Tract Infection In Girls Research Articles

Urinary Tract Infections in Girls: Age at Onset and Urinary Tract Abnormalities

Urinary tract infection in children is a common problem confronting pediatricians, family practitioners, and urologists. The prevalence of this problem for the general population under the age of 14 years has been found by Kunin1 to be 0.4% for boys and 1.2% for girls. The question of which patients require a complete radiologic evaluation (intravenous pyelogram [IVP] and voiding cystourethrogram [VCUG]) has been classically embalmed in controversy and confusion. Some authors have advocated investigating all children with a bacteriologically proven infection,2 while most others have recommended investigations after the first infection in boys and after the second infection in girls.3-5

External sphincter activity and recurrent urinary tract infection in girls

Urodynamic investigations, including pressure studies, anal sphincter electromyography, and cystourethrography, done in young girls having symptomatic urinary infection show hyperreflexive activity of both striated sphincter and detrusor muscles, due to increased afferent input. In our series, this activity ranged from a pattern similar to “uninhibited” bladder contractions, with normal voiding, to hyperactivity causing frequency, with voiding interrupted by frank sphincter spasms. The wide range and epidemiology of urinary infection in girls suggest that urethral dilatation (or urethrotomy) with long-term chemoprophylaxis is indicated only at one extreme — where the hyperactivity persists in the absence of infection. The role of persistent hyperactivity of detrusor and sphincter in recurrent urinary infection of childhood needs to be defined by a long-term longitudinal study; the high over-all recurrence rates of both covert bacteriuria and overt infection in girls still constitute a major medical problem.

Prevention of Recurrent Urinary Tract Infections in Girls

Eighteen girls between the ages of 3 and 13 years--with a history of at least three culture-documented episodes of bacteriuria in the previous year, but without radiologic evidence of major urinary tract abnormality--were placed on a double-blind, crossover study comparing the effectiveness of nitrofurantoin macrocrystals against a placebo in preventing the recurrence of bacteriuria. Each child was placed on a daily low dose of nitrofurantoin (1.2 to 2.4 mg/kg/day) or an identical-appearing placebo for six months. Each child was then placed on the opposite capsule for a similar period. There were 35 episodes of bacteriuria (4.2 episodes/patient/yr) in the patients taking the placebo, which compared with a rate of 3.8 episodes/patient/yr during the year prior to the study. Only two episodes (0.2 episodes/patient/yr) occurred in the patients taking the drug. The difference in the rate of recurrent bacteriuria between the girls on placebo and on medication is significant at the 0.01 level using the Wilcoxin matched-pairs test. There were no adverse reactions to the drug. Nitrofurantoin macrocrystals in a single daily low dose appear to be a safe, effective method of preventing recurrent bacteriuria in girls at high risk.

Recurrent urinary tract infection in girls. Group with lower tract findings and a benign course.

A group of girls is described with recurrent urinary tract infections characterized by predominantly lower tract symptoms. Clinical, laboratory, and radiography findings during the period of follow-up are presented. Infection persisted in most patients over several years. Response to medical and surgical treatment was unsatisfactory. The mean interval between the initial and most recent radiological study was 6 1/2 years. No case of renal parenchymal scarring was seen.

Internal urethrotomy and recurring urinary tract infection in girls: M. A. Immergut, and E. C. Gilert. J. Urol. 109:126–127 (January), 1973

Internal urethrotomy and recurring urinary tract infection in girls: M. A. Immergut, and E. C. Gilert. J. Urol. 109:126–127 (January), 1973

Bacteriuria in school children. Observations on outcome following detection in 110 girls.

Demographic data and occurrence of bacteriuria in 12,252 school children plus medical history by structured maternal interview for a randomly selected sample of 2,871 of these children provide information relevant to planning of screening programs. Data from 110 girls, discovered to be bacteriuric during the school surveys and observed for one to four years after initial detection and referral to their usual source of medical care, provide a measure of contemporary management of urinary tract infection in girls. No significant differences were noted for results of annual urine culture in these 110 girls, when analyzed by socioeconomic level, age of first urinary tract infection or bacteriuria, selection for or results of intravenous pyelogram, and therapeutic regimen (including no antibacterial agents). These data indicate a need to seriously question the advisability of treating all schoolgirls for bacteriuria; however, the fact that patients were not randomly assigned to treatment and control groups precludes a definitive recommendation.

A Blind Comparison of Dilatation, Urethrotomy and Medication Alone in the Treatment of Urinary Tract Infection in Girls

A Blind Comparison of Dilatation, Urethrotomy and Medication Alone in the Treatment of Urinary Tract Infection in Girls

Spastic striated external sphincter and urinary tract infection in girls: E. A. Tanagho, E. R. Miller, R. P. Lyon, and R. Fisher. Brit. J. Urol. 43:69–82 (February), 1971

Spastic striated external sphincter and urinary tract infection in girls: E. A. Tanagho, E. R. Miller, R. P. Lyon, and R. Fisher. Brit. J. Urol. 43:69–82 (February), 1971

The significance of urinary tract infections in girls in the absence of vesicoureteral reflux : S. J. Klein, N. R. Carlin and W. T. Bowles. J. Urol. 103:345–347 (March), 1970

The significance of urinary tract infections in girls in the absence of vesicoureteral reflux : S. J. Klein, N. R. Carlin and W. T. Bowles. J. Urol. 103:345–347 (March), 1970

Urinary Tract Infections in Girls: Prevalence of Spina Bifida Occulta

Urinary Tract Infections in Girls: Prevalence of Spina Bifida Occulta

The Significance of Urinary Tract Infection in Girls in the Absence of Vesicoureteral Reflux

The Significance of Urinary Tract Infection in Girls in the Absence of Vesicoureteral Reflux

Meatotomy in girls with meatal stenosis and urinary tract infections

Results of a controlled prospective study of the use of meatotomy in 37 girls with urinary tract infection and a radiologic diagnosis of meatal stenosis are presented. Patients were placed alternately in one of two groups: In group I meatotomy was done shortly after diagnosis of meatal stenosis; in group II it was done only if meatal stenosis persisted after a 9 month follow-up. Results were assessed in terms of symptomatology, recurrence rate, and radiologic findings. Meatotomy had no detectable effect in altering recurrence rate or symptomatology in our patients. The presence of an abnormal voiding pattern was associated with a high recurrence rate. Meatal stenosis or distal urethral obstruction as diagnosed by currently available techniques does not appear to be a factor of importance in the pathogenesis of urinary tract infection in the majority of cases. Widespread use of meatotomy in the management of urinary tract infections in girls is unwarranted.

Urinary tract infection in girls. I. A computerized analysis of urethral stenosis : J. M. Weiss, R. F. Dykhuizen, C. R. Sargent, and R. W. Tandy. J. Urol. 100:513–519 (October) 1968

Urinary tract infection in girls. I. A computerized analysis of urethral stenosis : J. M. Weiss, R. F. Dykhuizen, C. R. Sargent, and R. W. Tandy. J. Urol. 100:513–519 (October) 1968

The long term prognosis of non-obstructive urinary tract infection in infancy and childhood after the advent of sulphonamides.

SummaryOne hundred and seven cases of urinary tract infection in children, hospitalized during the years 1940‐1949, were reinvestigated with an observation time ranging from 15 to 24 years. Primary and late mortality was low. Non‐obstructive urinary infections in boys show a good prognosis, concerning recurrence as well as progressive renal disease.Non‐obstructive urinary tract infection in girls seems to be a potentially serious disease, where recurrence developed in half the cases in spite of the initial sulpha‐treatment given. A minimum of 19 % of the girls showed progressive renal disease according to radiological examinations. Early recurrence, according to the primary report, increased the risk of progressive renal disease from 4 to 30%. In 40% of the girls with late symptomatic recurrence, progressive renal disease could be diagnosed at about 20 years of age.The reinvestigation shows that in certain individuals the child's susceptability to recurrent urinary tract infection is retained even in the adult, in whom it manifests itself as acute pyelonephritis. It is of special interest to note that between one half to one third of those who had been pregnant had suffered from urinary tract infection of pregnancy.At about 20 years observation time negative results of single determination of blood pressure, sedimentation rate, haemoglobin, serum‐creatinine, protein or leucocytes or bacteria in the urine and maximal urinary concentration capacity does not seem to guarantee the ab‐scence of chronic or recurrent pyelonephritis. A thorough case history, including a paediatric history, is recommended in dealing with urinary tract infections in children and young adults.

Subclinical Neurogenic Bladder in Children

No AccessJournal of Urology1 Jan 1969Subclinical Neurogenic Bladder in Children Lionel E. Dorfman, James Bailey, and John P. Smith Lionel E. DorfmanLionel E. Dorfman More articles by this author , James BaileyJames Bailey More articles by this author , and John P. SmithJohn P. Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)62269-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1969 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByTiryaki S, Eraslan C, Soyer T, Calli C, Ulman I and Avanoglu A (2019) Nonneuropathic Neuropathic Bladder—Is it Really Nonneuropathic?Journal of Urology, VOL. 201, NO. 4, (802-809), Online publication date: 1-Apr-2019.Hinman F and Baumann F (2018) Vesical and ureteral damage from voiding dysfunction in boys without neurologic or obstructive diseaseJournal of Urology, VOL. 167, NO. 2 Part 2, (1069-1073), Online publication date: 1-Feb-2002.Ochoa B (2018) The Urofacial (Ochoa) Syndrome RevisitedJournal of Urology, VOL. 148, NO. 2 Part 2, (580-583), Online publication date: 1-Aug-1992.Hellström A, Hjälmås K and Jodal U (2018) Rehabilitation of the Dysfunctional Bladder in Children: Method and 3-Year FollowupJournal of Urology, VOL. 138, NO. 4 Part 1, (847-849), Online publication date: 1-Oct-1987.Hinman F (2018) Nonneurogenic Neurogenic Bladder (The Hinman Syndrome)–15 Years LaterJournal of Urology, VOL. 136, NO. 4, (769-777), Online publication date: 1-Oct-1986.Maizels M and Firlit C (2018) Pediatric Urodynamics: A Clinical Comparison of Surface Versus Needle Pelvic Floor/external Sphincter ElectromyographyJournal of Urology, VOL. 122, NO. 4, (518-522), Online publication date: 1-Oct-1979.Allen T (2018) The Non-Neurogenic Neurogenic BladderJournal of Urology, VOL. 117, NO. 2, (232-238), Online publication date: 1-Feb-1977.Hinman F and Baumann F (2018) Complications of Vesicoureteral Operations From Incoordination of MicturitionJournal of Urology, VOL. 116, NO. 5, (638-642), Online publication date: 1-Nov-1976.Bucy J and Carlin M (2018) The Silent Neurogenic BladderJournal of Urology, VOL. 114, NO. 2, (296-298), Online publication date: 1-Aug-1975.Mahony D and Laferte R (2018) Editorial: Enuresis—A Plea for Objectivity and SensitivityJournal of Urology, VOL. 109, NO. 4, (531-532), Online publication date: 1-Apr-1973.Hinman F and Baumann F (2018) Vesical and Ureteral Damage from Voiding Dysfunction in Boys without Neurologic or Obstructive DiseaseJournal of Urology, VOL. 109, NO. 4, (727-732), Online publication date: 1-Apr-1973.Martin D, Datta N and Schweitz B (2018) The Occult Neurological BladderJournal of Urology, VOL. 105, NO. 5, (733-738), Online publication date: 1-May-1971.Geist R and Antolak S (2018) Interstitial Cystitis in ChildrenJournal of Urology, VOL. 104, NO. 6, (922-925), Online publication date: 1-Dec-1970.Manley C and Frech R (2018) Urinary Tract Infections in Girls: Prevalence of Spina Bifida OccultaJournal of Urology, VOL. 103, NO. 3, (348-352), Online publication date: 1-Mar-1970. Volume 101Issue 1January 1969Page: 48-54 Advertisement Copyright & Permissions© 1969 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Lionel E. Dorfman More articles by this author James Bailey More articles by this author John P. Smith More articles by this author Expand All Advertisement Loading ...

Urinary Tract Infection in Girls. I. A Computerized Analysis of Urethral Stenosis

Urinary Tract Infection in Girls. I. A Computerized Analysis of Urethral Stenosis

Studies of urinary tract infections in infancy and childhood. X. Short or long-term treatment in girls with first or second-time urinary tract infections uncomplicated by obstructive urological abnormalities.

SummaryThe aim of the present investigation, concerned with 279 girls with their first‐time, or in a few cases second‐time urinary tract infection, was to explore the possibility to improve the “1‐year cure rate” by means of long‐term sulfonamide therapy (2 months) instead of short‐term sulfonamide therapy (10 days). A “1‐year cure” was then defined as an eradication of the index infection and freedom from infection during the following year. The “1‐year cure rate” was found to be equal in the two therapy groups i. e. 64 per cent.The material showed some characteristics which might permit some general statements about uncomplicated first or second‐time urinary tract infections in girls. The material showed a marked predominance of the younger age groups. This finding is discussed with regard to the pathogenesis of urinary tract infection. The bacteria isolated at the initial infections were in 90 percent E. coli and also in 90 per cent sensitive to sulfonamide. Thus for the present there is no reason to abandon sulfonamide as the drug of choice in uncomplicated first‐time infections in girls.The first recurrence had a tendency to appear shortly after the original infection rather than late. Observations suggest that recurrences, even those occurring immediately after cessation of therapy, were usually a reinfection and not a recrudescence. These findings are discussed in relation to the pathogenesis of recurrent urinary tract infections.The first recurrence was in 1/3 of the cases asymptomatic, in the other 2/3 symptomatic. During long term prophylaxis asymptomatic infections even outnumbered the symptomatic ones. Therapy thus may mask an infection.The bacteria isolated at the first recurrences after the index infection were in 30–90 per cent resistant to sulfonamide, the rate being related to the time interval between the cessation of therapy and the recurrence. The therapeutic consequences of the difference in sulfonamide sensitivity of the initial infection and the recurrences are discussed.

Roentgen evaluation of distal urethral obstruction.

Distal urethral obstruction by definition is a pathological diminution of the lumen or of the distensibility of this canal. About 20 per cent of urologic disorders in children are stated to be congenital stenosis of the urethra, with most of them located at the meatus (3). Tudor and his associates (11) declare this the most common obstruction in the male child, whereas Burns et al. (1) and Keitzer and Benavent (6) judge the occurrence equal in both sexes and often overlooked in little girls. Burrows, using micturition cystourethrography, found meatal stenosis in 44 girls and 2 boys in a total of 496 children (2). Inspection, bougie calibration, and roentgenology are employed to detect meatal stenosis, and its diagnosis has become quite popular (2), so much so that Heslin (5) recommends routine calibration in children being circumcised or undergoing tonsillectomy. Knappenberger (7) advises that systematic interval urethral dilatations prevent infective urethral stenosis or stricture and have definite clinical value in the treatment of recurrent urinary tract infections in girls. Roentgen features considered indicative of meatal stenosis are urethral dilatation, meatal narrowing, and splaying of the opaque material after it has passed through the meatus. Lyon and his co-workers (8, 9) call attention to another type of urethral obstruction in females which they describe as distal urethral stenosis. They find this in 90 per cent of little girls with recurrent urinary tract infections. Bougie à boule calibration is indicated as necessary to detect the lesion in some patients, but they also describe four roentgen patterns of this type of obstruction in which the distal urethral segment shows narrowing of 0.5–1 cm, with or without dilatation above it. Doubt of the validity of the roentgen features of meatal and distal urethral stenosis arose in our experience because of (a) a lack of normal standards of urethral caliber and (b) the presence of these features in children in whom inspection and urethral calibration obviously showed no obstruction. Furthermore, there were children in whom meatal stenosis or distal urethral stenosis was diagnosed by inspection and/or bougie calibration, but without the roentgen features of such obstruction, or forced and intermittent voiding, bladder trabeculation, vesicoureteral reflux, or documented urinary tract infection. Therefore, a study of the distal urethra was undertaken to establish normal standards and to evaluate the roentgen features considered diagnostic of meatal and distal urethral stenosis. The purpose of this communication is to report the results of this study. Material Voiding cystourethrography was performed in 478 children, 287 females and 191 males.

Prevention of recurrent urinary tract infections in girls.

Death from chronic pyelonephritis of several girls with otherwise normal urinary tracts has focused our attention on the importance of controlling bacterial infections of the kidney. At the same time, difficulties encountered in the management of kidney infections were emphasized by the stormy courses of six girls with frequently recurring pyelonephritis. Although these children had anatomically normal urinary tracts and each infection could be eradicated by appropriate therapy utilizing information gained from urine cultures and sensitivity studies, reinfection invariably followed. Prior to referral, several therapeutic approaches had been tried without achieving permanent remission, including one month of hospitalization for treatment with massive doses of antibiotic combinations. Finally, a program was instituted for the purpose of preventing recurrences. 1 After the infections had been cleared by appropriate antibacterial drugs, the patient was started on methenamine mandelate and, when indicated, a urinary acidifying agent. This paper describes this prophylactic program and its

Experiments with Induced Bacteriuria, Vesical Emptying and Bacterial Growth on the Mechanism of Bladder Defense to Infection

Experiments with Induced Bacteriuria, Vesical Emptying and Bacterial Growth on the Mechanism of Bladder Defense to Infection