Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
There are several suggestions that have been made by pediatric urologists to
lessen the likelihood of children developing urinary tract infections. These
Hygiene: Wipe females from front to back during diaper changes or after
using the toilet in older girls. With uncircumcised males, mild and gentle traction
of the foreskin helps to expose the urethral opening. Most boys are able to
fully retract the foreskin by 4 years of age.
emptying: Some toilet-trained children are in hurry to leave the bathroom.
Encourage "double voiding" (urinating immediately after finishing the first
void). Children should be encouraged to urinate approximately every two to three
hours. Some children ignore the sensation of a full bladder in the desire to
continue to play.
Avoid the "4 C's": carbonated drinks, high amounts of
citrus, caffeine (sodas), and chocolate. Some kidney specialists are not as
adamant about this option.
Avoid bubble baths: Some renal specialists also
view this recommendation with skepticism.
Encourage cranberry juice: Similar
to the above "4 C's," some specialists view this suggestion as folklore.
Prophylactic antibiotics: Daily low-dose antibiotics under a doctor's
supervision may be used in children with recurrent UTIs or in those with anatomic
or physiologic factors that predispose to UTIs.
Childhood urinary tract infections are fairly
common and are generally caused by bacteria. Routine antibiotic therapy is
successful in resolving these infections.
Recurrent UTIs in children may be
indicative of malformation or malfunction of the urinary tract.
symptoms and signs of UTIs in children include pain and urgency with urination,
blood in the urine, abdominal/pelvic pain, fever, flank pain, and vomiting.
Some selected children who experience a UTI should have diagnostic studies
performed. These children include children less than 2 years of age, any male
child, any child who has had more than one UTI or any child who has had
Several recommendations exist to help lessen the likelihood
of a child developing a UTI.
American Academy of Pediatrics. "The Diagnosis, Treatment and
Evaluation of the Initial Urinary Tract Infection in Febrile Infants and Young
Children." Pediatrics 103.4 Apr. 1999: 843-852.
Elder, Jack S. "Urinary Tract Infections." Nelson Textbook of Pediatrics. 18th ed. Philadelphia: Saunders, 2007.