Urinary Tract Infections

Urinary tract infections (UTIs) can be common in children but when left untreated, a UTI can develop into more serious kidney problems. While it is difficult to spot the signs of UTI in children, CHOC Urology Center have experts to effectively diagnose, treat and create prevention plans.

What are urinary tract infections?

Urinary tract infections are a serious, but common, health problem that affect millions of people each year. They are commonly caused by bacteria within the urinary tract. UTI symptoms usually include an increased urgency and frequency to urinate, fevers, dysuria (painful urination) or blood in the urine.

What causes urinary tract infections?

Normal urine is sterile and contains fluids, salts, and waste products that is free of bacteria, viruses, and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra, the hollow tube that carries urine from the bladder to the outside of the body, and begin to multiply. Poor water intake, infrequent voiding and constipation all contribute to the chances of having a urinary tract infection.

What are the different types of urinary tract infections?

A UTI may involve different sections of the urinary tract including the following:

• Urethritis: An infection of the urethra, the hollow tube that drains urine from the bladder to the outside of the body.
• Cystitis: A bacterial infection in the bladder that often has moved up from the urethra.
• Pyelonephritis: An infection of the kidneys that is usually a result of an infection that has spread up the tract. Pyelonephritis is more common in children with vesicoureteral reflux.

What are the symptoms of a urinary tract infection?

Although each individual child may experience UTI symptoms differently, the following are the most common symptoms:

• Frequent urination
• Urgency of urination
• A painful, burning feeling during urination
• Fever (often the only sign of infection in infants)
• Urine appears cloudy or red (blood may be present in the urine)
• Feeling pain even when not urinating
• Fatigue
• Pain in the back or side, below the ribs
• Nausea and/or vomiting
• Despite an intense urge to urinate, only a small amount of urine is passed

The symptoms of a urinary tract infection may resemble other conditions or medical problems. Our pediatric urology specialists will carefully work with the child to ensure a proper diagnosis.

How are urinary tract infections diagnosed?

In addition to a complete medical history and physical examination, our specialists may perform a microscopic urinalysis. These tests allow us to examine the child’s urine in a laboratory for various cells and chemicals, such as red blood cells, white blood cells and bacteria. All urine tested for an infection should have a microscopic urinanalysis completed to verify the presence of white blood cells. These tests can be ordered by our office or other healthcare providers.

What is the treatment for UTIs?

Specific treatment for UTIs is determined based on:

• The child’s age, overall health and medical history
• Extent of the infection and symptoms the child is having
• The likelihood that the bacteria causing the infection can be treated with specific medications
• The child’s current medications and medication allergies

In addition to prescribing antibacterial medication or other medicines to relieve pain for some patients, caregivers may also be asked to work with their children to make the following changes:

• Make sure the child drinks enough water to help cleanse the urinary tract of bacteria. Learn more about how much water your child should be drinking.
• Clearing constipation.
• Make sure the child urinates about once every two hours during the day.

If the child has an infection, our staff may also perform some or all of the following studies:

• Cystoscopy (also called cystourethroscopy), which is an examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions.
• Renal ultrasound, which is a noninvasive test in which a transducer is passed over the kidney producing sound waves that bounce off of the kidney and transmit a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney and to detect a mass, kidney stone, cyst or other obstruction or abnormalities. (Parents see their baby while pregnant with a similar ultrasound.)
• Voiding Cystourethrogram (VCUG) in which a thin catheter is inserted into the patient’s urethra. The bladder is filled with a dye while X-rays are taken of the bladder. This allows our specialists to see the shape of the bladder, the urethra and if there is any vesicoureteral reflux.

Learn more about the tests and procedures used to make diagnoses at the CHOC Urology Center.

How can urinary tract infections be prevented?

To reduce the likelihood of developing another UTI, a patient may consider the following:

• Drink enough water. Learn how much water children should drink each day.
• Encourage the child to not “hold” his or her urine. When the child feels the need to go, they should go as soon as possible. Frequent voiding reduces the length of time that urine sits in the bladder and bacteria can grow.
• Clear constipation.
• Females should wipe from front to back after using the toilet to prevent bacteria around the anus from entering the vagina or urethra.
• Uncircumcised males should retract their foreskin while voiding to ensure urine does not sit under the skin for long periods of time. They should also regularly clean their foreskin and the head of the penis in the bath or shower.

Learn more about the specific treatment for boys and girls with urinary tract infections.