Recurrent urinary tract infections and Related Conditions
About HWI
Urinary tract infections (UTI) are common in children, especially girls and uncircumcised boys. In fact, after 5 years, about 8%
of girls and 1% -2% of boys have had at least one urinary tract infection. UTIs occur when the kidneys, ureters, bladder, urethra or
infected.
Symptoms of a urinary tract infection may include:
Painful urination
Changes in frequency, appearance or odor of urine
Fever
Chills
Loss of appetite
Morning sickness
Throw up
Pain in the abdomen
Lower back pain or discomfort
UTIs can also cause children to wet the bed or their pants, even if they have not had these problems before. Infants and young children
Children may only show nonspecific symptoms such as fever, vomiting or loss of appetite or activity.
Some kids experience UTIs again and again - these are called recurrent UTIs. If left untreated, can cause recurrent urinary tract infections
Kidney damage, especially in children younger than 6 So it is important to know how to recognize the signs of these
Infections and help for your child.
Types of urinary tract infections
Common types of urinary tract infections include:
Cystitis: Cystitis this is the most common type of UTI. Cystitis occurs when bacteria move up the urethra (the
tubular structure, the urine discharged by the body of the bladder can be) and the bladder
Urethritis: when bacteria infect the urethra
Pyelonephritis: a kidney infection through infected urine flows backward from the bladder into the kidneys or caused
Infection in the blood stream reach the kidney
Related Terms
Recurrent urinary tract infections sometimes associated with other diseases, as happened, for example:
vesicoureteral reflux (VUR), the diagnosis found in 30% -50% of children with a UTI and is a congenital (present at the
Birth) condition in which urine flows backward into the ureter from the bladder. Ureters are thin, tube-like structures
that urine from the kidney to the bladder. Sometimes the urine back to the kidneys. When the urine in the bladder
infected with bacteria, VUR can lead to pyelonephritis.
hydronephrosis, the enlargement of one or both kidneys by securing or blocking the flow of urine, and is typically
caused by severe VUR or blocked ureter. Kids with hydronephrosis are sometimes at risk of recurrent urinary tract infections and have
daily to take low doses of antibiotics to prevent urinary tract infections, until the condition producing hydronephrosis is better or
determined by the operation.
But can not be traced back to that body structure abnormalities in all cases of recurrent UTI. For example,
dysfunctional voiding - when a child is not properly relax the muscles when urinating - is a common cause of urinary tract infections.
Rare urination - not pee often enough - also increase a child's risk of developing recurrent infections.
Both dysfunctional emptying and urination are rare with constipation.
Independent conditions, the natural defenses of the body, such as diseases affecting the immune system can also cause
recurrent urinary tract infection, although this is rare. Moreover, by means of a urinary catheter not sterile bacteria in the introduction
Urinary tract and cause an infection.
Detect abnormalities
Although urinary tract infections can be treated with antibiotics, it is important that a doctor to rule out underlying abnormalities in
urinary tract infections if they occur repeatedly. Children with recurrent infections should be a pediatric
Urologist to determine what is causing the infection.
Some changes can be detected before birth. Hydronephrosis, when it occurs as an innate, can
detected in a fetus by ultrasound as early as 16 weeks of pregnancy. In rare cases, doctors may consider neonatal surgery
(Performing surgery on an unborn child), if hydronephrosis affects both kidneys and poses a risk to the fetus.
Most of the time, though, doctors wait until after birth to treat the condition, because almost half of all cases, the
are prenatally by the time a baby born diagnosed disappear.
Once a baby with suspected hydronephrosis or other urinary tract abnormality is born, the baby have blood pressure
will be carefully monitored because some kidney abnormalities can cause hypertension. An ultrasound may be used
again to take a closer look at the bladder and kidneys. If the condition appears to be the kidney both, doctors
is arranged generally in blood tests to measure kidney function.
Diagnosis
If an abnormality of the urinary tract is suspected, doctors may order tests to make an accurate diagnosis, including:
Ultrasound
With high-frequency sound waves to bounce "echo" or, from the body and create a picture of him, an ultrasound can detect
some abnormalities in the kidneys, ureters and bladder. It is also possible to measure the size and shape of the kidneys.
If an ultrasound could give points VUR or hydronephrosis, renal scan or voiding cystourethrogram (MCU) doctors a
better idea of what is going on.
Renal scan (nuclear scan)
Radioactive material is injected into a vein and then through the urinary tract. The material may show the form
the kidneys, how well they work, if it is damaged kidney tissue, and the course of the urine. A small amount
Radiation received during the test and excreted from the body in the urine.
Voiding cystourethrogram (MCU or cystogram)
A catheter (a hollow soft tube) is used to inject a dye into the opaque bladder. The X-ray test can diagnose VUR and
identify problems with the bladder or urethra.
Cystoscopy
A cystoscope used lenses and a light source within a tube is inserted through the urethra to the inside of the right
Bladder. It is used to indicate if other tests or symptoms suggestive of bladder abnormality.
Intravenous pyelogram
Opaque dye is injected into a vein and then x-rays are taken to follow the progress of the dye through the urinary tract.
Although this test is still used sometimes the kidneys and renal MRI scan have replaced intravenous pyelogram in most
Cases.
Magnetic resonance urography (MR-U)
This method makes the magnetic resonance imaging (MRI) scan of the urinary tract without the use of dyes or
be radioactive substances has been shown to be as accurate as other scans and is now usually done instead of a
intravenous pyelogram.
Treatment
The treatment of recurrent UTI depends on what caused it in the first place. Sometimes the answer is as simple as
Teaching a child to empty the bladder as soon as he or she has the urge to go.
If a condition such as VUR, the cause of the infections, then the solution is a little more complicated. Children with VUR have
closely monitored because the condition, kidney infection (pyelonephritis) and subsequent kidney damage can result.
Usually, surgery is not necessary because many children outgrow the condition.
Some children with VUR benefit from daily treatment with a small amount of antibiotics that can also make surgery
unnecessary. Children with VUR should be examined by a pediatric urologist to decide whether antibiotic treatment is the best
Option for them.
In some cases, surgery is required to correct VUR. The most common type of surgery in these situations is ureteral
Reimplantation, in which one or both ureters into the bladder stretches to correct the reflux of urine from
the bladder to the ureter and kidney. The success rate for this type of procedure is high, but not everyone is a
good candidate for surgery.
Kids with the following situations may be candidates for ureteral reimplantation:
Intolerance to antibiotics
recurrent infections while on antibiotic treatment
serious or "high-grade" reflux
older children with reflux
An alternative to ureteral reimplantation is endoscopic injection of a material to the input of the ureter into the block
Bladder and prevent VUR. In this method, an endoscope as a narrow tube through the urethra in the inserted
Bladder. The endoscope has a tiny camera at the tip, allowing the surgeon to get it to run in the correct position and inject
the material, which helps keep urine from refluxing back into the kidneys. Endoscopic injection is less invasive than
open surgery, but the results are not so good. A pediatric urologist help families decide the best treatment for a
Child with VUR.
Children who have recurrent infections that are not caused by anatomical defects or other problems may be treatable
prescribed antibiotics for months or even years to prevent recurrent infections. This form of therapy is known
continuous antibiotic prophylaxis.
The future for the management of Recurrent Urinary Tract Infections
Recent studies have found that women and children who have recurrent urinary tract infections may lack certain immunoglobulins (a group of proteins
that fight infections). Some researchers are optimistic that a vaccine will be developed to increase the production of
Antibodies that fight urinary tract infections. Would protect a promising vaccine against E. coli (the most common bacterium that causes
UTI) is tested.
Home Treatment
Other things to note, in order to prevent recurrent urinary tract infections in children:
Diet Changes
Encourage children to drink 8 to 10 glasses of water and other liquids per day. Cranberry juice and cranberry extract are
often proposed because it can prevent the attachment of the walls of the bladder E. coli. Always consult your doctor
although if your child should cranberry juice or cranberry extract drink because they can interfere with some medicines.
Good Bathroom Habits
Frequent emptying of the bladder, preventing normal urination and constipation can all help to prevent recurrent
Infections.
Multivitamins
Vitamin C acidifies the urine, making the environment less friendly to bacteria. Vitamins are designed for children usually
sure, but always consult your doctor before increasing the dose above the currently recommended daily dose.
No Bubble Baths
Children should avoid bubble baths and perfumed soaps because they can irritate the urethra.
Frequent diaper changes
Children in diapers should be changed frequently to the stool with prolonged contact with the genital area, which prevent
, the likelihood that bacteria will move the urethra and into the bladder to increase.
Proper wiping technique
For women, wiping from front to back will reduce UTI-causing bacteria after using the toilet exposure of the urethra
in the chair.
Cotton underwear
Breathable cotton underwear is less likely that the growth of bacteria near the urethra to promote as nylon or other materials.
Frequent visits bathroom
Some children may disagree with the school bathroom or may be so engrossed in a project that they postpone urination. Kids
with UTIs should urinate at least every 3 to 4 hours to help flush bacteria out of the urinary tract.
When to call the doctor
Once you suspect your child has a UTI, it is important to contact your physician. The doctor may recommend another urine
Culture is completed by the treatment of a urinary tract infection, to ensure that the infection has cleared.
If your child suffers from recurrent urinary tract infections, consult a pediatric urologist, who can be a thorough evaluation and, if
necessary to test for urinary tract abnormalities. In the meantime, follow your doctor's instructions for treating
a UTI.