when they have to pee because urine that remains in the bladder gives bacteria a good place to grow. Here are some tips on how to prevent UTIs in boys:

Increase Water Intake

Children should drink one cup of water (equal to eight ounces) for each year they are old. For example, if a child is 4 years old, he should drink four cups of water each day. Once a child reaches 8 years old, he should be drinking close to two liters (a little over eight cups) per day and stay at this amount into adulthood. Increasing water dilutes the urine, making it more difficult for bacteria to grow. Monitoring the color of urine in the toilet is a good way to ensure good water intake. Urine should be clear to very pale yellow at each void. Darker urine tells us that the child needs more water.

Timed Voiding

Children should urinate about seven times each day–that’s every 2 hours while awake–even if he doesn’t feel like he needs to go. Children who hold their urine and wait until they absolutely have to go to the bathroom tend to be at a higher risk for UTIs and other bladder dysfunction problems.

Foreskin

If the child is uncircumcised, he should practice proper genital hygiene. This means pushing his foreskin back, so he can clean the head of the penis when he is in the shower or bath, just like he would clean any other part of his body. He must also return the foreskin back over the head of the penis once cleaning is complete. It is also important that he pulls his foreskin all the way back before urinating and then pulls it back over when he is done. Not doing this could allow urine to get stuck under the foreskin. When urine gets trapped under the foreskin, bacteria can form and eventually get into the urethra and bladder.

Get Going Everyday

Children should have a soft, easy-to-pass bowel movement every day. By increasing water, fiber (dried fruit, fresh fruit and vegetables) and activity, many children can find constipation relief. If this is not enough, then adding Miralax® (as directed) may help him go every day. Stool is where most of the E. Coli that causes UTIs comes from.

Treatment for Urinary Tract Infections in Boys

Prophylactic Antibiotics

Children may be given a prescription for prophylactic antibiotics. It is a very low dose of antibiotics that they should take every day, as prescribed, to help keep their urine sterile. It is important not to take medication that has not been prescribed for you specifically, please never share your medication with anyone.

CHOC Urology Center have experts to effectively diagnose, treat and create prevention plans. If the child has an infection, our staff may also perform some or all of the following studies:

• Cystoscopy
• Renal ultrasound
• Voiding Cystourethrogram (VCUG)