The "urinary tract" stands as the intricate system within your body tasked with the creation, storage, and elimination of urine, a vital waste product. The process begins within the kidneys, where urine is meticulously crafted, then travels through the ureters, connecting tubes leading to the bladder. In an adult, the kidneys produce approximately 1½ to 2 quarts of urine daily, with variations in quantity based on age. Children, for instance, possess bladders capable of retaining 1 to 1½ ounces of urine for each year of age, meaning a 4-year-old can contain 4 to 6 ounces, which is slightly less than a cup's volume.
The bladder serves as a reservoir for urine, preserving it until the moment arrives for expulsion through the urethra. The urethra acts as the conduit linking the bladder to the exterior of the body, facilitating the discharge of urine. In males, the urethra terminates at the end of the penis, while in females, it exits in front of the vagina.
Apart from their role in urine production, kidneys play a pivotal role in regulating the body's chemical balance, managing levels of substances such as sodium, potassium, calcium, and phosphorus, and producing essential hormones. These hormones assist in controlling blood pressure, stimulating red blood cell production, and supporting bone strength.
Ordinary urine maintains a bacteria-free composition thanks to its one-way flow, which functions as a natural defense against infections. However, on occasion, bacteria may infiltrate the urinary tract through the urethra, potentially leading to bladder infections.
In cases of urinary tract infections (UTIs), the linings of the bladder, urethra, ureters, and kidneys may become inflamed and swollen. Older children often complain of discomfort in the lower abdominal or back region and experience frequent urination. Pain during urination or discomfort when passing only a small amount of urine can also occur. Additionally, some children may struggle with urinary control, leading to accidents or bedwetting.
For infants and young children unable to express their sensations, symptoms may be vague and unrelated to the urinary tract. High fever, irritability, poor appetite, and foul-smelling diaper urine might be indicators. If a child exhibits a high fever without an apparent cause, prompt medical attention is essential, as an untreated kidney infection could escalate into a severe bloodstream infection or lasting kidney damage.
1. Pain, burning, or stinging sensation while urinating.
2. Frequent urination or a strong urge to urinate, even with minimal urine output.
3. Foul-smelling urine, possibly appearing cloudy or tinged with blood.
4. Fever.
5. Lower back or bladder area pain.
Normally, urine is sterile and devoid of bacteria. However, bacteria naturally reside on the skin and are abundant in the rectal region and stool. Occasionally, these bacteria can migrate up the urethra into the bladder, where they multiply and, if not expelled by the body, may trigger an infection.
There are two fundamental types of UTIs: bladder infections and kidney infections. Bladder infections, known as cystitis, result in bladder swelling and discomfort. When bacteria ascend from the bladder through the ureters, infecting the kidneys, it is termed pyelonephritis, a more severe kidney infection that poses a greater risk, particularly to young children.
While many children with UTIs have normally functioning kidneys and bladders, it's crucial to identify abnormalities as early as possible to safeguard kidney health. Two common abnormalities are:
1. Vesicoureteral Reflux: Under typical circumstances, urine flows from the kidneys through the ureters into the bladder, thanks to a "flap-valve" where the ureter connects to the bladder. However, vesicoureteral reflux causes urine to flow backward, potentially transporting bacteria from the bladder to the kidneys, resulting in pyelonephritis.
2. Urinary Obstruction: Urinary flow can be obstructed at various points in the urinary tract due to abnormally narrow areas, hindering the natural expulsion of urine from the body.
If you suspect your child has a UTI, promptly contact your healthcare provider. The definitive diagnostic tool for UTIs is a urine test. Your healthcare provider will determine the appropriate method based on your child's age and maturity. For toddlers not yet toilet-trained, a plastic bag may be attached to collect a sample from the skin. Older children may be asked to assist in obtaining a sample while urinating. It's vital to prevent skin bacteria from contaminating the sample. In some cases, a small tube may be inserted into the urethra or a needle into the lower abdomen to secure a proper bladder sample.
The urine sample undergoes microscopic examination, enabling the healthcare provider to detect the presence of bacteria and white blood cells, indicative of an infection. This test is quick, typically taking just a few minutes. Additionally, a urine culture may be ordered, where urine bacteria are cultivated in a laboratory incubator. This allows for the identification of specific bacteria strains and testing to determine the most effective antibiotics. Since various bacteria can cause urinary tract infections, tailored treatment is essential. Results from urine culture tests usually take several days to be available.
Antibiotics serve as the primary treatment for UTIs. Your healthcare provider will select an antibiotic based on the likely bacteria causing the infection. After receiving the urine culture results, the antibiotic might be adjusted to better target the specific bacteria found in your child's urine. Encouraging your child to drink ample fluids and urinate frequently can aid in combating the infection.
The choice of antibiotic, administration method, and duration of treatment depend on the type and severity of the infection. In severe cases, where a child is too ill to drink, antibiotics may be administered via injections in a hospital setting. In less severe instances, oral antibiotics may be prescribed. The frequency of doses varies, with some antibiotics taken once daily and others up to four times daily. It's crucial to adhere to the prescribed antibiotic regimen, even if symptoms improve. Incomplete treatment may lead to recurring UTIs or new infections.
If symptoms worsen or fail to improve within three days, seeking medical attention, possibly in a hospital, may be necessary.