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Incomplete bladder emptying is associated with febrile urinary tract infections in infants
J-D Tsai1, S-J Chang2, C-C Lin3
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Department of Pediatrics, Mackay Medical College, Taipei, Taiwan; Department of Pediatrics, Taipei Medical University, Taipei, Taiwan.
Insights
Infants with a history of febrile urinary tract infection (f-UTI) show signs of lower urinary tract dysfunction, including higher post-void residual urine (PVR) and lower voiding efficiency, compared to healthy infants.
Area of Science:
- Pediatric Urology
- Nephrology
- Infant Health
Background:
- Lower urinary tract dysfunction can manifest in infants.
- Febrile urinary tract infections (f-UTI) are common in infants and may impact bladder function.
Purpose of the Study:
- To investigate lower urinary tract dysfunction in pre-toilet trained infants.
- To compare bladder function in infants with and without a history of febrile UTI (f-UTI).
Main Methods:
- Enrolled pre-toilet trained infants with (Group 1) and without (Group 2) f-UTI history.
- Conducted four-hourly observations for Group 1 infants post-UTI treatment.
- Measured voided volume (VV) and post-void residual urine (PVR) using diaper weighing and ultrasound; calculated voiding efficiency (VV/(VV+PVR)).
Main Results:
- Infants with f-UTI history (Group 1) exhibited significantly higher average PVR (14.5 ml vs 8.9 ml) and lower voiding efficiency (71.2% vs 80.2%) compared to Group 2.
- Optimal cutoff values for differentiating groups were PVR ≥10 ml and voiding efficiency ≤80%.
- Group 1 infants showed significantly higher rates of repeat elevated PVR and low voiding efficiency.
Conclusions:
- Pre-toilet trained infants with a history of f-UTI demonstrate impaired bladder emptying.
- Elevated PVR and reduced voiding efficiency are associated with f-UTI in infants.
- These findings highlight potential long-term lower urinary tract dysfunction following infant f-UTI.
Objective:
To investigate lower urinary tract dysfunction in pre-toilet trained infants with and without history of febrile UTI (f-UTI).
Materials And Methods:
Pre-toilet trained infants with f-UTI (Group 1) from pediatric nephrology and urology clinics, and those without f-UTI (Group 2) from infant-care centers were enrolled for the present study. Infants in Group 1 underwent four-hourly (4-H) observations for at least one month after treatment for UTI. Voided volume (VV) and post-void residual urine (PVR) were measured by weighting diaper and suprapubic ultrasound after finishing voiding, respectively. Average PVR was defined as the mean value of PVR during 4-H observation. Interrupted voiding was defined as two or three voidings within 10 min. Voiding efficiency was defined as VV/(VV+PVR).
Results:
The mean ages of Group 1 (n=64) and Group 2 infants (n=56) were 10.6±7.5 months vs 10.2±5.1 months, respectively (p=0.70). Group 1 infants had significantly higher voiding frequency (3.0 times±1.2 vs 2.6 times±0.9, p=0.04), average PVR (14.5 ml±14.2 vs 8.9 ml±8.8, p<0.01) and lower voiding efficiency (71.2%±20.5 vs 80.2%±18.5, p=0.01) than Group 2. ROC curve analysis showed that the optimal cutoff values for PVR and voiding efficiency to differentiate Group 1 and Group 2 infants were 10 ml and 80%, respectively. Group 1 infants had significantly more repeat elevated PVR (≧10 ml) and repeat low voiding efficiency (≦80%) than Group 2 (44.8% vs 22.4%, p=0.03; 62.0% vs 28.6%, p<0.01, respectively).
Conclusion:
Pre-toilet trained infants with f-UTI were associated with elevated PVR and lower voiding efficiency than normal controls.
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