Common Urinary Tract Problems in Children

As children grow, it is common for them to experience bladder issues such as occasional urinary tract infections (UTI) or periods of daytime and night-time wetting, especially as they potty train. Urinary tract infections and nocturnal enuresis, commonly known as night-time bedwetting, are the most common bladder issues affecting children. However, if your child experiences frequent UTIs or prolonged difficulties with daytime or night-time urinary incontinence (often referred to as accidents), it may be time to seek help from a urologist.

What Causes Urinary Tract Infections in Kids?

Urinary tract infections are caused by the invasion of bacteria into the bladder, kidneys, or urethra. If your child is not completely emptying their bladder, they may be at risk of developing a UTI. However, some children are more susceptible to UTIs due to a urinary tract blockage or a condition that causes urine to flow backwards from the bladder to the kidneys.

If your child experiences any of the following UTI symptoms, their paediatrician can conduct a simple urine test to screen for a UTI:

-   Abdominal pain

-   Daytime accidents or night-time bed-wetting

-   Fever (this may be the only symptom evident in infants)

-   Foul-smelling, cloudy or blood-tinged urine

-   Frequent need to urinate, though little urine may be produced

-   Loss of energy

-   Nausea, vomiting or loss of appetite

-   Pain or burning sensation when peeing If your child frequently suffers from UTIs, it's advisable to speak to their paediatrician about seeing a urologist who can help screen for underlying physical conditions that may be contributing to the infections.

 

Preventing UTIs

Encouraging your child to use the bathroom when they need to go, rather than holding it in, is one way to help prevent UTIs. It's recommended to make bathroom breaks a regular part of your child's daily schedule, instead of asking them if they need to go. Remind them to take a bathroom break every few hours and to take their time when using the restroom. Rushing could cause them to not completely empty their bladder, so encourage them to take their time to ensure they're fully relieved.

 

What Are Some of the Most Common Urinary Tract Problems in Children?

Urinary tract problems in children can manifest in various ways. Common issues include:

 

Vesicoureteral Reflux (VUR)

VUR is often a congenital disorder, meaning it is present at birth. It occurs when the valve between the ureter and bladder (vesicoureteral valve) doesn’t function properly. This allows the urine to flow backwards from the bladder to the kidneys, increasing the risk of UTIs.

 

Bedwetting (Enuresis)

Bedwetting is often a normal part of a child’s development. Many children outgrow it as they grow older. Bedwetting is defined as involuntary urination during sleep, which can be related to developmental factors or underlying issues. Stressful events, changes in routine and emotional factors can contribute to bedwetting.

 

Bladder Dysfunction:

Bladder dysfunction refers to problems with the normal function of the bladder. This can result in inadequate bladder control, leading to issues such as urgency, frequency, or incontinence.

 

Structural Abnormalities

Congenital anomalies affect the kidneys, bladder, or ureters, which may impact normal urinary function.

 

Voiding Dysfunction

Difficulties in coordinating the muscles involved in urination lead to incomplete emptying or retention of urine. This can also lead to urinary urgency and frequency.

 

Obstruction

Physical blockages in the urinary tract, such as kidney stones or anatomical obstructions, can cause problems. There are different types of obstruction namely, urethral obstruction, ureteral obstruction and bladder outlet obstruction. The causes of obstruction are often due to kidney stones, benign hyperplasia of the prostate gland or tumours in the urinary tract.

 

Neurogenic Bladder

A neurogenic bladder is a condition where there is a dysfunction of the nerves controlling the bladder, which can affect normal urination. The causes of neurogenic bladder are often due to spinal cord injuries, multiple sclerosis, diabetes, stroke, or Parkinson’s disease.

 

When Should I Consult a Doctor?

If you suspect urinary tract problems in your child, it's important to consult a healthcare professional. If you notice any signs of a medical issue in your child, such as symptoms of bladder infection like pain or burning during urination, cloudy, dark, bloody, or foul-smelling urine, increased frequency of urination, strong urges to urinate with the passage of only a small amount of urine, pain in the lower belly area or back, crying while urinating, fever, or restlessness, take them to a healthcare professional immediately.

Early diagnosis and appropriate treatment are crucial to address these issues and prevent potential complications. Additionally, if your child dribbles urine or has a weak urine stream, these may be signs of a birth defect in the urinary tract. If your child was dry but has started wetting again, it's essential to get them checked out. Although each child is unique, healthcare providers often use age as a guideline to determine when to look for bladder control problems. Typically, by age 4, most children are dry during the day, and by age 5 or 6, most children are dry at night.