Urinary Tract Infection In Girls Research Articles

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

Urinary Tract Infection in Girls: A Ten Year Followup Report

Urinary Tract Infection in Girls: A Ten Year Followup Report

Recurrent Urinary Tract Infections in Girls

No AccessJournal of Urology1 May 1960Recurrent Urinary Tract Infections in Girls Morton Palken, and John M. Kennelly Morton PalkenMorton Palken More articles by this author , and John M. KennellyJohn M. Kennelly More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)65791-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1960 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByMulcahy J, Kelalis P, Stickler G and Burke E (2018) Familial Vesicoureteral RefluxJournal of Urology, VOL. 104, NO. 5, (762-764), Online publication date: 1-Nov-1970.Hutch J (2018) The Role of the Ureterovesical Junction in the Natural History of PyelonephritisJournal of Urology, VOL. 88, NO. 3, (354-362), Online publication date: 1-Sep-1962.Hutch J (2018) Theory of Maturation of the Intravesical UreterJournal of Urology, VOL. 86, NO. 5, (534-538), Online publication date: 1-Nov-1961. Volume 83Issue 5May 1960Page: 745-748 Advertisement Copyright & Permissions© 1960 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Morton Palken More articles by this author John M. Kennelly More articles by this author Expand All Advertisement PDF DownloadLoading ...

Prognosis in Childhood Urinary Tract Infections in Girls

Prognosis in Childhood Urinary Tract Infections in Girls

Chronic urethritis in girls.

Chronic posterior urethritis has proven to be, in our experience, the commonest single basis for urinary tract infection in girls. Understanding of the pathogenesis and characteristics of this clinical entity will hasten early recognition and appropriate treatment. To many practitioners today a girl who has an elevated temperature, urinary frequency, and pus in the voided urine specimen has pyelitis. They are happy to call the powerful sulfonamide and antibiotic agents to their aid and gratified to find that these agents appear to control the infection in most cases in very short order. Often not until there have been repeated recurrences and the entire chemotherapeutic and antibiotic armamentarium has been ineffective in bringing about a permanent cure is the possibility of an underlying process considered. Intravenous or retrograde investigation is then undertaken in the logical belief that a congenital obstruction will be found, but the urinary system drains normally. Cystoscopic examination