Urinary Tract Infection and Reflux Disorders in Children

It’s important to recognize and treat pediatric urinary tract infections and other related conditions early. This can help prevent complications such as advanced infection and pain or even kidney damage.

Normal urine flow goes downward as urine leaves the kidneys through tubes called ureters. In infants and children who have vesicoureteral reflux (VUR), some of the urine flows in the wrong direction. It goes back up toward the ureters and kidneys after it enters the bladder. This can create conditions that favor germ growth and increase the child’s chance of developing a urinary tract infection (UTI).

Without prompt, expert care, kidney UTIs can cause serious complications. A child may develop a high fever, chills and back pain. It can lead to scarred tissue, high blood pressure or reduced kidney function.

The pediatric urologists at Penn State Health can diagnose, monitor and offer treatment recommendations for VUR as well as potential UTIs. Our specialists have advanced expertise in caring for these and other urological conditions in children of all ages.

Causes of Pediatric UTI and Vesicoureteral Reflux (VUR)

Most children who have VUR are born with it, and its cause isn’t always clear. Contributing factors may include:

  • Genetic or inherited conditions
  • Structural defects of the child’s bladder or ureters causing urine to leak
  • Other conditions that can prevent the bladder from emptying normally

UTIs can be in the bladder or the kidneys. In addition to VUR, causes of UTI include:

  • Abnormal or blocked urinary tract
  • Bladder or bowel obstruction and constipation
  • Certain diseases and medical conditions
  • Infected urinary catheter (tube inserted to drain urine)
  • Urine reflux (backflow) in the bladder, ureters and/or kidneys

Symptoms, Diagnosis and Outlook

VUR doesn’t usually have symptoms unless it causes a UTI. Symptoms vary depending on the type and cause of VUR and UTI. Symptoms of VUR and UTI can include:

  • Blood in urine
  • Fever, chills and lower back pain
  • Frequent need to urinate
  • High blood pressure
  • Hydronephrosis (kidney swelling due to fluid buildup), visible on a kidney ultrasound
  • Pain in lower belly or side
  • Pain or burning sensation when urinating
  • Smelly urine that doesn’t improve with increased fluid intake
  • Vomiting

Diagnosis depends on your child’s age, symptoms, condition and other factors and may include these or other tests as recommended by your child’s doctor:

  • Physical exam and medical history
  • Blood tests to evaluate creatinine levels and other measures of kidney function
  • Blood pressure check
  • Urine samples and testing
  • X-ray, kidney ultrasound or other imaging tests
  • Voiding cysto-urethrogram (VCUG) – a painless test using a flexible tube to fill the bladder with fluid visible by X-ray to watch for abnormal urine flow

Evaluation and Treatment of VUR and UTI

Evaluation may include a referral to pediatric urology and nephrology specialists at Penn State Health for expert diagnosis and care recommendations. You can also contact us to schedule an appointment with a Penn State Health specialist.

Doctors will identify VUR and UTI and recommend treatment options. VUR can get better with age. If no infection is present, VUR may not require treatment other than close monitoring of symptoms through follow-up appointments.

Depending on the type and nature of the condition and health history, steps may include:

  • Testing urine for signs of infection
  • Low-dose antibiotics as a preventive measure for certain types of VUR
  • Surgery to repair leaky structures in rare instances where VUR is severe, doesn’t improve or a child has repeated kidney UTIs

Outcomes are typically good with early, expert evaluation, care and follow-up. Families can help prevent problems by taking these and other measures as discussed by your child’s doctor:

  • Give children a high-fiber diet with plenty of fluids to prevent constipation, which increases UTI risk.
  • Discourage children from trying to hold urine too long and aim for emptying the bladder every two to four hours while the child is awake.
  • For certain conditions, the doctor may recommend a gentle laxative.

Our Experts in Care

The experts at Penn State Health Children’s Hospital are committed to providing our pediatric patients with comprehensive and multidisciplinary care.

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Why Choose Penn State Health for Pediatric Urology Care

Our pediatric urology team treats conditions that involve the urinary tract, bladder, kidneys and sex organs (genitalia). We use the latest technology and treatments to help your child. Our physicians and teams offer high-level care across specialties with sensitivity to the unique conditions and concerns of children.

Pediatric Expertise Across Specialties

The pediatric surgeons at Penn State Health have multispecialty training and experience. Doctors are skilled in performing the most intricate and complex procedures in infants, children and adolescents. Areas of expertise include:

  • Dedicated cross-specialty team of caring pediatric experts before, during and after surgery or other treatments and procedures
  • Minimally invasive surgery (sophisticated instruments and surgical procedures with smaller incisions)
  • Neonatal surgery (premature babies and newborns)
  • Pediatric oncology (cancer care)
  • Pediatric surgical innovation (software and device development)
  • Prenatal diagnosis and treatment (for problems with the baby’s development during pregnancy)

Penn State Health Children’s Hospital: Leading the Way

At Penn State Health, children are cared for by teams that are nationally known for pediatric excellence across medical specialties and subspecialties. Penn State Health Children’s Hospital is:

  • Recognized by the American College of Surgeons (ACS) for exceptional surgical care. Our hospital is one of eight in the nation and the only Level 1 Children’s Surgery Center in Pennsylvania as part of the ACS Children’s Surgery Verification Program.
  • Routinely ranked among the best children’s hospitals in the nation because of our focus on patient care, safety and research. U.S. News & World Report has recognized Penn State Children’s Hospital specialties with top rankings.

Our Research and Clinical Trials Drive Better Care

The pediatric specialists at Penn State Health are leaders in clinical science research. We welcome interested volunteers to consider participating in clinical trials. These studies help our scientists:

  • Improve diagnostic techniques
  • Develop better treatments
  • Collaborate with other researchers to advance care

Learn more about Penn State Health clinical trials.

Support Groups

Support groups provide children and their families an opportunity to connect with others in similar situations. Learn more about the support groups offered at Penn State Health Children’s Hospital.

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