Urinary Tract Infections (UTI) in Children

What is a urinary tract infection (UTI) in children?

A urinary tract infection is inflammation of part of the system that takes urine out of the body. It’s caused by bacteria. The urinary tract includes the two kidneys. They remove liquid waste from the blood in the form of urine. Narrow tubes (ureters) carry urine from the kidneys to the bladder. Urine is stored in the bladder. When the bladder is emptied, the urine travels through a tube called the urethra and passes out of the body. Bacteria can infect any part of this system.

What causes a UTI in a child?

Normal urine contains water, salts, and waste products. It is free of germs such as bacteria, viruses, and fungi. An infection happens when germs enter the urethra, travel up to the bladder, ureters, and kidneys, and begin to grow. Most infections are caused by bacteria from the digestive tract. The most common is Escherichia coli (E. coli) bacteria. These normally live in the colon.

Which children are at risk for a UTI?

A UTI is not common in children younger than age 5. A UTI is much more common in girls. This is because they have a shorter urethra. A UTI is unlikely in boys of any age. But it can occur in boys if part of the urinary tract is blocked. Uncircumcised boys are more at risk for a UTI than circumcised boys. A child with a part or full blockage in the urinary tract is more likely to develop a UTI.

What are the symptoms of a UTI in a child?

Symptoms can occur a bit differently in each child.

Symptoms in babies can include:

• Fever
• Bad-smelling urine
• Irritability
• Crying
• Fussiness
• Vomiting
• Poor feeding
• Diarrhea

Symptoms in children can include:

• Sudden need to urinate
• Need to urinate often
• Loss of control of urine (incontinence)
• Pain while urinating
• Trouble urinating
• Pain above the pubic bone
• Blood in the urine
• Bad-smelling urine
• Nausea and vomiting
• Fever
• Chills
• Pain in the back or side below the ribs
• Tiredness

The symptoms of a UTI can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is a UTI diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. The provider will give your child a physical exam. Your child may also have tests, such as:

• Urine testing. This is also known as urinalysis. Your child’s urine is sent to a lab to check for red blood cells, white blood cells, bacteria, protein, and signs of infection. The urine will also be sent for a culture and sensitivity. This is done to figure out what type of bacteria is causing the infection and what medicine is best to treat the infection.
• Kidney ultrasound. This is a painless imaging test. It uses sound waves and a computer to make images of blood vessels, tissues, and organs. It can show internal organs as they function and can assess blood flow through vessels. A boy with a UTI or a girl younger than age 5 or 6 may need this test.
• Voiding cystourethrogram (VCUG). This is a type of X-ray of the urinary tract. A thin, flexible tube (catheter) is put in the tube that drains urine from the bladder to the outside of the body (the urethra). The bladder is filled with a liquid dye. X-ray images are taken as the bladder fills and empties. The images will show if there is any reverse flow of urine into the ureters and kidneys.

How is a UTI treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

• Antibiotic medicine
• A heating pad or medicines to relieve pain
• Drinking plenty of water

Your child’s healthcare provider may want to see your child back again a few days after treatment starts to see how treatment is working.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

How can I help prevent a UTI in my child?

You can help prevent UTIs in your child if you:

• Make sure your child drinks plenty of fluids
• Tell your child to empty his or her bladder fully when urinating
• Teach girls to wipe from the front to back after going to the bathroom
• Make your child doesn’t get constipated

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

• Symptoms that don’t get better, or get worse
• New symptoms

Key points about a UTI in children

• A urinary tract infection is inflammation of part of the system that takes urine out of the body.
• Most infections are caused by bacteria from the digestive tract. The most common is Escherichia coli (E. coli) bacteria. These normally live in the colon.
• A UTI is not common in children younger than age 5. A UTI is much more common in girls because they have a shorter urethra.
• A UTI is unlikely in boys of any age, unless part of the urinary tract is blocked. Uncircumcised boys are more at risk for a UTI than circumcised boys.
• Symptoms vary by age, and can include fever, need to urinate often, pain, and crying.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Urinary Tract Infections in Boys | UTIs in Children

Urinary tract infections (UTI) in boys are the result of bacteria getting into the bladder and staying there. UTIs are common in kids, especially girls and uncircumcised boys. E. Coli, responsible for over 75% of UTIs, doubles every 20 minutes in the bladder. That means if there are 100 bacteria of E. Coli in the bladder and you wait three hours to go to the bathroom, you will have over 50,000 bacteria in your bladder. The more bacteria in the bladder and the longer it stays there, the more likely you are to get a UTI.

There are many things that can be done to both treat urinary tract infections in boys and prevent them in the future.

What are recurrent UTIs?

Some boys get UTIs again and again – these are called recurrent UTIs. If left untreated, recurrent UTIs can cause kidney damage, especially in kids younger than 6. It’s important to recognize signs of these infections and get help for your child.

What are the symptoms of UTIs in children?

Symptoms of a UTI can include:

• Pain when peeing
• Changes in frequency of urination
• Changes in appearance or smell of pee
• Fever
• Chills
• Loss of appetite
• Nausea
• Vomiting
• Lower abdominal pain
• Lower back pain or discomfort

Causes of Urinary Tract Infections in Boys

• Poor water intake
• Improper genital hygiene
• Infrequent voiding
• Constipation

Types of UTIs in Children

Common types of UTIs include:

• Cystitis: this bladder infection is the most common type of UTI. Cystitis occurs when bacteria move up the urethra (the tube-like structure that allows urine to exit the body from the bladder) and into the bladder
• Urethritis: when bacteria infect the urethra
• Pyelonephritis: a kidney infection caused by infected urine flowing backward from the bladder into the kidneys or an infection in the bloodstream reaching the kidneys

Preventing Urinary Tract Infections in Boys

Many UTIs can be prevented by changing infants’ diapers frequently, encouraging kids to practice good hygiene, and instructing kids not to “hold it” when they have to pee because urine that remains in the bladder gives bacteria a good place to grow. Here are some tips on how to prevent UTIs in boys:

Increase Water Intake

Children should drink one cup of water (equal to eight ounces) for each year they are old. For example, if a child is 4 years old, he should drink four cups of water each day. Once a child reaches 8 years old, he should be drinking close to two liters (a little over eight cups) per day and stay at this amount into adulthood. Increasing water dilutes the urine, making it more difficult for bacteria to grow. Monitoring the color of urine in the toilet is a good way to ensure good water intake. Urine should be clear to very pale yellow at each void. Darker urine tells us that the child needs more water.

Timed Voiding

Children should urinate about seven times each day–that’s every 2 hours while awake–even if he doesn’t feel like he needs to go. Children who hold their urine and wait until they absolutely have to go to the bathroom tend to be at a higher risk for UTIs and other bladder dysfunction problems.

Foreskin

If the child is uncircumcised, he should practice proper genital hygiene. This means pushing his foreskin back, so he can clean the head of the penis when he is in the shower or bath, just like he would clean any other part of his body. He must also return the foreskin back over the head of the penis once cleaning is complete. It is also important that he pulls his foreskin all the way back before urinating and then pulls it back over when he is done. Not doing this could allow urine to get stuck under the foreskin. When urine gets trapped under the foreskin, bacteria can form and eventually get into the urethra and bladder.

Get Going Everyday

Children should have a soft, easy-to-pass bowel movement every day. By increasing water, fiber (dried fruit, fresh fruit and vegetables) and activity, many children can find constipation relief. If this is not enough, then adding Miralax® (as directed) may help him go every day. Stool is where most of the E. Coli that causes UTIs comes from.

Treatment for Urinary Tract Infections in Boys

Prophylactic Antibiotics

Children may be given a prescription for prophylactic antibiotics. It is a very low dose of antibiotics that they should take every day, as prescribed, to help keep their urine sterile. It is important not to take medication that has not been prescribed for you specifically, please never share your medication with anyone.

CHOC Urology Center have experts to effectively diagnose, treat and create prevention plans. If the child has an infection, our staff may also perform some or all of the following studies:

• Cystoscopy
• Renal ultrasound
• Voiding Cystourethrogram (VCUG)

causes, absence, should there be

Causes of morning erection

During an erection, the spongy and cavernous bodies in the male genital organ fill with blood, and it increases – this is a natural process ¹ . Contrary to popular belief, a morning erection does not at all indicate a man’s sexual arousal. It arises involuntarily and is caused by internal processes.

Sexual activity is strongly influenced by the level of hormones. And it is in the morning (from about 5 o’clock) that the level of testosterone, the main male hormone, reaches its maximum. In addition, at night the bladder fills up, and the nerve endings receive a signal about the urge to urinate – this causes a reflex erection.

Also during REM sleep, brain activity increases, which can also affect arousal.

What to do if there is no morning erection

The first involuntary erections in boys occur in the womb. From late adolescence morning erections become regular ¹ . They accompany a man until about 50 years of age. With excellent physical shape and the absence of disease, the frequency of involuntary erections remains at about the same level even at 70, but this is an exception.

If erections begin to disappear due to age, then this is normal, and you should not worry, but it is worth checking with a urologist. Over the years, the risk of prostatitis and oncology increases, one of the signs of which is problems with potency.

At a young age, the absence of morning erections for a couple of months is alarming. If there was no prolonged stress and lack of sleep that could cause a problem, you should contact a specialist. The reason may lie in hormonal failure, poor vascular function.

Even psychological problems affect potency. Only a specialist can determine exactly what affected the erection, and he will also tell you how to deal with the problem.

In addition to visiting a doctor, you need to rest more, play sports, eliminate bad habits – sometimes this alone is enough for the erection problem to recover.

Diagnostics

In isolated cases, when the morning erection disappears, you should not sound the alarm and run to the doctors. But if there was no morning erection for a long time, this indicates health problems. Each case needs a separate analysis at the urologist’s appointment. The doctor conducts an examination, a survey, if necessary, takes tests for infections – urine and a smear.

Before visiting a doctor, analyze after which the morning erection disappeared, how your lifestyle, nutrition, and well-being have changed lately. This will help determine the cause.

Doctor’s advice

The better the condition of the body, the more often the morning erection occurs. Sometimes, to restore potency, it is enough to fully rest, resume physical exercises, and eat right. If the problem persists even after lifestyle changes, you need to contact a specialist.

Popular questions and answers

The most popular questions of our readers about morning erection in men are answered by PhD, urologist-andrologist Alexander Zakutsky.

Should guys have an erection in the morning?

– Yes. This is a kind of indicator of the well-being and health of a man. In old age, it almost disappears over time, and this is normal. But in youth, morning erections are fairly regular.

Why can a morning erection disappear?

– The cause may be a sharp decrease in the level of the sex hormone testosterone, infection. Circulatory and heart problems due to low hemoglobin or taking drugs to treat hypertension. Some medications can affect the stability of erections. And in general, men’s health is quite “fragile” and reacts even to a simple lack of sleep.

How often should I have a morning erection?

– There is no exact frequency, but there is a dependence on age. Normal will be the appearance of a morning erection at least every day, at least once a couple of times a week. It occurs more often in younger men than in older men. Much depends on the time when you woke up – sometimes you can not find a morning erection, although it was. Usually, such morning erections do not last long and go away on their own.

There is a rare condition called intermittent nocturnal priapism. During it, an involuntary erection lasts for hours, is quite painful and does not subside on its own. The condition is considered dangerous and needs to be treated urgently to avoid future erection problems.

Sources:

1. Physiological bases of sexuality of men and women. Volgograd State Medical University. Department of Normal Physiology. 2006 http://attic.volgmed.ru/depts/physiology/s/myp_03.pdf
2. State educational institution of higher professional education “Orenburg State University”. Department of Preventive Medicine. E.S. Barysheva, N.M. RYBALKO, N.V. MALYSHEV. MALE REPRODUCTIVE HEALTH. Methodical instructions. Orenburg 2006. http://elib.osu.ru/bitstream/123456789/6366/1/1159_20110808.pdf

why it occurs, what to do if it disappeared

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Morning erection is a completely common occurrence for any healthy man. If you see in the morning that your loved one has not really woken up yet, and his penis is in full combat readiness, this is a good sign, then your man is healthy. But if the morning erection is gone, this is already an alarm signal.

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Male physiology

cheerful morning

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“Who did you dream about?” – jealous wives begin to be suspiciously interested and receive an on-duty answer: “No one, I just want to write.” But he is wrong. Old people also wake up with a desire to get to the pot as soon as possible, but they cannot boast of the same reaction.

Morning erection mechanism

It is a delusion that a morning erection is a sign of an overfilled bladder. As well as the fact that it is caused by erotic dreams. Consciousness does not take part in this process at all. The reason lies in the peculiarities of male physiology. Science knows at least four hypotheses about why morning erections occur.

Morning erection due to the fact that the brain overlooked

According to a study conducted by the International Society of Endocrinologists, it is possible that certain parts of the brain are turned off during REM sleep, and the brain stops keeping the penis in check. Therefore, there is a morning erection. Whereas normally the brain regulates the activity of the genitals and ensures that an erection occurs when needed, during REM sleep the penis is free to do what it wants. And what he wants is to appear in all its glory.

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Hormones are to blame for the morning erection

In the morning, a man has the highest testosterone level of the day. This explains the lack of a morning erection at the age of 40-50 something, when the level of testosterone in the male body decreases. Therefore, this phenomenon can be explained by the fact that in the morning a man, at the behest of nature, is at the peak of his abilities.

This is not an erection, but morning exercises for the penis

Another assumption of scientists is based on the fact that a morning erection is a kind of exercise on the ability of the penis to retain a significant supply of blood for a long time. Think about it: no other place can do that. If you pull a limb with a tourniquet so that the blood lingers in it, the arm or leg will withstand only half an hour without serious consequences. And a penis can hold blood quite calmly for at least an hour and feel at the same time happily ever after.

7 ways to break your penis

So a morning erection can be part of a training program designed by the body to get the penis used to doing its job perfectly.

Unconscious arousal during sleep

Even when a person is asleep, his body remains susceptible to external stimuli. He touched the sheet or the partner’s thigh – and you’re done. The brain recorded the fact of stimulation and decided: we are working! So, girls, if you see a guy with an erection in the morning, you can attribute this to the proximity of your hot body.

How often should I have a morning erection?

The first morning erections occur already in the womb. With the onset of puberty in adolescents, they become regular and accompany a man until about 50 years of age. With excellent physical shape and the absence of diseases, the frequency of morning erections remains at about the same level even at 70, but this is an exception.

There is no exact schedule for morning erections. However, there is a direct dependence on age. In young men, it occurs more often, in older men less often. Normal will be the appearance of a morning erection every day, and a couple of times a week.

There is also a rare condition where an erection can last several hours throughout the night, this is called intermittent nocturnal priapism. Such an erection is quite painful and does not subside on its own. The condition is considered dangerous and, if this happens, you need to urgently consult a doctor, otherwise it may lead to problems with erection in the future.

What to do if there is no morning erection

If the morning erection has disappeared due to age, then this is a normal phenomenon and you should not worry, but you can contact a urologist, just to exclude possible prostate cancer.

But if a young man does not have a “hard morning” time after time, this is already an alarming bell. The simplest reason may be stress or overwork. Then enough sleep and proper rest. However, there are other reasons for the lack of a morning erection, already signaling serious health problems. For example, such as:

• hypertension;
• sleep disorders;
• diabetes mellitus;
• hormonal failure;
• vascular diseases;
• erectile dysfunction.

Still the absence of a morning erection speaks in general about poor physical condition due to a large number of bad habits. Psychological problems are not excluded. It is difficult to determine exactly what affected the erection, so the only right decision is to go to the hospital with the problem.

The better the condition of the body, the more often the morning erection occurs. In most cases, to restore potency, it is enough to have a good rest, resume physical exercises, and eat right.