What is a urinary tract infection (UTI)?

A urinary tract infection (UTI) is caused by an abnormal growth of bacteria in the urinary system. The infection can either be in the bladder (called “cystitis”) or in the kidney (“pyelonephritis”).

Bladder infection causes and symptoms

Dysfunctional bladder elimination patterns are the most common cause of bladder infections in children. Some children develop very irregular patterns of urination and may urinate very frequently throughout the day. In these cases, the child may show signs of urinary urgency and posturing behaviors (like a “potty dance”). Other children may urinate very infrequently and instead hold their urine for a long period of time. Difficulty with bowel movements is often the trigger or primary cause of these behaviors.

Common symptoms of a bladder infection include:

• Burning or pain with urination
• Strong urine odor
• Frequent and urgent urination
• Wetting accidents during day or night

Causes and symptoms of a kidney infection

Vesicoureteral reflux (the back flow of urine to the kidney) and blockage of urine flow are the most common causes of kidney infections.

Common symptoms of a kidney infection include:

• Fever
• Nausea and vomiting
• Irritability
• Back pain

Testing and diagnosis

In infants, UTIs that are associated with fever can be a sign of abnormal flow of urine to or from the kidney. In this case, ultrasounds and x-rays (tests that take pictures of kidneys and surrounding area) will be performed to evaluate for any kidney or bladder abnormalities. In older children, UTIs can have various symptoms. The need for imaging will depend on these symptoms and the severity of the infection.

A urine culture is the only test that can diagnose a UTI.

Treatment of a UTI

Antibiotic medication will be prescribed to treat a UTI. Drinking fluids and urinating often to empty the bladder may also help relieve symptoms.

It is also important to determine the underlying cause of UTIs. Our team of experts will work with your child to improve elimination habits based on their individual needs. Recommendations may include timed emptying of the bladder and bowel, behavioral modification, biofeedback (treatment technique where child learns to relax pelvic floor muscles), bowel programs and possibly medications.

In some instances, surgery or procedures to empty the bladder (intermittent catheterization) may be necessary. Each child’s evaluation and treatment will be individualized and the treatment process usually occurs over many months.

Success often depends on child and parent participation, as well as the involvement of any other caregivers, and frequent follow-up with the pediatric urology team.