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Medical Edge Newspaper Column from Mayo Clinic
DEALING WITH A CHILD’S URINARY TRACT INFECTIONS
DEAR MAYO CLINIC: My daughter is 8 years old and has had problems
with urinary tract infections since she was born. She has had a complete
series of tests done on her kidneys and bladder three times and nothing
specific has been found. Nothing is working, and her bladder may have
stretched. Do you have any information or ideas to help my daughter? —
Willow City, N.D.
ANSWER: Your concern is well founded. Urinary tract infections
(UTIs) in children need to be taken seriously.
While you say that your daughter has had a series of tests, you don’t
specify what they were. The two standard tests for recurring UTIs are
a voiding cystourethrogram and a renal ultrasound. These tests help detect
if a malformation is present in a kidney or in the body’s urine drainage
system, or if urine is running back from the bladder up to the kidneys.
A key detail to confirm with your daughter’s physician is whether the
infections have been documented with the presence of bacteria grown from
a urine sample. This process verifies that your daughter’s symptoms are
caused by UTIs and not another condition.
Assuming your daughter has had these tests, and they have not revealed
the source of the problem, the next factor to investigate is inadequate
voiding. Some kids just don’t empty their bladders fully or often enough.
Germs in the bladder then can multiply for hours at a time, causing infections.
Having an ultrasound taken after your daughter urinates is one way to
see if she is completely emptying her bladder. Before you do that, however,
it may be useful to try frequent, or “timed,” voiding. Every two or three
hours during the day, have your child urinate. Make sure she drinks plenty
of fluids, and have her take a bathroom break around breakfast, midmorning,
lunch, after school, dinner and before bedtime. Frequent voiding may resolve
recurring UTIs.
You mention that your daughter already may have changes in her bladder
due to the infections. We encourage you to consult a pediatric urologist
who can determine if irregularities within the urinary tract are contributing
to the problem. The urologist also may prescribe medication that makes
bladder emptying more effective.
— Philip Fischer, M.D. and Lauren McGovern, M.D., Pediatrics, Mayo Clinic,
Rochester, Minn.
Additional Resources:
Urinary
Tract Infections
Appointment
Information
More
Information on Urinary Tract Infections
READERS: Weekend warriors — beware of an Achilles rupture.
If you jump into a strenuous tennis match or a basketball game on the
weekend, with little or no related exercise during the week, you’re at
risk for an Achilles injury, according to the Mayo Clinic Health Letter.
The Achilles tendon is at the back of your leg, just above the heel. It
attaches your calf muscle to your heel bone. It allows you to push off
with your foot and to stand on your tiptoes.
But a quick move on the tennis court could cause a tear or rupture, an
injury most common in middle-aged men or older adults. You might hear
a pop and feel immediate, sharp and possibly severe pain at the back of
your ankle and lower leg.
Usually there is no warning of a rupture. However, certain medical conditions
may contribute to tendon rupture — among them chronic inflammation of
a tendon (tendonitis), gout and overproduction of parathyroid hormone.
Certain antibiotics called fluoroquinolones may further increase tendon
risks.
If you suspect an Achilles rupture, elevate the affected leg and avoid
putting any weight on it. Ice the area of pain and seek a doctor’s care
as soon as possible. Proper treatment ranges from physical therapy to
surgery.
Additional Resources:
Achilles
Rupture
Appointment
Information
More
Information on Achilles Rupture
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Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite
114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2005 TRIBUNE MEDIA SERVICES, INC.
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