Urologic Consultants, P.C.

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Downtown / Main Office
25 Michigan Street NE, Suite 3300
Grand Rapids, MI 49503-2515
CONSTRUCTION Apr. 12 – Aug. 2010
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Allegan Medical Clinic
511 Linn Street
Allegan, MI 49010-1524


Cascade - CT Imaging Center
4070 Lake Drive, Suite L101
Grand Rapids, MI 49546-8294

Greenville United Memorial Clinic
705 S. Greenville West Drive, Suite 202
Greenville, MI 48838-3556


Metro Health Village
2093 Health Drive, Ste 202
Wyoming, MI 49519



What Does My Child Have a Urinary Tract Infection UTI?

George F. Steinhardt, M.D., F.A.A.P., F.A.C.S.
Member, Society of Pediatric Urology

Myths of the causes of urinary tract infections:

  • Not wiping correctly ("from front to back")
    • Wiping from front to back may seen logical by not encouraging germs from the anus and vagina into the urinary opening, but it is not a proven fact that it is the cause of a UTI.
  • Taking too many bubble baths
    • Soap can be irritating to the perineum and the irritation could lead to a UTI, but bubble baths themselves do not cause UTI's.

Truths
The following conditions may lead to a urinary tract infection:

  1. Constipation
  2. Holding urine or not emptying the bladder completely
  3. Wetting or soiling (this includes even a small "leakage of urine")

Why do GIRLS get more urinary tract infections than BOYS?

    Girls get more infections by the things described above, the presence of bacteria, and the ability to store the bacteria in the vaginal area. Girls also have a shorter urethra (passageway of the urine from the bladder). Because of the shorter urethra, bacteria (from an irritated/reddened perineum) can more easily get into the bladder.

Constipation/Soiling-

  • It has been suggested that having a distended rectum can push on the bladder causing frequency and wetting thus compromising the bladder's ability to store urine in a normal fashion. You may be unaware that your child has an issue with constipation. It is good to have at least one bowel movement a day if not more.
  • Soiling (streaks) in underwear could mean that your child has trouble with constipation. Soiling is also an irritation to the perineal area and could cause a UTI.
  • If your child has constipation, it may be helpful to increase the fiber in their diet and also avoid constipating foods. Often attention to the bowel habit alone will resolve the wetting problem in many children.

Holding Urine-

  • Holding urine or not emptying completely could lead to leakage of urine and wetting. Often children will squat, cross their legs, and do the "pee pee dance" to try to effectively minimized the release of urine. Tightening up the external sphincter is ineffective in holding back urine and damp pants ensue.

Wetting-

  • Wetting is very irritating to the perineum and can cause redness, itching, and burning, a prime breading ground for bacteria. Keeping your child dry is the key as well as keeping their bottom clean.
  • The voiding history is very important in the evaluation of the child with wet pants but is often difficult to obtain. Once the history of daytime wetting is established, it is important to try to establish the frequency and volume of urination. Often we suggest that the family keep track of a "voiding diary"; measuring the frequency and volume of urination (on the weekends is fine). In addition, the daily volume of fluid ingested by the patient is relevant. Many wetters are simply big drinkers.
  • Bladder stimulants such as caffeine and chocolate also contribute to wetting problems. Avoidance of bladder stimulants may be helpful in keeping your child dry and thus prevent a UTI.

Your doctor may order one or more of the following labs or radiology tests:

  • ULTRASOUND- This test is done to check the kidney size and to follow the growth of the kidneys. The test does not involve a catheter (tube) or needles. It also helps check for any abnormalities such as hydronephrosis (swelling of the kidney).

  • VCUG- This test is done when a ultrasound suggests there may be reflux or an obstruction. It involves insertion of a small catheter (tube), into the urethra, contrast fluid is infused through the catheter (tube), and x-ray pictures are taken. When the bladder is filled, your child will urinate and further pictures are taken of the bladder, ureters, and kidneys.

  • URINALYSIS- This involves testing the urine with a dipstick to see if there are abnormal levels that may suggest a UTI. Your doctor may also look at the urine under a microscope. This test does not diagnose a UTI but could suggest one.

  • URINE CULTURE- A urine culture takes 48-72 hours for a result. This is because the lab watches the see if any bacteria grows, and then determines what type of bacteria it is. There are many antibiotics, but not every antibiotic is good for every infection. Each antibiotic is tested on the bacteria grown to see if it kills it. Then we can choose what type of antibiotic would be BEST for you child.

Steinhardt, George F. and Shahida Naseer. (1994). Dysfunctional Voiding: Diagnosis and Management. In S. Rous (Ed.), Urology Annual (Vol. 8, pp. 261-271). New York: W.W. Norton & Company.


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