反覆泌尿道感染於無尿路異常的兒童─奇美醫院治療經驗
郭名捷、蘇家震、沈坤宏
奇美醫學中心 外科部 泌尿外科
Experience in treatment of recurrent urinary tract infection
in children without specific anatomical or functional abnormality
Ming-Chieh Kuo, Chia-Cheng Su, Kun-Hung Shen
Division of Urology, Department of Surgery
Chi Mei Medical Center, Tainan, Taiwan
Background: According to previous literature, prevalence of urinary tract infection (UTI) in children with fever was about 7%. Furthermore, approximately 8~30% of children with UTI experience one or more symptomatic reinfections. Recurrent UTI in children may resulted from anatomical or functional abnormality in urinary tract. Congenital causes such as ureteropelvic junction (UPJ) obstruction or ureteroceles, vesicoureteral reflux (VUR), and neuropathic bladder gain much attention as we faced with a child with recurrent UTI. However, still some children without anatomical or functional abnormality experienced recurrent UTI, who were treated simply by antibiotics once infection relapsed
Materials and Methods: We collected 3 children with recurrent UTI, in whom no specific anatomical or functional abnormality was found, simply treated by behavioral education and symptomatic medication, and see if any risk factor were related with these population and the over prognosis
Conclusion: Bowel and bladder dysfunction, a frequently over-looked diagnosis of exclusion, plays an import rule in these children.As antibiotics treatment once infection relapsedmay lead to increased resistant rate to common antibiotics, simply behavioral education and symptomatic medicationmay decrease the recurrence rate.