ABSTRACT
During the first year of life, males have more urinary tract infections than females. Uncircumcised males are at greater risk.
After the first year of life, females have more urinary tract infections than males (10:1 risk compared with males).
Most common pathogen is E. coli.
Pediatric urinary tract infection requires further evaluation in the following situations: children <5 years, fever, family history of vesicoureteral reflux, and school-age girls with recurrent infections.
Commonly used antibiotics include trimethoprim-sulfamethoxazole, nitrofurantoin, and amoxicillin.
Vesicoureteral reflux affects up to 1–5% of children. It may be primary (due to abnormal implantation of ureter into bladder) or secondary (due to increased intravesical pressure). It is generally diagnosed on voiding cystourethrogram. Treatment is medical (antibiotic prophylaxis) or surgical (reimplantation of ureters into bladder or transurethral injection of bulking agents into ureter).
Voiding dysfunction disorders in children include urinary incontinence, dysfunctional elimination syndrome, and nocturnal enuresis.
Treatments for nocturnal enuresis include behavioral modification, DDAVP (desmopressin), and imipramine.
