Pediatric Urinary Tract Infections

A common problem in children that hold their urine/stools excessively is urinary tract infections (UTI). A pediatric urologist should evaluate any child with a history of a urinary tract infection as many medical conditions can predispose to UTI. If a child has no medical problems, however, he/she may be having infections due to their holding urine/stool.

An important point to keep in mind regarding UTI is that almost all are due to bacteria migrating from the bottom into the bladder to cause an infection. The distance from the bottom to the bladder is much shorter in girls than in boys, so it is usually more common for girls to have infections than boys. If we can keep these bacteria from making it into the bladder, we can prevent UTI.

Prevention of Pediatric UTI

The techniques described to treat Holding(Timed Voiding and the therapies for Constipation), can also help prevent infections. The more the bladder is kept empty, the less chance for bacteria to set up an infection. It is also important to keep the bottom clean, since this is the source of all infections.

Another important component of UTI prevention is good Voiding Hygiene. This applies specifically to girls, as their anatomy is very susceptible to UTI. When girls sit on the toilet to void, it is important that they straddle the toilet (imagine sitting on the toilet backwards) so their legs are spread apart. The urine will then have a direct path from the urethra (the hole you urinate out of) into the toilet. This keeps girls from urinating into their vagina (a common cause of minor wetting) and keeps their perineum dry and free from the irritation of urine, which can be a setup for infections. They should also try to wipe front to back, to avoid bringing bacteria from the bottom close to the urethra.

Girls that have trouble with recurrent UTI despite all these efforts may need to be placed on a suppressive antibiotic for a short while to break their cycle of infections. These measures would obviously have to be guided by a pediatric urologist.