Evaluation of Toilet Habits in Children with Recurrent Urinary Tract Infections and Investigation of Risk Factors That Play a Role in The Development of Kidney Damage

Abstract

Objective: Urinary tract infection is one of the common infections in children. The patients with recurrent infection are at risk for permanent renal damage in later life. In this study, it was aimed to investigate the toilet habits and risk factors for renal scarring in children with recurrent urinary tract infection without congenital anomalies of the kidney and urinary tract.Materials and Methods: Patients between the ages of 6 and 18 with a diagnosis of recurrent urinary tract infection who were toilet trained were included in this study. Data of patients with congenital anomalies of kidney and urinary tract were excluded from the study. The detailed information on the voiding postponement, infrequent voiding, holding maneuvers and renal scarring were obtained from file records.Results: The 208 patients (146 girls, 62 boys) were included in this study. The more than half of the patients (n=132, 63.5%) had a habit voiding postponement, and one third (n=65, 31.3%) had holding maneuver. There was infrequent voiding in 47 (22.6%) patients. Renal scarring was determined in 38 (18.3%) patients. The frequencies of voiding postponement, holding maneuver and infrequent voiding were higher in patients with renal scarring than those of without [30 (78.9%)/102 (60%), p=0.048; 12 (31.6%)/53 (21.2%), p=0.039; 15 (39.5%)/32 (18.8%), p=0.009, respectively]. It was determined a significant positive association between renal scarring and voiding postponement with infrequent voiding [Odds ratio=3.21, p=0.011; Odds ratio=1.46, p=0.021; Odds ratio=3.43, p=0.001, respectively]. Conclusion: Toilets habits should be questioned in routine follow-up program in children with recurrent urinary tract infection. The development of true toilet habits may be useful to prevent the development of renal scarring in children.