Today Health Direction

UTI in 3.5 year old boy

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

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 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!

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