women! you are more susceptible to Urinary tract infection, you can easily avoid it!

Urinary tract infection (UTI) is a significant childhood problem, probably second only to infection of the respiratory tract. Although its exact incidence is not known, it is suggested that from 1% to 2% of school-age children have Urinary tract Infection as demonstrated by significant bacteriuria. The peak incidence of UTI not caused by structural anomalies occurs between 2 and 6 years of age, Except for the neonatal period, females have a 10 to 30 times greater risk for developing UTI than males. It has been estimated that approximately 5% of school-age females will develop bacteriuria by 18 years of age. Such statistics attest to the importance of preventing, diagnosing, and treating this problem to prevent recurrent infections and possible renal damage in later years.

Predisposing factors

A number of factors predispose to the development of UTI. The major ones included here relate to anatomic, physical, and chemical causes. These factors seem to account for the increased incidence of bacteriuria in females. The short urethra, which meansures about 2cm in young females and 4 cm in mature women, provides a ready pathway for invasion of organisms, The longer male Urethra (as long as 20cm in an adult) and the antibacterial properties of porstatic secretions inhibit the entry and growth of pathogens.

Introduction of bacteria can occur in females during tub baths. Soap or water softeners decrease the surface tension of the water, increasing the possibility of fluid entry into the short urethra. Tight clothing or diapers, poor hygiene, and local inflammation, such as from vaginitis or pinworm infestation, may also increase the risk of ascending infection.

Physical factors relating to the functioning of the bladder are of major importance in the occurrence and spread of infection. Ordinarily, Urine is sterile, but at 37 degress celcius it is an excellent culture medium. Under normal conditions the act of completely and repeatedly emptying the bladder flushes away any organisms before they have an opportunity to multiply and invade surrounding tissue. However, Urine that remains in the bladder allows bacteria from the Urethra to rapidly become established in the rich medium.

Incomplete bladder emptying may result from reflux, anatomic abnormalities, especially involving the ureters, or dysfunction of the voiding mechanism, Vesicoureteral; reflux (VUR) refers to the retrograde flow of bladder Urine into the ureters. Reflux increases the chance for and perpetuates infection, since with each void urine is swept up the Ureters and then allowed to empty after voiding. Therefore, the residual Urine in the ureters remains in the bladder until next void. Primary reflux results from the congenitally abnormal insertion of the ureters into the bladder and predisposes to development of infection. Secondary reflux occurs as a result of infection. Normally the Ureters enter the bladder wall in such a manner that the accumulating Urine compresses the submucosal segment of the Ureter, preventing reflux. However, the edema caused by bladder infection renders this mechanism at the Ureterovesicula junction incompetent. In addition, in infants and young children the shortness of the submucosal portion of the Ureter decreases the effectiveness of this antireflux mechanism, Other causes of secondary reflux are neurogenic bladder from either chronic obstruction or neural dysfunction or as an iatrogenic result from progressive dilation of the ureters following surgical urinary diversion.

Reflux with infection can lead to kidney damage, since refluxed Urine ascending into the collecting tubules of the nephrons allows the microorganism to gain access to the renal parenchyma, initiating renal scarring. 

Prevention of Urinary tract infection

One major risk factor is short females having Urethra close to the Vagina and Anus. Measures of prevention could be Perinea hygiene-wipe from front t back. Avoid tub baths, especially with bubble bath water softener; use showers.

Incomplete emptying (reflux) and over-distention of bladder are another sets of risk factors to UTI. Control measures are; avoid "holding" urine. Encourage child to void frequently, especially before a long trip or other circumstances when toilet facilities are not available. Empty bladder completely with each void and avoid staining at stool.

Concentrated and alkaline Urine can cause UTI too. Measures of prevention are: Encourage generous fluid intake. Acidify Urine with Juices such as apple or cranberry and a diet high in animal protein.

Urinary tract infection could be prevented as much as possible, if only we want to.

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