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Urinary Tract Infections in Teens

The urinary tract begins with the kidneys, two bean-shaped organs that skim waste products and excess water from the blood to create urine. A pair of narrow tubes called the ureters carries the urine to the baglike bladder for storage. From there it travels down another tube, the urethra, and leaves the body through the penis or the vulva. In the process, the urine washes away germs from the opening of the urinary system. But sometimes microorganisms slip into the urethra and begin to multiply and inflame its inner lining. The culprit behind most urinary-tract infections (UTIs) is Escherichia coli (E. coli), a bacteria that resides in the intestinal tract. An infection confined to the urethra is called urethritis. However, many times the germs continue upward, landing in the bladder. Cystitis, the most common UTI, frequently occurs in tandem with urethritis. If not treated promptly, the infection can spread to the ureters and the kidneys. The medical term for this more serious condition is pyelonephritis.

Young women develop urinary-tract infections at more than three times the rate of young men. One probable reason why is that the female urethra, at just one and a half inches long, affords germs easy access to the bladder. The male urethra, in contrast, measures eight inches in length. A second factor is the close proximity of the urethral opening to the vagina and anus, both of which serve as fertile environments for bacteria. During intercourse, germs from the vagina may be pushed into the bladder. In fact, as Dr. Alain Joffe points out, a UTI may be a sign that a teenager is sexually active. “There is a significant overlap between the symptoms of urinary-tract infections and the symptoms of chlamydia, gonorrhea and other sexually transmitted diseases,” says the director of adolescent medicine at Baltimore’s Johns Hopkins School of Medicine.

Symptoms That Suggest A Urinary-Tract Infection May Include:

  • Pain or burning sensation when urinating
  • Frequent urge to urinate, though only a small amount is passed
  • Fever and chills
  • Pressure sensation
  • Pain in the abdomen, pelvis or lower back
  • Nausea and vomiting
  • Blood or pus in the urine
  • Urinary incontinence

How a Urinary-Tract Infection is Diagnosed

Physical examination and thorough medical history, plus one or more of the following procedures:

  • Urinalysis, to detect the presence of bacteria and white blood cells (wbc’s)
  • Urine culture, to determine which antibiotic can be used to treat it

How a Urinary-Tract Infection is Treated

Drug therapy: Three days on an oral antibiotic usually clears up infections of the lower urinary tract. Once the kidneys are involved, however, treatment takes longer. Among the drugs most commonly ordered: trimethoprim, trimethoprim/sulfamethoxazole, amoxicillin, ampicillin, ofloxacin and nitrofurantoin. Additional medications may be prescribed to relieve pain and inflammation. Approximately one in five female sufferers will experience at least one subsequent urinary-tract infection. The new illness usually stems from a different strain of E. coli or an entirely different bacteria.

Helping Teenagers Help Themselves

The following measures may help prevent urinary-tract infections:

  • Drink the equivalent of eight glasses of water a day.
  • Don’t resist the urge to urinate, void at frequent intervals (every 3 to 4 hours).
  • Urinate after sexual intercourse.
  • Change tampons and sanitary napkins frequently.
  • Do not douche.
  • Wipe front to back, or from urethra/vagina toward the anus.
Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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