Why do children get cystitis?
In girls, the urethra is short and wide, and its external opening is close to the vagina and anus, so E. coli easily enters the bladder. In young boys, severe phimosis is a risk factor. Behavior plays a big role: children often tolerate and do not go to the toilet during play or at school, which is why the urine stagnates. Constipation also contributes to infection because a full rectum prevents the bladder from emptying completely. Hypothermia reduces local protection.
- Short urethra in girls
- The habit of tolerating and rarely going to the toilet
- Constipation and a full rectum
- Poor hygiene after defecation
- Phimosis in young boys
- Vesicoureteral reflux and urinary tract abnormalities
Symptoms at different ages
In children over 2–3 years old, the picture is clear: frequent urges, pain and burning when urinating, small portions of urine, pain in the lower abdomen, and sometimes daytime incontinence occurs. In infants and toddlers, symptoms are nonspecific: restlessness and crying when urinating, refusal to eat, regurgitation, poor weight gain, unexplained fever. That is why, in a child under two years of age with fever for no apparent reason, a urine test is included in the mandatory examination. A high temperature with cystitis is uncharacteristic and indicates kidney involvement.
- Frequent urges in small portions
- Pain and burning when urinating
- Pain in the lower abdomen
- Daytime incontinence in a habituated child
- Cloudy urine with a strong odor
- In infants - restlessness, crying, refusal to eat
How to properly collect urine
The reliability of the analysis depends on correct collection, and this is where errors most often occur. Urine is collected in the morning, immediately after thoroughly washing with warm water without soap and antiseptics, into a sterile container from a pharmacy. Take the middle portion: the first drops are released past. The material must be delivered to the laboratory within one to two hours, and until then stored in a cool place. For infants, they use special sterile urinals, and do not wring out the diaper or pour it from the pot - this way the result will be unreliable.
- Sterile container from pharmacy
- Washing with warm water without antiseptics
- Average morning urine sample
- Delivery to the laboratory within 1–2 hours
- Infants have a sterile urinal bag
- Do not collect urine from a potty or diaper
Survey
The diagnosis is confirmed by a general urine test with an increased number of leukocytes and bacteria. Urine culture is needed to identify the pathogen and select an antibiotic to which it is sensitive. Ultrasound of the kidneys and bladder is prescribed to all children with the first episode of urinary tract infection to exclude developmental abnormalities and dilation of the pelvis. With repeated episodes, especially with fever, the child may be prescribed voiding cystography to detect vesicoureteral reflux and a radioisotope study of the kidneys.
- General urine test
- Urine culture with sensitivity
- Ultrasound of the kidneys and bladder
- Complete blood count for fever
- Void cystography for relapses
- Examination by a pediatric urologist
Treatment and prevention
The doctor selects the antibiotic taking into account the child’s age, weight and culture results; The course for uncomplicated cystitis is usually short, but you need to finish it completely. The child is given more fluid, they make sure that he urinates every 2-3 hours and does not tolerate it. Be sure to treat constipation: without this, the episodes are repeated. Girls are taught to wash and dry themselves from front to back, choose cotton underwear, and avoid prolonged sitting in cold water and on cold surfaces. After recovery, the urine test is repeated at the time prescribed by the doctor.
- Antibiotic by age and culture results
- Full course of treatment
- Drinking enough and urinating regularly
- Treatment and prevention of constipation
- Proper hygiene and cotton underwear
- Control urine test after treatment
