Treating UTI In Children: When Does A Child Need To See A Pediatric Urologist?

Urinary tract infections (UTIs) in children can be concerning, particularly when they occur frequently. While many cases respond well to antibiotics, recurrent infections may signal underlying conditions that require specialized care. Dr. Prabhu Karunakaran, Consultant Pediatric Urologist at Asian Institute of Nephrology and Urology, Hyderabad, explains that nearly 30% of children with repeated UTIs have anatomical abnormalities like vesicoureteral reflux (VUR), which can lead to long-term kidney issues if left untreated. Identifying warning signs early and seeking timely medical evaluation is essential for protecting a child’s health.

How Common Are UTIs in Children?

UTIs affect boys and girls differently. Dr. Karunakaran explains that male infants, particularly those who are uncircumcised, have a higher risk of developing UTIs. However, after the first year of life, girls become more vulnerable due to their shorter urethra, which allows bacteria to enter the urinary tract more easily.

Signs and Symptoms of UTIs in Children

Identifying a UTI in children can be challenging since symptoms vary by age:

Infants may display

• Persistent fever
• Unexplained irritability
• Difficulty feeding
• Vomiting

Older children may experience

• Painful or burning sensation during urination
• Frequent and urgent need to urinate
• Lower abdominal pain or discomfort
• Cloudy, foul-smelling urine

A fever could indicate that the infection has reached the kidneys, necessitating urgent medical intervention.

Diagnosing and Treating UTIs in Children

UTIs are diagnosed through urinalysis, urine cultures, and imaging tests like kidney ultrasounds to check for structural abnormalities. Treatment usually involves oral antibiotics, but severe infections might require hospitalization and intravenous therapy. If anatomical issues such as VUR are detected, surgical correction may be recommended.

When Should a Pediatric Urologist Be Consulted?

A pediatric urologist should be involved in cases where a child experiences:

• Recurrent UTIs (two or more in six months or three or more in a year)
• High fever with UTIs
• Infections that do not respond well to standard antibiotic treatment
• Symptoms suggesting kidney involvement, such as back pain or persistent fever

A specialist can conduct further tests, such as a voiding cystourethrogram (VCUG) or renal scans, to identify any underlying abnormalities that may contribute to recurrent infections.

Preventing UTIs in Children

Dr. Karunakaran suggests several measures to help reduce the risk of UTIs:

• Encouraging good hygiene habits, including proper wiping techniques
• Ensuring adequate hydration to help flush bacteria from the urinary tract
• Treating constipation, which can contribute to incomplete bladder emptying
• Considering circumcision for male infants, which has been shown to lower UTI risk
• Using low-dose antibiotic prophylaxis in children with VUR to prevent recurrent infections

Early diagnosis and intervention are essential in preventing complications associated with recurrent UTIs. Parents should seek medical advice whenever they notice unusual symptoms in their child.

For more insights on UTIs in children and expert recommendations, read our detailed article: Urinary Tract Infections in Children: Risk Factors, Symptoms, and Treatment.