Recurrent Urinary Tract Infections and Related Conditions
Urinary tract infections (UTIs) are common in kids, especially girls and uncircumcised boys. In fact, by age 5, about 8% of girls and 1%-2% of boys have had at least one UTI. UTIs occur when the kidneys, ureters, bladder, or urethra become infected.
Symptoms of a UTI can include:
- pain when urinating
- changes in frequency, appearance, or smell of urine
- loss of appetite
- lower abdominal pain
- lower back pain or discomfort
UTIs can also cause kids to wet their pants or the bed, even if they haven't had these problems before. Infants and young children may only show nonspecific signs such as fever, vomiting, or decreased appetite or activity.
Some kids experience UTIs again and again — these are called recurrent UTIs. If left untreated, recurrent UTIs can cause kidney damage, especially in kids younger than 6. So it's important to know how to recognize the signs of these infections and get help for your child.
Types of UTIs
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
Recurrent UTIs sometimes happen in conjunction with other conditions, such as:
- vesico-ureteral reflux (VUR), which is found in 30%-50% of kids diagnosed with a UTI and is a congenital (present at birth) condition in which urine flows backward from the bladder to the ureters. Ureters are thin, tube-like structures that carry urine from the kidney to the bladder. Sometimes the urine backs up to the kidneys. If the urine in the bladder is infected with bacteria, VUR can lead to pyelonephritis.
- hydronephrosis, which is an enlargement of one or both kidneys due to backup or blockage of urine flow and is usually caused by severe VUR or a blocked ureter. Kids with hydronephrosis are sometimes at risk of recurrent UTIs and may need to take daily low doses of antibiotics to prevent UTIs until the condition producing hydronephrosis gets better or is fixed through surgery.
But not all cases of recurrent UTIs can be traced back to these body structure-related abnormalities. For example, dysfunctional voiding — when a child doesn't relax the muscles properly while urinating — is a common cause of UTIs. Infrequent urination - not peeing often enough - can also increase a child's risk of developing recurrent infections. Both dysfunctional voiding and infrequent urination are associated with constipation.
Unrelated conditions that compromise the body's natural defenses, such as diseases of the immune system, can also lead to recurrent UTIs, although this is rare. In addition, using a nonsterile urinary catheter can introduce bacteria into the urinary tract and cause an infection.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation. All rights reserved.
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