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Refractory Urinary Tract Infection

Refractory Urinary Tract Infection is quite common and many children suffer from this. The symptoms are quite prominent and are as follow : Persistent symptoms of urgency (wanting to pass urine urgently) Frequency (passing urine often), Dysuria (pain on passing urine), Low grade fever or recurrent fever It is very important to evaluate the child thoroughly by looking at the start of symptoms, including antenatal history, food habits, bowel and bladder habits, screen time, physical activity. It is important to examine the child looking at the abdomen for any swelling, examining their external genital to look for any abnormality and including an examination of the spine. Investigations may be repeated such as urine culture (sample take by catherization or bladder aspiration), ultrasound (to look for kidney swelling, bladder thickness, urine remaining after voiding). Other tests such as MCUG, EC scan, urodynamic study may be done as per requirement. Sometimes the child may need an evaluation under general anesthesia including a cystoscopy with an instrument with a light camera are passed into the urinary passage and bladder. The treatment involves improving bowel bladder habits – starting with regulating sleep cycle, passing stools in the morning, passing urine regularly, drinking plenty of fluids. Adequate antibiotics should be used and the course must be completed without fail. Some children may require a short duration of prophylactic antibiotics at night until the symptoms improve. The child must be taught to pass urine every 2-3 hours and empty their bladder to the last drop. Some children may need medication to improve the bladder muscle function. Very rarely the bladder function may be abnormal leading to high pressures in the bladder and thus cause kidney damage. Such children may need additional treatment like catherization, surgery to protect the kidneys. During such conditions, the pediatric urology team (including the pediatric nephrologist) must work with the child and the parents to improve the quality of life and protect the kidneys. To know more visit To book an appointment visit 

Dr. Lavanya Kannaiyan

Consultant - Pediatric Surgeon & Urologist

Rainbow Children's Hospital, Banjara Hills