When Things Go the Wrong Way
Sometimes a doctor will order additional urinary tract tests to determine if an anatomical abnormality is the cause of a UTI. "Typically we'll perform an ultrasound of the bladder and kidneys to look for abnormalities, as well as perform a Voiding Cystourethrogram (VCUG)," explains Dr. Duel. A VCUG is an x-ray test that allows specialists to watch the flow of urine from the bladder to see if the bladder is emptying normally.
What tests like a VCUG often reveal is a condition called Vesicoureteral Reflux—an anatomical quirk that causes some urine to flow backward up to the kidneys as the bladder fills. Dr. Duel estimates that "about 40% of kids (boys and girls) with UTIs have Reflux," and it can cause recurrent urinary tract infections. Dr. Duel says, "Reflux will often go away on its own but children with the condition will be prescribed low-dose antibiotics–sometimes for years at a time. They also undergo annual VCUG screenings to make sure reflux is improving and that their kidneys are growing normally." Children who continue to get infections despite ongoing medication can have surgery to correct the anatomical problem that causes some of their urine to flow in the wrong direction.