Urinary Tract Infections

How kids get them and what to do when they keep coming back.

READER’S QUESTION

My 10-year-old daughter keeps getting urinary tract infections, which really has me concerned. She’s very clean about her hygiene. What could be the cause?

DR. BLUM’S ANSWER

Urinary Tract Infections in a 10-year-old are pretty unusual, but do occur. If a 10-year-old is getting frequent infections a search for the cause would be warranted.

Urinary Tract Infections (UTIs) are caused by the growth of bacteria in the urinary tract. The urinary tract includes the urethra, bladder, ureters, and kidneys. Typically people refer either to bladder infections or kidney infections but all are part of UTIs. Bladder infections typically involve only the lower part of the urinary tract and have milder symptoms. Symptoms include frequent urination, burning or pain with urinating or a feeling of having to urinate but being unable to. Kidney infections tend to be more severe and cause fever, abdominal pain or flank pain, and vomiting.

Urinary Tract Infections are much more common in girls than boys, likely due to anatomical differences. The urethra, which is the tube that carries urine from the bladder out of the body, is very short in girls and this can allow germs to travel up the urethra into the bladder and cause infections. Boys have a longer urethra and this helps prevent infections. Uncircumcised boys have a higher rate of infections than circumcised boys.

There can be many causes for a person to have repeat infections. For girls before puberty the number one cause is probably bubble baths. The soap bubbles can help germs travel up the urethra. After puberty, the change in tissue type seems to protect against this. For all girls, mechanical irritation can cause infection. This can be from masturbation or sexual intercourse. It is always recommended that women empty their bladder after intercourse to prevent UTIs. We will assume that your 10 year old is not having sex and think about other potential causes. The most likely would be an anatomical defect that is preventing complete emptying of the bladder. If some urine is retained after urinating, this urine can act as a source for infection. Some people have obstructions in the ureters or poorly functioning values between the bladder and ureter. Some people will even have duplicate ureters where they have an extra tube, which does not function properly and can cause infection.

If your child is having repeat infections, she needs to be evaluated by either her pediatrician or a by a pediatric urologist. The doctor should have the urine tested in a lab radiologic tests should be done to assess for anatomic abnormalities. She may even need to have a voiding study to see if she is completely emptying her bladder.

Frequent urinary tract infections can be more than a nuisance. They can actually cause damage to the kidneys and lead to significant problems in latter life. For this reason, UTIs should be evaluated aggressively to find the cause of the infections and prevent damage to the kidneys.

Dr. Robert M. Blum is a pediatrician at Southfield Pediatrics in Bingham Farms and West Bloomfield.

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