Children's Hospital Colorado

Urinary Tract Infection (UTI)

What is a urinary tract infection?

A urinary tract infection (UTI) is a bacterial infection along the urinary tract. It may involve the urethra, the bladder or the kidneys.

Normal urine is sterile and contains fluids, salts and waste products and it should be free from bacteria, viruses and fungi. An infection occurs when bacteria cling to the urethra and travel upwards towards the bladder, where they multiply quickly.

If your child is experiencing any of the symptoms listed below, see your provider. If your child has had recurrent UTIs, please have your child evaluated in the Urology Program at Children's Hospital Colorado.

What causes urinary tract infections?

Most infections are caused by an organism known as Escherichia coli (E. coli), which is normally found in the colon (bowel).

UTI prevention includes ensuring your child is urinating regularly (about every 2 to 3 hours) and is taking the time to completely empty the bladder in a relaxed fashion.

Teach your child to wipe their bottom from front to back. If your child is uncircumcised, teach him to retract the foreskin and clean himself. The foreskin should retract easily; if not, do not forcibly retract. Do not allow the foreskin to stay retracted for long periods, as this may cause pain and possible injury.

Who gets urinary tract infections?

Urinary tract infections are uncommon in children who are not yet toilet trained. If this should occur in your child, a medical evaluation will likely be performed, including radiology scans, to determine the issue.

Most infections occur in children who are working through potty training, or afterwards, as they are more likely to have abnormal voiding patterns or trouble with hygiene. Infections are also more likely in females because females have a shorter urethra that is more susceptible to ascending bacteria. Males who are uncircumcised have a higher rate of UTI in the first year of life. Children with a blockage of the urinary tract are also more likely to develop infections. Sometimes urinary tract infections can run in families.

What are the signs and symptoms of urinary tract infections?

The symptoms of a UTI vary depending on the age of the child and may resemble other conditions or medical problems. Always consult your child's provider for a diagnosis.

Symptoms in infants and young children include:

Symptoms in older children include:

  • Frequent urination
  • Urgency to urinate
  • Painful urination
  • Inability to void more than a small amount, even with feeling of urgency
  • Foul-smelling urine
  • Incontinence day or night
  • Blood in the urine
  • Nausea and/or vomiting
  • Fever
  • Chills
  • Fatigue
  • Pain in the back, side or pubic bone

How do doctors at Children's Colorado make a diagnosis?

Diagnosis is based on a history of symptoms, a physical examination and a urine analysis and culture. During a urine analysis and culture, it is very important that the urine is collected correctly, and this will involve a catheter in children who are not potty trained.

Children with a confirmed diagnosis may require additional studies of the bladder and kidneys, including a renal ultrasound (RUS) and/or a voiding cystourethrogram (VCUG), which is an X-ray examination of the kidneys, ureters, bladder and urethra.

How is a urinary tract infection treated?

Treatment of a urinary tract infection depends on the child's age, overall health, extent of the infection and medical history. Treatment may include antibiotics, increased fluid intake and pain relief methods, as well as behavioral modifications of bladder habits in potty trained children.

Why choose Children's Colorado for your child's recurrent urinary tract infections?

Infants with urinary tract infections require swift evaluation and management of the condition to help decrease the risk of future UTI recurrences. Children who have repeated urinary tract infections require management and motivation in voiding behaviors to decrease the long term risk.

Our team works to treat current acute issues, as well as potential long term issues, by closely managing and encouraging a bowel and bladder program. We can also work in combination with a clinical psychologist to help children with adhere to healthy bladder habits through motivational techniques, which can help decrease the risk of future UTIs. Occasionally, children with recurrent UTIs require surgery and Children's Colorado has a team of experienced urologists to help.

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