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February 14, 2025

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

Dr. Prabhu Karunakaran, consultant pediatric urologist at the Asian Institute of Nephrology and Urology, Hyderabad, emphasizes the importance of understanding urinary tract infections (UTIs) in both adults and children, as there are differences in risk factors and prevalence. In children, repeated UTIs require evaluation by a pediatric urologist since approximately 30 percent may have anatomical abnormalities, such as vesicoureteric reflux (VUR). UTIs are more prevalent in male infants, particularly those who are uncircumcised.

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However, after the first year, the risk shifts, with females becoming more susceptible due to anatomical factors, including their shorter urethra, which is closer to the anus and facilitates bacterial entry. Symptoms of UTIs vary by age; infants may show non-specific signs like fever, irritability, poor feeding, or vomiting, while older children might experience painful urination, frequent urges, lower abdominal pain, and foul-smelling or cloudy urine. Fever can occur if the infection reaches the kidneys. Risk factors for UTIs include congenital urinary tract abnormalities, dysfunctional voiding, constipation, and VUR.

Diagnosis involves urinalysis, urine culture, and kidney ultrasound, with treatment typically consisting of oral antibiotics; severe cases may require hospitalization with intravenous antibiotics. Surgical correction, such as ureteric reimplantation, may be necessary for conditions like VUR and other abnormalities that cause recurrent UTIs. Preventive measures include maintaining proper hygiene, treating constipation, and circumcision in males, which has been shown to reduce UTI risk in infancy. Long-term prophylactic antibiotics and surgical procedures may be needed for recurrent UTIs, especially in children with VUR.