My son will be 4 in April and is almost fully trained (some bm's and not night trained). Last week while in the bathroom with him I noticed blood in the drop of urine he'd left on the seat (boys!!!). I thought maybe it was a fluke thing but when he came back in about 15 minutes later to go again there was blood again. I called the ER and after much debate about the very crappy stormy weather we were having they decided to have us wait till morning to come in. When we did we took a sample with us but the dr really believed that the blood was from him playing with his uncircumsised (sp?) penis as the test they ran showed no trace of infection, blood or anything. However a further lab test on the urine showed a slight trace of blood and slightly elevated WBC's. We were told it was likely clean out from a virus he'd had the week before and we should bring another sample back on Friday. In the meantime they would send the sample away to be cultured.
I almost didnt' go Friday as he seemed fine, never had a fever etc. He was having a lot of accidents though (both bowel and bladder).
This time the first test (just a urine dip) showed blood and WBC's in the urine. The dr we saw this time looked at my sons chart from his last visit and couldn't understand why antibiotics weren't prescribed although the culture did come back negative. He asked a lot of questions about kidney and bladder health of both my dh and I and also about how hard ds had been to toilet train (VERY difficult...only really since Oct/Nov). He mentioned a few things...that of course I don't remember now but one had to do with a secondary sac or something that collects urine??? He decided to prescribe antibiotics speculatively as the culture wouldn't be back for a few days and also made referrals for an ultrasound on his kidneys and to a paediatric urologist (sp?).
Today he called to let us know that the culture came back positive this time.
I am just wondering if anyone has had any experience with little boys getting UTI's and if they ever are innocent (they are usually rare and often indicative of more serious problems from what I understand).
My son continues to have bowel accidents again (everyday) and some day wetting and is soaked every morning (was dry 3-4 out of 7 days). He's eating fine, has no fever and seems to be fairly normal in behaviour although more teary than normal.
Thanks for any help you might be able to offer!!!
Today this dr called to let us know that

**bump**
Just hoping anyone might have some info on UTI's especially in boys and what they mean.

I haven't had any personal experience with it, but I have heard of young boys getting UTI's wheather they are circ.'d or not. My son never had one, but one of his buddies did. One of the biggest problems I found was at the day care center my son went to. They used to put diaper ointment on his little wuwu, because they didn't know how to take care of an uncirc.'d boy. This made my son's wuwu red, so I told them right away not to put anything on it. The only thing you do is wipe it with a fresh/clean wipe. One of the other problems is that people will wipe the kid's butt then use the same wipe to wipe the wuwu, which deposits bacteria on it and causes a UTI. The best thing to do is to teach him to always wipe the wuwu first with clean toilet paper.

I don't think this is my sons problem but not sure...with the increase in bm accidents there might have been some bacteria travel to the penis but from what I've read and been told by nurses and doctors it is still pretty hard for fecal matter/bacteria to travel up their urethra and cause an infection. But with him really being toilet trained there really isn't an issue about wiping the area at all.
Interesting about the daycare not knowing how to care for uncircumsised penis's. Around here they are the norm now I think. The first dr we saw told us to pull the skin back and put polysporin on the head as it was a bit inflammed but the second dr said never to pull it back to clean it. Just water, no soap too in that area. Funny how everyone has a different opinion on this.
I am just concerned about how it happened because most of what I've read indicates that UTI's in boys mean some other physcial issue...abnormal growth, kidney problems etc. I want to have some idea of what to expect before the testing is done...at least to be prepared.

Hi, my son had his first UTI at age 6 weeks which turned into urosepsis. It was horrible. He was hospitalized for 2 weeks on IV antibiotics.

When the UTI appeared, a VCUG was ordered, which tests the way the urine flows. My son has bilateral VUR--kidney reflux and then they apply a grade level to it and it can be on one or both sides....from the way it was explained to me the urine back flows to kidneys then out...He's also had a kidney ultrasound and he gets DMSA scans done to monitor if there is any scarring/damage to his kidneys. He was placed on a continous antibiotic from the day he was discharged from the hospital, due to the risks of recurrence. Surgery may be an issue some day, at this point he is closely followed by a specialist, takes medication, and a stool softener...

My son has not had another UTI since this, so the meds are doing their job! UTI's are very uncommon in little boys, and he probably should have the testing to rule out VUR. I ended up having to have my other kids tested for this also (they were all little still & they all tested fine, no signs of VUR).

Any questions, ask away! We've been down this road and back--unfortunately!

Thanks so much for your reply. Some questions:
Was your son sick with his UTI? Mine was whiny, a bit out of sorts and aggressive with his baby brother but ate fine and had no fever then although he'd had one the week before. What were the signs of your sons UTI?
Did he require hospitilization before the diagnosis and tests or was it in result of them? I assume that with his age they were being extremely cautious. I wonder if age is a factor in how they treat this/diagnos this???
I think that the dr will order further testing if the kidney ultrasound shows anything. The first dr we saw (who misdiagnosed) had actually told us that if he had a UTI that we'd have to take him to a bigger center for some type of scan (that I assume is what your son had). We may not get any answers though until we see the specialist in the city.
I was kind of figuring that UTI's in boys don't usually mean anything good and often are genetic problems. My dh is adopted and we have NO information on his birth family so I don't know if genetics plays a part in this case or not.
Thanks again!!!

Hi, my son's signs were crying nonstop for over 3 hours and nothing would stop it (kinda sounds like the baby version of your son). His skin looked mottled. We called the pediatrician and were sent to ER, due to his age. They did testing, and a few hours in, he spiked a fever(however that was the one and only time he had a fever). We were told he would be admitted. He was kept for so long because of the eventual culture results, Group B strep...A nephrologist was called in immediately, and took over his care--this is who cares for our sons urinary issues now. I think the way it's treated depends on the type of infection and needed treatment.

They think he contracted it during his birth and it was late onset, even though I was treated with two doses of antibiotics. I was induced just before 37 weeks due to preeclampsia, and I delivered in just under 4 hours and now they aren't sure if the antibiotics had time to work (I was a carrier of Group B). But, we will never know for sure!

My son is doing well and hasn't had any other other issues. My son was definently a more extreme case of infection. I think you are doing the right thing my getting the tests done and following up with the specialist! I could be wrong, but I don't think a kidney ultrasound can show reflux, I think a VCUG has to be done (it is done be catheter with a dye)--yes unfortunately not the best test for our little ones...I would ask if they plan on doing any type of reflux testing (like you said that may be the other test)...It's just best to rule out the stuff, things can always happen just because, but it is nice to know that everything else checks out too!!

Do they plan on retesting him after he finishes the antibiotics to make sure its gone? Do you think he is feeling better? Take care and if you have more questions just ask!

Thanks again...you are so helpful!!!
I thought of that question...the retesting once he was done the antibiotics AFTER I got off the phone with the doctor. So no, it wasn't mentioned but if he is still voiding as often as he is now (anywhere between 45min and 2.5 hours apart and ALWAYS soaked in the morning) I will call to have him rechecked. I might even drop off a urine sample when we are in for the ultrasound.
I think the ultrasound is to look for any abnormalities in his kidneys/bladder. I am positive that the reflux test is the one the other ER doc talked about so that may be what happens next if it doesn't clear up.
He's doing a bit better....still having bm accidents daily, voiding a lot as I said and his behaviour is still a bit off but he is definately better than he was a week ago.
Do you know if there are many other problems that a UTI in boys can indicate? Any chance it is simply a UTI with no other issues? (A girl can hope!!)

oops...double post!!!

odds are in your favor, that this is simply a one-time UTI, and not reflux, by about 100 to 1.

Hi, sounds like you are doing everything right! Probably a good idea to get that follow up urine like you said, my son gets his checked every three months now just as a precaution. I don't know much about other problems that UTI's could mean with the kidneys/bladder.

Try not to worry too much (I know easier said then done, when it comes to our kids). Some things happen as flukes and thats all they are.

When do you have your tests done and see the specialist?

The ultrasound is on Monday but other than that, I don't know...haven't heard anything yet. I think I will drop off a urine sample at the clinic when we are there on Monday for the u/s...providing the little munchkin will provide one for me when we are there.
I know that the odds of reflux are pretty low but from what I've read, the odds of it being just a one time UTI and not something else are actually just as low.

I know what you mean about the whole odds thing. I hope he is feeling better and the ultrasound goes well. Keep in touch, and if you have any other questions, just ask!

Hi again!
Ds had his ultrasound today and all went fine I guess...no one raced in to tell us we couldn't leave the hosptial or anything!!!
He's been done his antibiotic for 36 hours and I suspect that he's still having troubles with something as he had 2 accidents today already (voiding) and has had bm accidents every time he's had one in the last 10 days except for 2 times.
I talked to my mom today and she said that without knowing our lives lately someone might wonder if we've changed something (added a child, moved, been fighting a lot, excess stress etc.) as his accidents sound like a regressive behaviour. BUT as she knows (and I) that nothing really has changed. It will in 2 weeks when I go back to work but ds didn't know I was going back soon until about 3 days ago but the accidents date back to 2 weeks or more ago.
I did get specimen jar for a urine sample incase I need to get one and if the voiding accidents continue I am going to take him back in because something just doesn't feel right about all of this.
I just wish I knew if I am making more of this than I should and what it could be. I'll keep you posted on the u/s results.

Hi! I hope things are doing a little better for you and your family...Have you heard anything on the results yet? It does sound like your son is having a hard time still, but like you said it is hard to know what it is, but another urine sample can't hurt anything and at least you would know if that infection definently cleared his system.

Hang in there! I'm a worrier my nature, so I know what you mean about making more of things, but with kids I tend to go on the side of caution and rule things out, but that is my personality and what we went through with our son that made me this way....

I just heard from the specialist and we go to see him on Feb 7. In the meantime I think I may head back to the dr and have his urine checked again as he continues to have accidents or wet multiple times as night in his pull up and last night he fell asleep before 7:00 while colouring at the table. Other than that his behaviour is pretty good although he does get easily frustrated and teary.
I've been collecting his urine off and on and it is sometimes very cloudy and other times very clear. Anyone know if this means anything (other than I am obsessed with pee???)

It's probably just a UTI. Uncircumcised boys are at a higher risk due to the foreskin and the bacteria that it harbors which may be the cause. Hopefully it will get cleared up by an antibiotic and won't happen again.

Actually in the studies I've read both online and in medical resources this is really only true in boys under 1 year. There is a very slight increase over uncirc'd boys but all in all the incidence of UTI's in boys is less than 1.1%...
which to me says this is pretty rare. I am not about to go out and get him circ'd to change these odds!!! However, if this is the root of the problem and needs to be done, I'm not against it but think I'll keep things the way nature made them for now.

Just an update that the specialist has ordered a VCUG and is looking for the origin of the infection...well maybe not the origin as the infection has cleared up but atleast the cause. He will be checking for relfux as well as abnormalities that can cause the urine to leave the bladder, remain in the bladder too long, pool in the wrong places etc.
Despite what an earlier poster stated, this is not likely an isolated UTI with no other issues (the chances are much greater than 100 to 1 that there is a root cause for this UTI) nor does it have ANYTHING to do with the fact that he is not circumsized. He made both of these points VERY clear to us but also told us that there is a chance that it could never happen again.
Has anyone had any experience with a VCUG? My son will be sedated for this procedure.
Thanks

My 3-year-old son (4 next month) just had a VCUG yesterday. He was sedated, the catheter was inserted, then came the dye. The radiologist monitored as the bladder filled up, then saw the reflux on the left side (as expected in our case). The catheter was removed and my son urinated all over the table within a minute. The whole procedure took about 5 - 7 minutes. He was already admitted to the hospital, so he was brought back to his room and he woke up within about 10 minutes (will vary based on sedation used). He complained about pain in his penis during urination until the next morning. Nothing that brought tears, but he was certainly uncomfortable and hesitant. He also had an ultrasound and renal scan during his hospitalization. Now he's home with 10 days of one antibiotic and 3 months of another. Follow-ups with ped. nephologist and ped. urologist are scheduled in a month. Good luck.

I'm glad you were able to follow up and start to get some questions answered...How is your son?

My son and daughter had a VCUG, since it can be heridatary(sp?)-the reflux that is, we had to have our daughter tested as precaution-she was fine..It's what the previous poster said, fairly quick, I was able to watch it and given the results at the time by the doctor performing.

I was reading the rest of your post and I don't think I metioned previously that my son was born with hypospadias and was unable to be circumsized at birth, since that skin was needed for his surgery at age 1 to repair this. We were told the same thing as you.

Were your children sedated with oral sedatives or general anesthetic? I am just wondering how out of it he will be as I can't imagine him being happy about peeing all over himself if he's at all aware of what's going on.
Any other things they look for in a VCUG besides reflux?

Glad you are getting good advice and hope the procedure goes well and gives you some answers,
Geoff

Thanks. Unfortunately we have to wait till April 13th (a Friday...hopefully not unlucky for us and I am not really superstitious at all anyway) to have the test done. In the meantime I just keep over analysing every voiding accident, strange behaviour and feel like I am on 'pee patrol'!!!!

The purpose of my son's VCUG was to look for reflux; I don't know if there are other things to look for... We did find out that my son's bladder is "huge" and that that may add to some of his urinary problems (not fully emptying, just voiding until the pressure is gone because he wouldn't want to take the time to empty completely).
Because he was already admitted to the hospital, he was sedated thru his IV with a drug that I cannot find the correct spelling for, that I have jotted down as prophenol.
I found this link as I was looking for other VCUG info:
http://www.inova.org/inovapublic.srt/ifhc/vcug.pdf
Good luck in April.