Urinary problems in children

by Dr. Manjiri Somashekhar

Urinating should never be a painful experience and many parents often get worried and concerned when their child cries or screams while urinating. Most often this is related to pain and with some underlying condition indicating an issue with the urinary tract. 

Urinary tract infection (UTI) is a common problem that occurs among children, infants and teenagers. The infection occurs anywhere in the urinary tract and is most often caused by microbes such as fungi, bacteria and viruses in the kidney, ureters, urethra or bladder. This condition can be extremely painful with critical consequences if the infection spreads to the kidneys. 

What are the common urinary problems faced by children?

The common urinary problems faced by the children include - 

  • Urinary infection
  • Urinary tract stones
  • Incontinence of urine
  • Bedwetting beyond 5 years of age

What are the signs and symptoms of UTI in children?

Children often showcase several signs and symptoms which include - 

  • Painful urination
  • Associated fever
  • Blood or pus passed along with urine
  • Inability to pass urine with a good stream
  • Retention of urine
  • Abnormal opening of the external urethral meatus
  • Infection or painful swelling of the genitalia

What causes UTI among children?

UTI among children can be triggered due to the following factors - 

  • Gender - Girls are more prone to UTI than boys and are at a higher risk as they have shorter urethras (tubes through which the urine exits the body) and have more sensitive and thinner skin around the urethras. 
  • Age - Children less than six years of age are more likely to get UTIs than older kids because their immune system isn’t fully developed and they are still learning to clean themselves after going to the bathroom. Additionally, avoiding frequent changes of diapers too can trigger UTIs among children in this age group. 
  • History of Urine Infections - If your child has suffered at least three previous infections within six months before their current UTI, then they may be considered as a ‘recurrent case’. In such a situation, the urinary system of the child causes difficulty in keeping the bacteria out and away from the urethra opening and this wouldn’t happen until their immune system matures enough to tackle the disease-causing bacteria. 

How can UTI be treated?

Depending on the severity of the illness of your child, your doctor may prescribe antibiotics which can be taken orally or through injectables. While most children make good recovery without any complications, in a very small number of children there may be underlying kidney or bladder problems which may need follow-up care. 

It is recommended that children should undergo routine urine tests that can detect the possibility of a UTI. Parents whose children have had UTIs in past, they must get their child’s blood pressure checked yearly and such children should also undergo a urine test in every subsequent episode of fever. 

Many children with UTI Below the age of 5 years, may have underlying problems of the urinary bladder or kidneys and several common tests can help in identifying these problems. These include - 

  • Ultrasound scan
  • Micturating Cystourethrogram (MCU) 
  • Special scans such as DMSA scan

Is there any emergency with urinary symptoms?

In case your child showcases the following symptoms then you must take the child immediately to the pediatric emergency room.

  • Blood or pus in the urine
  • Inability to pass urine-retention
  • Not passed urine 24 hours or more
  • Extreme pain while passing urine
  • Any kind of injury to the external genitalia.

How can you prevent your child from UTI?

With the help of below mentioned healthy practices, you can prevent your child from UTI. 

  • Frequent Urination - Encourage your child to urinate every two to three hours and never hold it. This will help in emptying their bladder fully and will ensure that they get rid of toxins. Avoiding holding or delaying urine until complete voiding can also reduce their risk factors for developing UTI or recurrent UTI (repeat infections). 
  • Make your child consume plenty of fluids - Children should drink at least six to eight glasses of water in a day even if they feel thirsty or not as it can help in keeping their kidneys healthy. If your child has been sweating or vomiting a lot, then they need to drink even more fluids.
  • Avoid Tight-Fitting Undergarments and Bubble Baths - Wearing tight underwear and frequent bubble baths may irritate the urethra of your child which leads to the formation of bacteria and diseases in the urethra.  
  • Encourage frequent and thorough washing of hands - Proper hand hygiene can prevent the spread of the virus from person to person and can restrict the spread of germs and diseases among children.